CQ’s Carey Looks at Health Legislation in 2002

Bills That Became Law

• Anti-Bioterrorism: The bill (S 1715) authorizes funds to increase the U.S. medicine and vaccine stockpile, expands CDC facilities and labs and offers grants to train state and local governments and health facilities to respond to possible bioterrorist attacks. The bill also reauthorizes drug company user fees to help the FDA review and approve new drugs. While Carey says some critics claim more money is needed to fight bioterrorism, she adds that the measure passed "with widespread support" because it was aimed as a response to the Sept. 11 attacks.
  

• Medical Devices: The bill (HR 3580) allows medical device manufacturers to pay user fees that allow the FDA to hire new regulators to speed up the device approval process.
  

• Community Health Centers: The measure (S 1533) reauthorizes funding for community health centers and telehealth and rural health programs.
  

• Mental Health Parity: Congress extended for one year the 1996 mental health parity law, which mandated that health plans that cover mental illnesses could not establish different annual and lifetime benefits for those illnesses than for physical illnesses (Carey, "Congressional Quarterly Year in Review," 12/16). Congress failed to pass a bill that would have closed a loophole in the bill by forbidding health plans to establish higher deductibles or copayments for mental health benefits than for other medical conditions (Kaiser Daily Health Policy Report, 11/22).
  

Bills That Did Not Become Law

• Medicare Drug Benefit: The House passed a GOP-sponsored prescription drug benefit bill this summer, but the Senate failed four times to pass Democrat-backed legislation (Kaiser Daily Health Policy Report, 12/11). According to Carey, politics "played a huge role" in the bills' failure, as did the cost and structure of the proposals.
  

• Medicare Provider 'Giveback': Carey says that lawmakers could not agree on the size of a bill boosting reimbursements to Medicare providers, adding that some members disagreed with proposals to raise pay for physicians but not for other providers. In addition, Carey states, some members did not want to raise Medicare reimbursements without also providing drug coverage under the program.
  

• Patients' Bill of Rights: The House and Senate in 2001 passed separate patients' rights bills, but the chambers did not convene a conference committee, and the bills died. The differences between the bills centered around liability, with Democrats favoring a broader right for patients to sue insurers. Carey adds that differences over liability also helped defeat in the Democrat-led Senate a House bill that would have capped punitive damages and attorneys' fees in medical malpractice lawsuits.
  

• Aid for State Medicaid Programs: Despite requests from governors, Congress did not pass legislation giving states money to help them address rising Medicaid costs. Carey says that given the federal deficit, the cost of the measure was deemed too great.
  

• International HIV/AIDS: While the Senate and House both passed bills increasing U.S. support for overseas HIV/AIDS programs, the Senate bill was more expensive than the House version, and members could not reconcile the two.
  

• Human Cloning: The House passed a broad cloning ban in 2001, and the Senate in 2002 considered three bills, none of which gained enough support to end a filibuster.
  

• Generic Drug Access: The Senate in July passed legislation to increase access to generic drugs by making it more difficult for brand-name drug makers to extend their patent protection, but the House did not address the bill. According to Carey, election-year political considerations kept the bill from being passed.
  

• The Uninsured: While Congress did pass a bill granting temporary health insurance coverage to U.S. workers displaced by international trade, members did not address broader efforts to reduce the number of uninsured. Carey says that "[p]art of the problem was funding," as most of the money set aside for health initiatives was dedicated to the Medicare prescription drug benefit. In addition, she states, Democrats favor expanding public health programs to aid the uninsured, while Republicans prefer using tax credits ("Congressional Quarterly Year in Review," 12/16).