Congressional Calendar

The 111th Congress officially convened on Jan. 6. Unlike previous presidential inaugural years, Congress is working hard to have legislation ready for the new president's signature when he officially takes office on Jan. 20. Congress will remain in session until the President's Day recess that begins Feb. 13 and ends Feb. 23.

Presidential/Congressional Transition

HHS Secretary Nominee Daschle Receives Praise from Both Parties During Senate Nomination Hearing
As expected, Tom Daschle, President-elect Obama's nominee for secretary of the Department of Health and Human Services (HHS) and former Senate majority leader, was warmly received at the first of two scheduled Senate hearings on his nomination. The Jan. 8 hearing was held by the Health, Education, Labor and Pensions (HELP) Committee. The Senate Finance Committee, which has the authority to vote up or down on the nomination of the HHS secretary, has yet to announce the date for its hearing on the Daschle nomination.

Though the HELP committee does not have the authority to approve or disapprove the Daschle nomination, the committee has oversight over most health-related federal programs, with the exception of Medicare and Medicaid, and will play a key role in the development of national health care reform legislation. Among the agencies under the committee's purview are the National Institutes of Health (NIH), the Centers for Disease Control and Prevention, the Food and Drug Administration, and the Health Resources and Services Administration. These agencies administer health professionals training, clinical research, drug rebates and discounts including the 340B Drug Discount program, and preventive health programs, among others.

Daschle emphasized in his testimony that the incoming administration's work on health care reform will be bipartisan in nature. Daschle also asserted that he would prefer to move health care reform legislation through Congress under normal procedures that require committee hearings and a minimum of 60 votes to end floor debate and move a bill to a final vote. Alternatively, some have proposed using budget reconciliation rules to pass health care reform, which would bypass many of the Senate parliamentary rules and would end debate (or a filibuster) on a bill with a simple majority vote. Daschle's preference reflects his commitment to building broad consensus on the reform legislation that ultimately is debated by Congress.

Daschle also testified that he will focus on making prevention a priority, strengthen the NIH, and push the Centers for Medicare and Medicaid Services to play a larger role in promoting higher quality and greater efficiency in health care.

House Passes Rules Change Limiting Republican Voice
Emboldened by a larger majority and a Democrat in the White House, House Democrats approved new procedural rules that will prevent the Republican minority from using certain maneuvers that, in the last Congress, resulted in the demise of some contentious bills. The new rules will prevent the minority from adding unrelated provisions to a bill and forcing the bill back to committee, delaying its passage. For example, during the 110th Congress, the FY 2009 Labor, Health and Human Services Appropriations Bill was a victim of a Republican "motion to recommit." The new rules still allow the minority to amend a bill within certain time constraints.

FY 2010 Budget

Appropriators Announce New Requirements for Earmark Transparency; Total Earmark Funding Cut in FY 2010 Budget
House and Senate appropriators have come to agreement on new requirements for earmarks in the FY 2010 budget cycle. Sen. Daniel Inouye (D-HI), chair of the Senate Appropriations Committee, and his House counterpart, Rep. David Obey (D-WI), recently announced that any member who requests an earmark in the FY 2010 appropriations bills will be required to post information about that earmark on their Web site. That information must include the purpose and rationale for the earmark. In addition, a complete list of earmarks will be provided to appropriations subcommittees at their markups. In the past, lists of earmarks were revealed at the full committee markup, which reduced the level of public scrutiny of the special funding requests and limited the ability of members to review, and possibly question, a particular request. The appropriations chairs also announced that the total amount of funds available for earmarks in the FY 2010 spending bills will be one-half the amount provided in FY 2006.

Medicaid and SCHIP

House Passes SCHIP Reauthorization Bill

This afternoon, with the support of N.A.C.H. and children's hospitals from across the country, the House passed H.R. 2, The Children's Health Insurance Program Reauthorization Act of 2009. The final vote was 289-139. 249 Democrats and 40 Republicans supported the bill, while two Democrats and 137 Republicans voted against it. The bill extends funding for SCHIP for four and a half years, and will provide health care coverage to approximately 4 million currently uninsured children. The legislation also includes provisions, championed by N.A.C.H., which provide a badly needed investment in the development of pediatric health care quality measures. Finally, the bill ends the current five year waiting period for legal immigrant children to access Medicaid and SCHIP.

Senate Action Expected Soon

The Senate Finance Committee is considering similar companion legislation tomorrow morning. Senate leaders hope to have that bill ready for floor action next week. The Senate legislation is very similar to what was passed in the House. A notable difference is that the Senate bill does not include language that would end the five year waiting period for legal immigrant children to access Medicaid and SCHIP.

Questions Remain, Concerns Raised About Provisions of Economic Stimulus Package
President-elect Obama has stepped up the pressure on Congress to enact his economic stimulus package, but he faces increasing questions about its specifics. With new reports of growing unemployment numbers, members of Congress are in general agreement with Obama that a stimulus package is urgently needed and that his general framework is workable. That framework includes a temporary increase in the federal Medicaid matching rate for states (FMAP), an infusion of funds to encourage the adoption of health information technologies (health IT), investment in medical and biomedical research, and an extension and expansion of COBRA benefits to maintain health care coverage for the long-term unemployed. However, some Democrats, as well as Republicans, are not in agreement about the funding streams to the states and new program innovations, with some calling for the establishment of specific criteria to target the funds. Others in Congress would like to make additional investments and still others are concerned about the price tag of the overall package. In response to the growing noise on the Hill, Obama has said that he will consult with Democratic leaders to improve the package.

Meanwhile, House and Senate leaders have laid out a tentative schedule for consideration of the economic stimulus legislation. House Majority Leader Steny Hoyer (D-MD) announced that committee hearings and markups will take place in the next few weeks. Speaker Nancy Pelosi (D-CA) has publicly stated that she will keep House members in Washington until a bill is passed, even if they must stay in session during the scheduled President's Day recess that begins Feb. 13. In the Senate, Finance Committee Chair Max Baucus (D-MT) anticipates committee markups the week following the presidential inauguration.