Congress Proposes Huge Spending Cut for Health Programs in FY 2014
House Republican leaders are calling for continued deep cuts in federal spending that will have an impact on the budget of the National Institutes of Health (NIH) in fiscal year (FY) 2014.
In May, the Labor, Health and Human Services, Education, and Related Agencies Subcommittee, which establishes annual funding levels for federal public health programs (including NIH), received from House Appropriations Committee Chairman Hal Rogers (R-KY) allocation recommendations to be used in formulating its FY2014 budget. If the House recommendations are followed, spending on programs under the Subcommittee’s umbrella would be cut by 18.6 percent below the final FY 2013 sequester level and 22.2 percent below the FY 2013 pre-sequester funding level. Such an austere budget would virtually assure a spending cut for NIH in FY 2014 that would come on top of the cuts already in place as a result of sequestration.
At the time this issue of The Hematologist went to press, the Senate Appropriations Committee had not released its budgetary recommendations; however, major differences between the recommendations of the two chambers are anticipated. At issue is the lingering dispute between the House and Senate over the total spending level for FY 2014. Chairman Rogers is following the House budget plan that established the FY 2014 discretionary spending level at $966 billion and shifted allocations such that non-defense discretionary accounts will absorb all of the spending cuts mandated by the second year of sequestration. In contrast, Senate Appropriations Committee Chair Barbara Mikulski (D-MD) has indicated that she is committed to writing spending bills that total $1.058 trillion, the amount both agreed to in the Budget Control Act and requested by President Barack Obama in his FY 2014 budget proposal. As a result of this nearly $90 billion difference, the House and Senate bills are certain to be widely divergent, making finalizing a funding bill challenging, if not impossible, unless a compromise agreement can be brokered later in the fall.
Both the House and Senate Appropriations Committees intend to consider the majority of the spending bills by August 2, the date on which Congress adjourns for a month-long recess.
What’s the takeaway?
As Congress continues to formulate the FY 2014 budget, the Society encourages all ASH members to visit the ASH Advocacy Center and take action in support of funding for NIH in FY 2014. Senators and representatives need to hear from their constituents about the negative impact that cuts in funding have had (and will continue to have) on hematology research. Find the latest information about the FY 2014 budget and its potential impact on NIH.
Congress Working on Legislation to Reform Physician Payment; ASH Advocates for a Minimum of Five Years of Congressionally Mandated Stable Payment
Republicans in the House of Representatives recently released a detailed version of their proposal for repealing the Sustainable Growth Rate (SGR) formula and plan to move forward with a vote this summer. ASH submitted comments in response to the proposal indicating the Society’s support for repealing the SGR and replacing the current payment formula with predictable payment rates for at least five years while stakeholders develop a new system that combines a base payment rate with a variable rate tied to performance parameters.
The Senate Finance Committee has also sought input from ASH and other health-care providers and groups on how to reform Medicare physician payment, and there appears to be room for optimism. Unlike previous years when only short-term patches were passed, policy analysts expect that legislation to reform Medicare payment is likely to be completed this year. Two factors have influenced this position shift: the cost estimate for repealing the SGR has been reduced significantly, and Members of Congress have finally come to understand that the current system, which has scheduled significant payment cuts each year, is not sustainable.
What’s the takeaway?
Members of the ASH Committee on Practice met with congressional offices in April to advocate for appropriate and stable Medicare physician reimbursement. ASH clinicians are strongly encouraged to join the Society’s online advocacy campaign urging Congress to repeal the current payment formula and provide appropriate Medicare reimbursement to physicians.
Oral Cancer Drug Parity Legislation Introduced in Congress; ASH Advocates for Patients to Have Equal Access to Treatment
Representative Brian Higgins (D-NY) and Peter King (R-NY) have introduced bipartisan legislation, the Cancer Drug Coverage Parity Act (H.R. 1801), in the U.S. House of Representatives that would ensure that patients enrolled in certain federally regulated health plans have access and insurance coverage for all anti-cancer regimens. The bill would require any health plan that provides coverage for cancer chemotherapy treatment to establish a reimbursement rate for orally administered and self-injectable medications that is no less favorable than that used for payment of port-administered or injected drugs.
Rep. Higgins introduced similar legislation in the 112th Congress, but the bill was not considered in committee or by the full House. Senator Al Franken (D-MN) has expressed an interest in introducing a bipartisan companion bill to the Cancer Coverage Parity Act in the Senate. A number of states have already passed payment parity bills or are currently reviewing related legislation.
What’s the takeaway?
While legislation will not solve the problem of the high cost of drugs, it does seek to lift the economic burden from patients. ASH supports this legislation and encourages members to join ASH’s advocacy campaign urging Congress to support oral cancer drug payment parity.
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