Senate, House Committees Hear Governors Talk Medicaid
On June 15, the Senate Finance Committee and House Energy & Commerce (E&C)
Health Subcommittee heard testimony on behalf of the National Governors Association
(NGA), regarding NGA’s position on Medicaid reform. Governors Mark Warner
(D-VA) and Mike Huckabee (R-AR) testified for NGA. While the E&C hearing
featured only the governors, the Finance Committee also took testimony from
Alan Weil of the National Academy for State Health Policy, Jeanne Lambrew of
the Center for American Progress, and Stuart Butler of the Heritage Foundation.
NGA presented what the organization describes as a bipartisan
consensus of all 50 governors that Medicaid reform is essential and that reforms
need to
address specific aspects of the program. Warner emphasized that although every
governor has signed on to the principles, what was being presented is the “beginning
of the process,” not a finished product. He noted that Medicaid in its
current form can’t be sustained by States over the long term. He said
reform should be driven by policy, not budget, and stated NGA opposes
block grants or caps. Huckabee agreed, saying States want to test their ideas
in order to serve people better, not to save money.
Among the identified issues were prescription drug payment reforms. The testimony
emphasized the need for more drug pricing transparency, the difficulty for
States to get the best price, and that the AWP-based system is convoluted and
should be changed. According to the testimony, governors want tools to organize
their Medicaid prescription drug programs in the best interest of their residents.
In addition, the governors identified other needed reforms, including closing
asset loopholes, modifying cost-sharing rules, increasing benefit package flexibility,
reforming waiver rules, and judicial reforms that would allow States to make
decisions and changes regarding optional coverage and not be sued in federal
court.
Sen. Ron Wyden (D-OR) asked the governors whether they would support his bill
(S.1128, with Sen. John Sununu (R-NH)) to increase Medicaid rebates for drugs
with DTC advertising. “At first blush,” responded Warner, it makes
sense.” He added the caveat that one would need to have accurate numbers
regarding advertising spending vs. R&D spending. Huckabee, without indicating
support for the Wyden bill, emphasized the importance of reducing prescription
drug spending under Medicaid. He said in his State, the Medicaid program pays
more than twice what Blue Cross pays for the same drug.
At the E&C hearing, Committee Chair Rep. Joe Barton (R-TX), asked if NGA
supports federal Medicaid reform legislation this year. The governors responded
affirmatively. Barton stated his intention to “report a bipartisan Medicaid
reconciliation package this year.”
The E&C hearing hilighted Democratic Members’ concerns
about the impact the governors’ proposal could
have on Medicaid beneficiaries. In particular, they questioned proposals to
alter
cost-sharing,
stating such proposals would adversely affect the poor. Rep. John Dingell (D-MI)
questioned Warner about whether NGA, in developing its proposals, had consulted
with the affected populations of beneficiaries; Warner stated the proposals
were developed by governors and State Medicaid directors.
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Stem Cell Debate Headed for Senate
The Senate is expected to take up the stem cell issue in July, while the President
has continued to threaten to veto the bill – which would be the first
legislative veto of his Presidency. The House did not pass the bill by a veto-proof
margin, and it is unlikely the Senate will have a 2/3 majority.
Continuing to work the debate from behind the scenes, former First Lady Nancy
Reagan is expected to contact lawmakers who remain on the fence. Last month,
Reagan made numerous phone calls to Republican members. While it is unclear
how many votes she affected, reports say that Members took her calls.
Yesterday, the House Appropriations Committee approved the FY2006 Labor-HHS-Education
Appropriations bill, the funding bill for the National Institutes of Health
(NIH) and other agencies for Fiscal Year 2006.
During the Committee markup, Rep. David Weldon (R-FL) offered an amendment
to the bill which would have prevented NIH funding to any entity involved with
somatic cell nuclear transfer. Appropriations Committee Chair Jerry Lewis (R-CA)
and Labor-HHS-Education Subcommittee Chair Ralph Regula (R-OH) helped defeat
the amendment by 36-29.
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Senate Agrees to 8-Billion-Gallon RFS;
Extends Ethanol, Biodiesel Tax Incentive Program
As debate begins in the full Senate over the future of omnibus energy
legislation, one of the first amendments accepted would increase the
Renewable Fuel Standard (RFS) mandate on ethanol and biodiesel blending
to 8 billion gallons, 3 billion more than approved by the House. The
Senate easily overcame northeastern and western opposition to the increase.
Just as floor action began, the Senate Finance Committee
completed markup of an $18-billion package of tax incentives to be
included in
the full bill. As part of this deliberation, the committee approved
an extension from December 31, 2006, until December 31, 2010, of a
program under which tax incentives are provided to refiners for use
of ethanol
and biodiesel. For so-called agrobiodiesel – vegetable and first-use
animal fats – the tax incentive is $1 per gallon; for “biodiesel” – recycled
fats and oils – the tax incentive rate is 50 cents per gallon.
New England and California Senators object to the 8-billion-gallon
RFS level, saying it will increase gasoline prices over time based
on estimates in an EPA study. They further argue it is unfair to states,
like theirs, where ethanol is less plentiful. Insiders say the compromise
between the House and Senate levels will be somewhere between 6 and
7 billion gallons.
The RFS requires diesel and gasoline refiners to begin blending ethanol
and biodiesel into their mixtures beginning in 2006, hitting 8 billion
gallons by 2012. Current production of ethanol is about 4 billion gallons
a year; for biodiesel, production is significantly less.
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USDA to Retest November, 2004, Suspect
BSE Cow; Japan Says Retest Will Not Affect Progress on Resuming Trade
USDA announced June 9 it would retest brain tissue
samples from a suspect BSE animal originally tested in November 2004.
The retest
was ordered by the department’s Inspector General, who has
been monitoring USDA’s overall BSE prevention, surveillance and
mitigation program.
However, the decision to retest the sample will have no effect on
the progress made between the U.S. and Japan, officials of both countries
said this week.
The November 2004 animal is known to be born before
the 1997 feed ban. It was originally tested twice at the USDA facility
in Ames, Iowa,
using the immunohistochemistry (IHC) testing method, following an inconclusive
test result on a rapid test done at the rendering facility. The final
result of the Ames testing was that the animal was negative for BSE.
However, the Inspector General told USDA’s APHIS
to retest the animal following a storm of criticism over the department’s
handling of the testing. USDA this week hand-carried tissue samples
to the World
Animal Health Organization (OIE) testing facility in Weybridge, England,
after USDA decided on which testing protocol Weybridge will use. Weybridge
will use the Western Blot test, a more sensitive methodology traditionally
used on low-quality or degraded tissue samples. At the same time, remaining
tissue samples will be retested by USDA at the Ames laboratory. The
testing should take about two weeks, USDA officials said.
The Japanese Minister of Agriculture joined Secretary of Agriculture
Mike Johanns in reiterating the retesting – should it result
in a positive case of BSE – is of little concern to the Japanese
because the animal is older than 20 months. In 2003, Japan imported
$1.3 billion worth of U.S. beef and beef products, or 36% of the total
U.S. exports that year.
Meanwhile, South Korea and Taiwan said they were disturbed
by the retesting. Taiwan, which recently resumed importing U.S. beef,
said
it would halt imports if the tests come back positive. Following discovery
of a BSE-positive Canadian cow in Washington State in December 2003,
53 countries cut off all imports of U.S. beef.
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Senate Finance Gives Green Light to CAFTA Vote;
Sugar May Win Protections in Battle for Passage
The Senate Finance Committee gave an informal green light to full
Senate floor consideration this week when its “mock markup” approved
the controversial treaty. At the same time, the White House has signaled
the sugar industry it’s willing to talk sugar protections.
Sen. Byron Dorgan (D-ND) called the Finance Committee action “political
theater” and the 11-9 vote in favor of the treaty less than a
ringing endorsement. “Today’s action won’t change
a trade agreement that is fundamentally flawed and threatens our domestic
sugar industry,” Dorgan said.
Agriculture Secretary Mike Johanns sent a letter this
week to Sen. Craig Thomas (R-WY) saying the Administration is open
to discussing
solutions that might afford greater protections for U.S. sugar interests
and mitigate that industry’s opposition to CAFTA. The letter
tipped Thomas’ vote in the Finance Committee in favor of the
trade pact.
Johanns said he was willing to talk about any reasonable proposal,
but stopped short of defining what that might be. U.S. Special Trade
Representative Rob Portman said excluding sugar from any future trade
pact was not on the table.
Earlier this week, six senior GOP Senators met with sugar interests
in hopes of identifying a compromise that will allow sugar to drop
its opposition to the treaty.
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USDA Announces First Farm Bill Forum, Sets Topics
The first of USDA’s announced 2006 Farm Bill
Forums will be held July 7, in Nashville, TN, at the studios of RFD-TV,
from which
it will be broadcast from 6-9 p.m. The public is invited. Details can
be found at www.usda.gov/farmbill.
Secretary of Agriculture Mike Johanns jumped both House and Senate
Agriculture Committees when he announced last month his department
would hold the series of listening sessions across the country. Following
his announcement, the Senate Agriculture Committee announced it will
hold late summer hearings. It is understood the subcommittees of House
Agriculture will begin their hearings late this summer or early fall,
as well.
Johanns says he is open-minded on farm policy changes, and has pledged
to have senior department officials with him at the sessions. Topics
to be covered at the sessions include commodity programs, conservation,
rural economic development, food assistance, research and education.
However, not all topics will be covered at all sessions, he said.
The public is invited to provide comments on six specific questions
based on these policy considerations:
1. How should farm policy be designed to maximize U.S. competitiveness
and our country's ability to effectively compete in global markets?
2. How should farm policy address any unintended consequences and ensure
that such consequences do not discourage new farmers and the next generation
of farmers from entering production agriculture?
3. How should farm policy be designed to effectively and fairly distribute
assistance to producers?
4. How can farm policy best achieve conservation and environmental
goals?
5. How can Federal rural and farm programs provide effective assistance
in rural areas?
6. How should agricultural product development, marketing and research-related
issues be addressed in the next farm bill?
Notice of these questions was published in the June
17 Federal Register. Comments will be accepted at public forums and
may also be submitted
electronically at the USDA home page (http://www.usda.gov/)
by selecting "Farm
Bill Forums," by email to FarmBill@usda.gov or by mail to:
Secretary of Agriculture Mike Johanns
Farm Bill
1400 Independence Avenue, SW
Washington, DC 20250-3355.
USDA will review the public comments received by December 30, 2005,
including any analyses, reports, studies and other material submitted
with the comments that address the six questions.
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New Bills
A number of new bills have been introduced. Click
here to send a request for a copy of the text or more information about
the bill.
S.RES.169
Sen. Rick Santorum (R-PA) offered a resolution expressing the sense
of the Senate with respect to free trade negotiations that could
adversely affect consumers of sugar in the United States as well
as United States agriculture and the broader economy of the United
States.
S.1227
Sens. Debbie Stabenow (D-MI) and Olympia Snowe (R-ME) introduced a
bill that would establish a program to award grants to eligible entities
for the purpose of off-setting the costs related to clinical health
care informatics systems and services designed to improve quality
in health care and patient safety.
S.1262
Sens. Bill Frist (R-TN) and Hillary Clinton (D-NY) offered the “Health
Technology to Enhance Quality Act of 2005.”
H.R.2956
A bill introduced by Rep. Bart Stupak (D-MI) would establish certain
restrictions on drugs containing isotretinoin (including the drug marketed
as Accutane).
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