ASRM Washington Wire

Federal Budget for Fiscal Year 2008
The House Labor-HHS-Education Appropriations Subcommittee, which sets spending levels for the federal health programs, including the National Institutes of Health (NIH), has completed its work on its FY 2008 spending bill. The subcommittee was working with an allocation of $151.1 billion, an increase of $6.6 billion (4.6%) over the current year's funding level.

For the National Institutes of Health, the bill provides $29.650 billion, an increase of $750 million (2.6%) above the current year's funding level and $1.029 billion (3.6%) above the President's request. However, the bill also increases the amount of the transfer from NIH to the Global HIV/AIDS fund from the $99 million in FY 2007 to $300 million in FY 2008, which means the net increase in the NIH budget is $549 million (1.9%) over FY 2007.

For the Centers for Disease Control and Prevention (CDC), the bill provides a program level of $6.449 billion, an increase of $183 million (2.9%) over FY 2007. The bill provides $329.6 million for the Agency for Healthcare Research and Quality (AHRQ), which is a $10.6 million (3.3%) increase above FY 2007. There is $30 million allocated for clinical effectiveness research, a $15 million increase above last year, while patient safety research is cut by $5 million to $79 million for FY 2008. All of the AHRQ funding is a direct appropriation, rather than transfers from other agencies, which is how the agency was funded in FY 2007 and in the President's proposed FY 2008 budget.

It is expected that both the House and Senate will complete their work on this and other domestic funding bills by midsummer. Unfortunately, this bill is among those facing a veto threat from the White House because it exceeds the funding levels requested by the President.

ASRM is continuing to work with the American Medical Association (AMA) and other groups in organized medicine to attempt to fend off pending cuts in Medicare reimbursements. Without Congressional action, there will be a 10% cut in physician payments for FY 2008. There are a number of bills that have been introduced designed to block the cuts, unfortunately none have really gained momentum yet.

Stem Cells
In June, the House passed S. 5, the Stem Cell Research Enhancement Act, and sent it to the President. Unfortunately, the President vetoed the bill and while action had not yet been taken at press time, it is thought unlikely that the Congress has the votes to override the veto.

The bill would have lifted the President’s restrictions on embryonic stem cell research and allowed federally funded scientists to work with stem cell lines created from IVF created embryos which were beyond the clinical needs of the patients.

Senate Moves to Increase Post-market Protections from FDA
The Senate has passed a bill that would offer some “reforms” at FDA. These are primarily designed to improve drug safety and increase the ability of FDA to require more postapproval surveillance and when the data indicates, issue stronger warnings. Some of the stronger provisions of the bill were removed prior to final passage in the Senate; however it appears many of them may reappear as the House begins its consideration of the measure. For example, the bill may require the FDA to prepare risk-management plans for every drug it approves. The agency would also require companies to place an identifying mark on labels to alert consumers to which drugs are newly
approved. Another proposal would give the FDA the power to ban companies from advertising some new drugs to consumers for up to three years.

The Senate bill also incorporated some elements of a bill from Senator Barack Obama (D- IL) on genetic testing. Specifically, the legislation currently calls on the Institute of Medicine (IOM) to do a study on the safety and oversight of genetic tests, presumably including testing done during preimplantation genetic diagnosis.

Prevention First
ASRM continues to work with a variety of groups concerned with women’s and reproductive health to advance what is being termed the “Prevention First” agenda.

The bill would increase funding for family planning clinics, expand Medicaid and private health insurance coverage of contraceptives, require hospitals to make emergency contraception available to rape victims, and allocate money for comprehensive sex education programs that teach youths about birth control as well as abstinence.

In addition, a separate bill, the Access to Birth Control Act, has been introduced and seeks to ensure that women can access contraceptives at pharmacies regardless of whether any employee they encounter has moral objections.

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