On Monday President Trump nominated Brett Kavanaugh to fill the vacancy left by retiring Justice Anthony Kennedy on the Supreme Court. Judge Kavanaugh is a conservative judge from the US Court of Appeals for the DC Circuit. He is a connected Washington insider with roots in the George W. Bush White House and played a role in the investigation and impeachment of President Bill Clinton. Judge Kavanaugh could play a pivotal role in deciding future cases related to abortion, the continuation of the Affordable Care Act, and other health care issues. The US Senate already has focused much of its attention on reviewing the nominee and preparing for the confirmation hearings.
On Wednesday after a marathon mark-up that lasted over 12 hours, the House Appropriations Committee approved its FY 2019 Labor-HHS-Education bill. The bill provides $38.3 billion for the National Institutes of Health (NIH) (a $1.25 billion or 3.4 increase over FY 2018), the same level approved by the subcommittee earlier in June. The Senate Appropriations Committee already approved its version of the bill on June 28. The Senate version included a $2 billion increase for NIH.
Appropriations Insider Baseball
The big question is whether House leaders will bring the bill to the floor for a vote. Last year, the version that advanced from committee passed on the House floor when packaged with several other appropriations measures. Senate appropriators want to combine a Labor-HHS-Education bill with the Defense spending measure. The House already passed its Defense appropriations bill. However, if the Senate passes a combined bill and sends it to the House, the House might skip a floor vote on the Labor-HHS-Education measure and head straight to conference. However, another alternative is that the House cannot find a way to bring this bill for a vote, opts to have a Continuing Resolution, which would mean flat funding for NIH, and, even worse, President Trump could still refuse to sign unless he deducts money to use to pay for his border wall. In other words, the appropriations battle is far from over and it could get really ugly….
What We Are Working On:
We gave support to new legislation introduced by Senator Cory Booker (D-NJ) and Representative Rosa DeLauro(D-CT) to increase insurance coverage for infertility services. The Access to Infertility Treatment & Care Act will require that health plans offered on the group and individual markets, in addition to the Federal Employees Health Benefits Program, TRICARE, and the VA provide coverage for treatment of infertility and also cover fertility preservation services for individuals who undergo medically necessary procedures that may cause infertility.
We are currently working on comments to proposed regulations that could limit women”s access to care (see summary of proposed rule). Draft comments will be sent to APOCC for review.
Transgender health care
We are planning a briefing for July 30 to educate congressional offices about the research and access to care issues related to transgender health care. This will be a great event with exceptional speakers.
We continue to participate in amicus curiae briefs to educate courts on transgender health issues. Most recently we joined with the American Medical Association, American College of Physicians, and eight other leading health care organizations in a brief related to an appeals case involving the Trump Administration policy to exclude transgender individuals from military service. Our brief focused on what it means to be transgender, diagnostic criteria, and accepted treatment protocols for gender dysphoria.
We continue to advocate for increased NIH funding and encourage all US Society members to join our online campaign. We are preparing for a congressional battle as we get closer to September 30 (the end of the current fiscal year). We are bringing several Society members who are from key appropriator states to Washington in September to participate in the research community’s Rally for Medical Research.
We are planning several advocacy events during the first week of October when we will receive the American Society of Association Executives’ (ASAE) Summit Award for our work on hurricane relief. This will include a clinician Hill Day and congressional briefing on October 1, Endocrine Society leadership Hill visits on October 2-3, and a congressional reception to present our Diabetes Champion Awards to the House and Senate co-chairs of the Congressional Diabetes Caucus.
Today, CMS published the proposed Physician Fee Schedule Rule for 2019. It includes provisions for the Quality Payment Program (QPP) for 2019 as well as the physician fee schedule. GPA is reading the 1,473-page proposed rule and will provide a summary in the near future. We will work with CACC and APOCC to develop our comments on the rule. Comments are due to CMS on September 10, 2018.