Government Update from ENA
December 15, 2018
ENA Government Relations
Senate Advances Pediatric Emergency Program, Ready for House
On December 11, the Senate passed the Emergency Medical Services for Children Program Reauthorization Act of 2018 (S. 3482) by unanimous consent, an expedited senate method for quickly considering noncontroversial legislation. The bill continues the successful Emergency Medical Services for Children (EMSC) program at the Department of Health and Human Services. The program has provided critical funding to all fifty states and territories to improve capacity to respond to all manners of pediatric emergencies. Enacted in 1984, the program celebrates its 35th year in 2019.
Although the program doesn't expire until next year, Congressional leaders saw cause to move the reauthorization forward before the end of the current session. Sen. Orrin Hatch (R-UT) is retiring at the end of the 115th Congress and passing the bill would be a nice send-off. Sen. Hatch was one of three senators, who sponsored the original legislation that created the program in 1984 and has championed the program for more than three decades. The bill is now ready for consideration in the House of Representatives, and leaders there have indicated they intend to take up the bill this month.
Congress, President Trump Avoid Government Shutdown - For Now
The state funeral for President George Herbert Walker Bush forced Congress to pass another short-term spending bill, keeping the federal government operating now through Dec. 21. Whether the extension averts a government shutdown remains to be seen. While Congress has passed six of twelve of the spending measures needed to fund the government in 2019, funding for the Departments of Commerce, Justice, Homeland Security, Interior, State, Transportation, and Housing and Urban Development, as well as several smaller agencies, remain up in the air.
President Trump is threatening to let the government shut down Friday at midnight if Congress fails to appropriate $5 billion for a wall along the nation's southern border. Congressional Democrats have offered $1.6 billion for border security, which does not necessarily mean funding for the wall. House Minority Leader Nancy Pelosi and Senate Minority Leader Charles E. Schumer clashed publicly with the President on the issue at the White House last Tuesday.
Intra-Party Spat Threatens Movement of ENA Priority This Congress
An uncommon disagreement between two Republican senators sheds light on a long-held tradition of the Senate and threatens the movement of two ENA-supported bills before the end of this Congress. Sen. Johnny Isakson (R-GA) is the sponsor of S. 2315, which would impose new fees on over-the-counter drug manufacturers to help fund a more efficient FDA approval process. Sen. Richard Burr (R-NC), has expressed skepticism that the agency is using current user fee dollars appropriately, and has placed a "hold" on the bill, preventing its progress to the Senate floor. A hold is a procedural action that any senator can use to prevent bills from being considered on the floor.
In retaliation, Sen. Isakson placed a hold on one of Sen. Burr's bills, the Pandemic and All-Hazards Preparedness and Advancing Innovation Act (PAHPA, S. 2852). Supported by ENA, PAHPA would reauthorize a number of public health, trauma readiness and disaster preparedness programs. This version of the legislation also includes another ENA priority, the MISSION ZERO Act (S. 1022), which would establish a grant program for military-civilian partnerships in trauma care that will allow both sectors to benefit from the others' expertise and experience. Ironically, Sen. Isakson is the sponsor of the MISSION ZERO Act, which would benefit from the passage of the PAHPA bill.
Under normal conditions, neither bill would have been seen as controversial, and would most likely have been brought up under expedited consideration and easily passed. As of now, it is unclear if the two senators will resolve their differences to allow these bills to be considered before Congress adjourns. If this happens, they will need to start over again next Congress.
Despite Declining Prescriptions, Opioid Deaths Continue to Climb
While the prescribing rates for opioids fell significantly in 2017 to 58.7 per 100 people - the lowest rate in more than 10 years, according to Centers for Disease Control and Prevention (CDC) data - the number of opioid deaths continues to climb. The prescribing rate had peaked at 87.3 per 100 people in 2012. Still, according to the CDC, in 16% of U.S. counties, enough opioid prescriptions were dispensed in 2017 for every person to have one, and some counties had prescribing rates seven times higher than the national average.
CDC data also shows that, from 1999 to 2016, more than 200,000 people died in the United States from overdoses related to prescription opioids. And, while prescription rates have been falling since its 2012 peak, overdose deaths involving prescription opioids were five times higher in 2016 than in 1999. Many more deaths are from non-prescription drugs. According to the National Institute on Drug Abuse, more than 72,000 people died from drug overdoses deaths in 2017. Of those, the sharpest increase occurred from deaths related to fentanyl and fentanyl analogs (synthetic opioids), with nearly 30,000 overdose deaths.
Divided Congress May Hint at Drug Pricing Compromise
When the 116th Congress is sworn in on Jan. 3, Democrats will control the House and Republicans the Senate. With Congress divided along political and ideological lines, not much is expected to be accomplished, but both sides have hinted interest in reining-in escalating prescription drug prices. The incoming House Democratic leadership had made drug pricing a top campaign issue. It is also a top issue for Republican President Donald Trump.
The already-high, and rising, out-of-pocket costs for prescription drugs forces some patients to choose between essentials like food and their medications. Failing to adhere to medication regimes, especially for serious conditions like cancer, heart disease and diabetes, can have disastrous consequences. Two bipartisan drug pricing bills are said to be on the table. One would go after drug companies that delay the introduction of cheaper generics. The other would force drug companies to display their list prices in consumer advertisements. That bill, the Fair Accountability and Innovative Research in Drug Pricing Act, passed the Senate last year but was blocked by House Republicans.
Federal Advocacy Update: ENA Priority Legislation
Here you will find monthly updates on the status of bills that are of priority concern or focus for ENA. We will utilize this section to provide basic information such as new cosponsors that have signed on in the last month or updates on the status of the bill's movement through Congress. When bills are first added, existing cosponsors will be listed. Following, you will see only new cosponsors listed monthly. You may review the legislation and a complete list of cosponsors by clicking the link provided.
Health Care Workplace Violence Prevention Act
Sponsor: Rep. Khanna, Ro [D-CA]
No new cosponsors since August 10, 2018
Status: This bill currently awaits action in the House Energy & Commerce, Education & Workforce, and Ways & Means Committees
MISSION ZERO Act
Sponsor: Rep. Burgess, Michael [R-TX]
Status: This bill was passed in the House of Representatives on February 26, 2018 by voice vote.
This bill was also passed in the House of Representatives as part of the Pandemic and All-Hazards Preparedness and Advancing Innovation Act on September 25, 2018 by voice vote.
Sponsor: Sen. Isakson, Johnny [R-GA]
Status: A modified version of MISSION ZERO was approved by the HELP Committee as part of reauthorization of the Pandemic and All-Hazards Preparedness Act reauthorization bill on May 23, 2018.
Stop, Observe, Ask, Respond (SOAR) to Health and Wellness Act
Sponsor: Rep. Cohen, Steve [D-TN]
No new cosponsors since September 13, 2017
Status: This bill was passed in the House of Representatives on February 26, 2018 by voice vote
Sponsor: Sen. Heitkamp, Heidi [D-ND]
No new cosponsors since June 12, 2018
Status: This bill awaits action by the Senate HELP Committee
Air Ambulance Quality and Accountability Act
Sponsor: Rep. Hudson, Richard [R-NC]
No new cosponsors since September 12, 2018
Status: This bill currently awaits action by the House Energy & Commerce and Ways & Means Committees
Senate: Please note there is currently no Senate companion for H.R. 3780
Good Samaritan Health Professionals Act
Sponsor: Rep. Blackburn, Marsha [R-TN]
No new cosponsors since August 24, 2018
Status: Passed by House Energy & Commerce Committee on February 14, 2018
Sponsor: Sen. Cassidy, Bill [R-LA]
No new cosponsors since July 25, 2018
Status: This bill currently awaits action by the Senate HELP Committee