When Congress returns after the holiday weekend, lawmakers face a packed list of priorities, including the small task of funding the government. Bitter election-year partisanship, as well as the few weeks left in the year to #dotheirjobs, only complicates the situation.
Despite the headache, we can't turn it off. From biomarkers to broadband, here are the issues we’ll be watching in what’s left of the 114th.
The bill would require the FDA to issue guidance on drug development tools, biomarkers for example. Biomarkers are measurable signs that serve as stand-ins for actual symptomatic changes triggered in response to a treatment. They predict the health outcome when the outcome itself is too difficult to measure. They’re used in clinical research in roughly 50% of new drug approvals, but they have downsides.
“Their main disadvantage is that favorable effects on surrogates do not automatically translate into benefits to health,” according to the Congressional Research Service. One diabetes medication was shown to lower a biomarker level relevant for that illness, for example, but also increased patients’ risk of having an actual, real-life heart attack.
The bill would appropriate funds for early-stage investigations and other research, boost loan repayment programs for emerging scientists, and promote pediatric research. In several ways, it would revise the pipelines for drugs, vaccines, devices and software. And, because Congress is a wacky place, it also includes a requirement that the Energy Department sell crude oil from the Strategic Petroleum Reserve.
The House passed the bill overwhelmingly in July, and there’s been some pretty strong chatter during the summer recess. Senate HELP Committee Chair Lamar Alexander (R-TN) may plan to advance Cures in September, while Democrats may try to attach more comprehensive drug cost reforms after all.
It would allow same-day billing in Medicaid for mental and physical healthcare services. It would support new models of care, including for schizophrenia, and expand youth suicide prevention services to all ages. The bill also contains provisions to support mental health workforce development and to strengthen parity law, which requires insurers to cover mental health with the same urgency as physical health. The companion bill covers much of the same territory.
Last month, the American Psychiatric Association and the National Alliance on Mental Illness wrote letters to the editor and mobilized constituents on the issue, with access to care (or the lack thereof) serving as a central theme.
“Far too many Americans with mental illness get their care not from physicians’ offices or hospitals, but rather from our nation’s jails and prisons,” said Maria A. Oquendo, M.D., President of the APA. “In most states, the largest mental health provider is a correctional facility.”
This comes as Hillary Clinton has just released a major mental health proposal, potentially raising the issue’s profile.
House Republicans wanted to match Democrats’ call for $1.1 billion, but at the expense of other health programs and with the inclusion of what Democrats say are unacceptable partisan riders.
Over the break, the American Public Health Association called on congressional leadership to craft a compromise funding package that can pass immediately in September, saying, “Anything less would represent a historic failure to protect our nation from a significant threat to the health of our children.”
The Senate Appropriations Committee passed a bill that appropriates funding for NSF, as well as the Commerce and Justice departments and a smattering of other agencies. The bill would provide $7.5 billion, $46 million more than the NSF’s 2016 budget. The House committee-approved version would appropriate $7.414 billion, about $57 million down from 2016.
With only a month left in the fiscal year, there’s always the possibility of a continuing resolution and a flat budget—or a wild card, in the form of the omnibus spending bill that Democrats began hinting at before the break.
Meanwhile, on the authorization side, research advocates are calling on the Senate to pass S. 3084, but extend the bill’s reach from two to four years.
“While we appreciate the four-percent increase in funding (not counting inflation) for fiscal year 2018, we would also welcome a longer authorization bill that sets aspirational funding targets to inform appropriators of the resources the agency needs to accomplish its important mission and to adequately support the new programs included in the bill,” wrote the Coalition for National Science Funding.
The House bill contains a number of provisions to bar EPA from moving forward on Obama Administration priorities, including implementation and enforcement of the greenhouse gas rules finalized last year for new and existing power plants.
“I’m proud to be at the forefront of the House’s efforts to stop President Obama’s harmful regulatory overreach that has created our stagnant economy,” said House Interior and Environment Appropriations Subcommittee Chair Ken Calvert (R-CA).
That version largely stuck to energy, at least: modernizing energy infrastructure and addressing cybersecurity for the electric grid while also expediting permits for certain mining projects and repealing the fossil-fuel phase-out in federal buildings, among many other provisions.
But in May, the House approved a version that the Sierra Club called “the legislative equivalent of the middle finger.” The critique is based on provisions they say obstruct energy efficiency standards for buildings, promote fossil fuel generation and consumption, create new subsidies for coal and nuclear, and reduce environmental assessments for logging certain forests.
Over the break, the U.S. Chamber of Commerce and a group of energy industry representatives called on Energy Committee leadership to express for support for the bill. The Sierra Club is working hard on defense as the bills go to conference committee in September. They would much rather see the bills reintroduced under Democratic Senate leadership in 2017.
The bill would make at least 255 megahertz of federal and nonfederal spectrum below the frequency of 6000 available for mobile and fixed wireless broadband use. It would also require states to coordinate broadband infrastructure with federally funded highway projects and promote broadband access in low-income neighborhoods and rural areas.
The bill, however, seems to remain stalled. “It’s just kind of this whole political quagmire,” said Alisha Green, tech reporter for CQ Roll Call during recess. “I’m not really sure what role if any Congress will be able to play at this point.”
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