We are international

Funding and Medicare Issues Still Debated by Congress
By Greg Brozeit

Congress is still working on funding bills and the Medicare reform legislation in hopes of finalizing both prior to a targeted mid-November recess. The appropriations bills, which should have been passed prior to the end of the fiscal year on September 30, must be finished prior to the recess. The fate and final version of the Medicare bill is uncertain.

Medicare Reform

Both the House and Senate versions of the Medicare reform package are being debated within a joint conference committee. The committee, made up of leaders from both chambers of Congress, threatens to take as much as $500 million out of the cancer drug reimbursement process. This would be devastating to all cancer patients.

A number of members of Congress are now aware of the implications and have pledged to work behind the scenes to limit the impact of this issue. The Myeloma Minute will provide an update next week.

Additionally, Senators Rockefeller (D-WV) and Snowe (R-ME), sponsors of the Oral Drug bill to provide Medicare coverage for all oral cancer drugs, are pushing to have their bill included in the final package. Since this was not included in either version passed by the House and Senate, it seems unlikely that the conference will include it.

Appropriations Process

As the Myeloma Minute reported last month, the Senate failed to pass an amendment to the Labor, HHS, and Education appropriations bill to increase funding for the National Institutes of Health (NIH) by $1.5 billion. The amendment fell 8 votes short of the required 60 needed.

Members of the House and Senate are still working hard to convince the conferees to the bill to do all they can to substantially increase NIH funding levels beyond the approximate 2% increases included in each chamber’s bill.

In the House, 213 members signed a letter distributed by Reps. Capps (D-CA), Bell (D-TX), Foley (R-FL) and Leach (R-IA) asking the conferees to support higher funding levels than was included in the House version.

In the Senate, 57 senators signed a similar letter that was distributed by Sens. Feinstein (D-CA) and Collins (R-ME). Interestingly, a number of senators who voted against the Specter-Harkin-Feinstein Amendment on September 10, 2003 signed the letter. Some who voted for the amendment did not sign the letter.

If the conferees do not agree on a final Labor, HHS, and Education appropriations bill within the next two weeks, it is likely that it will be rolled into an omnibus bill including all the appropriations measures not yet passed. This would open the process up and provide an opportunity to achieve substantially higher funding for NIH than is now in play.

The key players at this stage of the process are the chairmen of the respective Appropriations Committees, Sen. Ted Stevens (R-AK) and Rep. Bill Young (R-FL). Both have been strong supporters of medical research funding. Sen. Stevens was one of the supporters of the Specter-Harkin-Feinstein Amendment and made an impassioned speech in favor of research funding on the floor of the Senate before it was voted on.

Action Needed by Advocates

Please review that lists below.

If your senators either voted for the Specter-Harkin-Feinstein Amendment and/or signed the Feinstein-Collins letter, please call and write to thank them for their support and encourage them to convey their support to Sen. Stevens.

If your senators neither voted for the Specter-Harkin-Feinstein Amendment nor signed the letter, call and write them to express your disappointment and encourage them to support Sen. Stevens to request the highest possible funding levels for NIH.

If your representative signed the Capps-Bell-Foley-Leach letter, please call and write them to thank them for supporting NIH funding and encourage them to convey their view to Rep. Young.


Listed below is the roll call vote on the Specter-Harkin-Feinstein Amendment. Signers of the Feinstein-Collins letter to the conferees requesting the highest possible funding levels for NIH are italicized.

Sen. Richard Shelby (R) – Yes
Sen. Jeff Sessions (R) – No

Sen. Ted Stevens (R) – Yes
Sen. Lisa Murkowski (R) – Yes

Sen. John McCain (R) – No
Sen. John Kyl (R) – No

Sen. Blanche L. Lincoln (D) – Yes
Sen. Mark Pryor (D) – No

Sen. Dianne Feinstein (D) – Yes
Sen. Barbara Boxer (D) – Yes

Sen. Ben Nighthorse Campbell (R) – Yes
Sen. Wayne Allard (R) – No

Sen. Christopher Dodd (D) – No
Sen. Joseph Lieberman (D) – Not Voting

Sen. Joseph Biden (D) – Yes
Sen. Thomas Carper (D) – No

Sen. Bob Graham (D) – Not Voting
Sen. Ben Nelson (D) – Yes

Sen. Zell Miller (D) – Yes
Sen. Saxby Chambliss (R) – No

Sen. Daniel Inouye (D) – Yes
Sen. Daniel Akaka (D) – Yes

Sen. Larry Craig (R) – No
Sen. Michael Crapo (R) – No

Sen. Richard Durbin (D) – Yes
Sen. Peter Fitzgerald (R) – No

Sen. Richard Lugar (R) – No
Sen. Evan Bayh (D) – No

Sen. Tom Harkin (D) – Yes
Sen. Charles Grassley (R) – No

Sen. Sam Brownback (R) – Yes
Sen. Pat Roberts (R) – Yes

Sen. Mitch McConnell (R) – No
Sen. Jim Bunning (R) – No

Sen. John Breaux (D) – No
Sen. Mary Landrieu (D) – Yes

Sen. Olympia Snowe (R) – Yes
Sen. Susan Collins (R) – Yes

Sen. Paul Sarbanes (D) – Yes
Sen. Barbara Mikulski (D) – Yes

Sen. Edward Kennedy (D) – Yes
Sen. John Kerry (D) – Not Voting

Sen. Carl Levin (D) – Yes
Sen. Debbie Stabenow (D) – Yes

Sen. Mark Dayton (D) – Yes
Sen. Norm Coleman (R) – Yes

Sen. Thad Cochran (R) – No
Sen. Trent Lott (R) – Yes

Sen. Christopher Bond (R) – No
Sen. James Talent (R) – No

Sen. Max Baucus (D) – No
Sen. Conrad Burns (R) – No

Sen. Chuck Hagel (R) – No
Sen. Ben Nelson (D) – Yes

Sen. Harry Reid (D) – Yes
Sen. John Ensign (R) – No

New Hampshire
Sen. Judd Gregg (R) – No
Sen. John Sununu (R) – No

New Jersey
Sen. Jon Corzine (D) – Yes
Sen. Frank Lautenberg (D) – Yes

New Mexico
Sen. Pete Domenici (R) – Yes
Sen. Jeff Bingaman (D) – No

New York
Sen. Charles Schumer (D) – Yes
Sen. Hillary R. Clinton (D) – Yes

North Carolina
Sen. John Edwards (D) – Not Voting
Sen. Elizabeth Dole (R) – Yes

North Dakota
Sen. Kent Conrad (D) – No
Sen. Byron Dorgan (D) – Yes

Sen. Mike DeWine (R) – Yes
Sen. George Voinovich (R) – No

Sen. Don Nickles (R) – No
Sen. James Inhofe (R) – No

Sen. Ron Wyden (D) – Yes
Sen. Gordon Smith (R) – Not Voting

Sen. Arlen Specter (R) – Yes
Sen. Rick Santorum (R) – No

Rhode Island
Sen. Jack Reed (D) – Yes
Sen. Lincoln Chafee (R) – No

South Carolina
Sen. Ernest Hollings (D) – Yes
Sen. Lindsey Graham (R) – No

South Dakota
Sen. Tom Daschle (D) – Yes
Sen. Tim Johnson (D) – Yes

Sen. Bill Frist (R) – No
Sen. Lamar Alexander (R) – No

Sen. Kay Bailey Hutchison (R) – Yes
Sen. John Cornyn (R) – No

Sen. Orrin Hatch (R) – Yes
Sen. Robert Bennett (R) – Yes

Sen. Patrick Leahy (D) – Yes
Sen. James Jeffords (I) – Yes

Sen. John Warner (R) – No
Sen. George Allen (R) – No

Sen. Patty Murray (D) – Yes
Sen. Maria Cantwell (D) – Yes

West Virginia
Sen. Robert Byrd (D) – No
Sen. John Rockefeller (D) – Yes

Sen. Herb Kohl (D) – Yes
Sen. Russell Feingold (D) – Yes

Sen. Craig Thomas (R) – No
Sen. Michael Enzi (R) – No

House of Representatives

Listed below are the signers of the Capps-Bell-Foley-Leach letter to the conferees requesting the highest possible funding levels for NIH.

Abercrombie (D-HI)
Acevedo-Vila (D-PR)
Ackerman (D-NY)
Alexander (D-LA)
Allen (D-ME)
Andrews (D-NJ)
Baca (D-CA)
Bachus (R-AL)
Baker (R-LA)
Baldwin (D-WI)
Ballance (D-NC)
Becerra (D-CA)
Bell (D-TX)
Berkley (D-NV)
Berman (D-CA)
Biggert (R-IL)
Bishop (D-NY)
Blumenauer (D-OR)
Boehlert (R-NY)
Bordallo (D-GU)
Boswell (D-IA)
Boucher (D-VA)
Bradley (R-NH)
Brady (D-PA)
Brown, Corrine (D-FL)
Brown, Sherrod (D-OH)
Capito (R-WV)
Capps (D-CA)
Capuano (D-MA)
Cardin (D-MD)
Cardoza (D-CA)
Carson, Julia (D-IN)
Carson, Brad (D-OK)
Case (D-HI)
Christensen (D-VI)
Clay (D-MO)
Clyburn (D-SC)
Conyers (D-MI)
Cooper (D-TN)
Costello (D-IL)
Cramer (D-AL)
Crowley (D-NY)
Cummings (D-MD)
Davis, Susan (D-CA)
Davis, Danny (D-IL)
Davis, Jim (D-FL)
Davis, Tom (R-VA)
Davis, Artur (D-AL)
Davis, Lincoln (D-TN)
DeFazio (D-OR)
DeGette (D-CO)
Delahunt (D-MA)
Deutsch (D-FL)
Dingell (D-MI)
Doggett (D-TX)
Dooley (D-CA)
Doyle (D-PA)
Edwards (D-TX)
Emanuel (D-IL)
Engel (D-NY)
English (R-PA)
Eshoo (D-CA)
Etheridge (D-NC)
Evans (D-IL)
Faleomavaega (D-AS)
Fattah (D-PA)
Ferguson (R-NJ)
Filner (D-CA)
Foley (R-FL)
Ford (D-TN)
Frank (D-MA)
Frost (D-TX)
Garrett (R-NJ)
Gephardt (D-MO)
Gonzalez (D-TX)
Goode (R-VA)
Gordon (D-TN)
Graves (R-MO)
Green, Gene (D-TX)
Green, Mark (R-WI)
Grijalva (D-AZ)
Gutierrez (D-IL)
Hall (D-TX)
Harman (D-CA)
Harris (R-FL)
Hastings (D-FL)
Hill (D-IN)
Hinchey (D-NY)
Hinojosa (D-TX)
Hoeffel (D-PA)
Holden (D-PA)
Holt (D-NJ)
Honda (D-CA)
Hooley (D-OR)
Houghton (R-NY)
Inslee (D-WA)
Israel (D-NY)
Jackson-Lee (D-TX)
Jefferson (D-LA)
John (D-LA)
Johnson, Tim (R-IL)
Johnson, Eddie Bernice (D-TX)
Jones, Stephanie Tubbs (D-OH)
Kildee (D-MI)
Kind (D-WI)
King (R-NY)
Kucinich (D-OH)
Lampson (D-TX)
Langevin (D-RI)
Lantos (D-CA)
Larsen (D-WA)
Larson (D-CT)
Leach (R-IA)
Lee (D-CA)
Levin (D-MI)
Lewis (D-GA)
Lipinski (D-IL)
LoBiondo (R-NJ)
Lofgren (D-CA)
Lucas (D-KY)
Lynch (D-MA)
Majette (D-GA)
Maloney (D-NY)
Manzullo (R-IL) \
Markey (D-MA)
Marshall (D-GA)
Matheson (D-UT)
Matsui (D-CA)
McCarthy, Carolyn (D-NY)
McCarthy, Karen (D-MO)
McCollum (D-MN)
McDermott (D-WA)
McGovern (D-MA)
McIntyre (D-NC)
McNulty (D-NY)
Meehan (D-MA)
Meek (D-FL)
Menendez (D-NJ)
Michaud (D-ME)
MilendeR-McDonald (D-CA)
Miller, George (D-CA)
Miller, Brad (D-NC)
Moore (D-KS)
Moran (D-VA)
Nadler (D-NY)
Napolitano (D-CA)
Neal (D-MA)
Norton (D-DC)
Oberstar (D-MN)
Ortiz (D-TX)
Pallone (D-NJ)
Pascrell (D-NJ)
Payne (D-NJ)
Peterson (D-MN)
Pickering (R-MS)
Pomeroy (D-ND)
Price (D-NC)
Quinn (R-NY)
Radanovich (R-CA)
Rahall (D-WV)
Ramstad (R-MN)
Rangel (D-NY)
Reyes (D-TX)
Rodriguez (D-TX)
Rogers (R-AL)
Ros-Lehtinen (R-FL)
Ross (D-AR)
Ruppersberger (D-MD)
Rush (D-IL)
Ryan, Tim (D-OH)
Ryan, Paul (R-WI)
Sanchez (D-CA)
Sanders (I-VT)
Sandlin (D-TX)
Saxton (R-NJ)
Schakowsky (D-IL)
Schiff (D-CA)
Scott, David (D-GA)
Scott, Bobby (D-VA)
Serrano (D-NY)
Shaw (R-FL)
Sherman (D-CA)
Simmons (R-CT)
Skelton (D-MO)
Slaughter (D-NY)
Smith, Christopher (R-NJ)
Smith, Adam (D-WA)
Snyder (D-AR)
Solis (D-CA)
Spratt (D-SC)
Stark (D-CA)
Strickland (D-OH)
Sullivan (R-OK)
Tanner (D-TN)
Tauscher (D-CA)
Thompson (D-MS)
Tierney (D-MA)
Towns (D-NY)
Turner (D-TX)
Udall, Mark (D-CO)
Udall, Tom (D-NM)
Upton (R-MI)
Van Hollen (D-MD)
Velazquez (D-NY)
Watt (D-NC)
Waxman (D-CA)
Weiner (D-NY)
Weldon (R-PA)
Wexler (D-FL)
Woolsey (D-CA)
Wu (D-OR)
Wynn (D-MD)
Young (R-AK)

 related articles