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Senate Committee Approves Health-Related Bills

On June 27, the Senate Health, Education, Labor, and Education Committee easily approved, by voice vote, two bills aimed at improving health care. Pressed for time due to impending floor votes on June 26 and the inability to obtain a quorum, Committee Chair Edward Kennedy (D-MA) announced that the committee would approve the measures in a meeting off the Senate floor after votes on June 27. The committee approved the Alzheimer’s Disease Research, Prevention, and Care Act of 2002 (S. 2059) and the International AIDS Treatment and Prevention Act of 2002 (S. 2649), while postponing action on a bill (S. 710) to provide for colorectal cancer screening.

Alzheimer’s Disease
S. 2059, sponsored by Sen. Barbara Mikulski (D-MD), would direct the National Institute on Aging (NIA) at the National Institutes of Health (NIH) to undertake an Alzheimer’s Disease Prevention Initiative. The initiative would aim to accelerate the discovery of new risk and protective factors for the disease; identify diagnostics, therapies, or preventive interventions; support clinical trials; and implement effective prevention and treatment strategies.

The bill also would direct the NIA to establish an Alzheimer’s Disease Cooperative Study Group, which would support a national consortium for cooperative clinical research on Alzheimer’s disease. The legislation also would authorize research on Alzheimer’s disease and caregiving.

S. 2059 would authorize $1.5 billion for such activities in FY2003 and such sums as necessary in FY2004 through FY2007. Another $25 million would be authorized in FY2003 for Alzheimer’s disease demonstration projects. Additionally, the bill would reauthorize a research program on women and aging through FY2007.

The global HIV/AIDS bill (S. 2649) would authorize the Centers for Disease Control and Prevention (CDC), the U.S. Agency for International Development (USAID), and the Health Resources and Services Administration (HRSA) to undertake a range of HIV prevention, care, and treatment services in countries with, or at risk for, a severe HIV epidemic. The bill would authorize $400 million in FY2003 for the CDC and $40 million for HRSA to carry out such activities.

Additionally, the bill would authorize $50 million in FY2003 for the National Institutes of Health (NIH) and HRSA to award grants to provide support for clinical education and training in the delivery of HIV/AIDS care and treatment services. A new family survival program would be authorized at $45 million in FY2003 and $30 million in FY2004. The program would support public-private partnerships to provide medical care and support services to HIV-positive parents and their children.

S. 2649 also includes a section devoted to microbicide research. Specifically, the bill would direct the Office of AIDS Research at the NIH to expand, intensify, and coordinate all activities with respect to microbicide research. Additionally, the bill would require the NIH to expedite the implementation of its strategic plan for microbicide research. The NIH also would be required to award grants to support the operation of multidisciplinary teams to conduct microbicide research.

S. 2649 also would authorize $10 million in FY2003 for the Department of Labor to undertake workplace HIV/AIDS prevention and education programs in countries with, or at-risk for, a severe HIV epidemic.

Colorectal Screening
While the committee also was slated to consider the Eliminate Colorectal Cancer Act of 2001 (S. 710), Senators were only able to give their opening statements. Consideration of the bill will be resumed on July 10. S. 710, sponsored by Sen. Kennedy, would require group health plans to cover colorectal screening at regular intervals for beneficiaries age 50 and over and any beneficiaries who are at high risk.

During opening statements, Sens. Judd Gregg (R-NH) and Bill Frist (R-TN) expressed their concerns with the bill. “There are a number of significant reservations, the first goes to this issue of mandated benefits,” stated Sen. Gregg.

While offering his support for increased screening and preventive services, Sen. Bill Frist (R-TN) questioned, “Is this legislation necessary and what is the data that people are being denied?” Noting that the American Association of Health Plans conducted a study, which showed that 99 percent of health plans are providing coverage for colorectal cancer screening, he said, “Based on the data,…I don’t believe that people are being denied.”

Adding that he hesitates “to do this disease by disease, body system by body system,” Sen. Frist admitted that there are certain insurance mandates that are necessary, pointing to mental health as an example. “Mental health is different because there are obvious disparities, and there is data that mental health is being treated differently from physical health.”

Sen. Kennedy countered that medical evidence clearly shows that screening can be effective. “We all know that colorectal cancer is the second leading cause of cancer death in men and women. Colorectal cancer can be prevented through early detection and screening….; however, only one-third of the population is screened.”

Sen. Pat Roberts (R-KS) offered his support of the bill, noting that the committee substitute amendment to be considered in July “makes some significant improvements to the bill.” Noting that he shares the concern of his colleagues, Sen. Roberts added, “I think on balance, we should proceed with the bill.”

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