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Next Challenge for Cures Bill: The Senate

By Melanie Zanona, CQ Staff

July 20, 2015 -- Winning overwhelming support for a medical innovation package in the House this month was no simple feat.

After resolving fights over offsets, mandatory funding for the National Institutes of Health (NIH) and abortion policy riders, the House passed the 350-page "21st Century Cures" bill (HR 6) on July 10 in a 344–77 vote. Now the bill faces new challenges in the Senate.

Senate Health, Education, Labor and Pensions Chairman Lamar Alexander, a Tennessee Republican, plans to release a draft in the fall and mark it up before the end of the year. Bipartisan working groups have been meeting weekly on a variety of Food and Drug Administration and NIH topics related to drug and device innovation.

But coming up with legislation that is palatable to Republicans and Democrats in both chambers won’t be easy.

Three potential hurdles:

  • Narrower bill. The House-passed Cures bill was a vast piece of legislation that incorporated nearly 50 different ideas from lawmakers. The Senate version is likely to be more targeted, according to committee aides. Any provisions that get cut could upset House members who pushed for them. The bill is also expected to largely focus on electronic health records. The House measure addresses interoperability issues, but the Senate is eyeing whether to also alter a $30 billion federal program to encourage the adoption of electronic medical records, which could be contentious.
  • Timing. If the Senate doesn’t make progress on a bill before the end of the year, it could be an uphill battle to advance any bipartisan health priorities. The rest of this year will already be occupied by funding the government and the Highway Trust Fund and weighing in on the Iran nuclear deal. "Support for the legislation in the House was overwhelmingly bipartisan. But as we get closer to the end of the year, that bipartisan spirit is apt to wane because of the presidential campaign season," says Marc Boutin, chief executive officer of the National Health Council, who has lobbied for the bill.
  • Going to conference. A conference on the House and Senate measures—which lawmakers say is the goal—could prove tricky, especially if the two bills are far apart. But if they don’t go to conference, it puts the Senate in the undesirable position of just passing the House version without weighing in. The chamber already experienced a similar situation when it cleared legislation drafted by the House to change the oft-criticized sustainable growth rate formula, a major victory where credit went largely to House lawmakers.

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