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HELP Panel Approves Health Innovation Bills, but Funding Issues Loom

By Andrew Siddons, CQ Roll Call

February 9, 2016 -- Senate Health, Education, Labor, and Pensions (HELP) Committee Chairman Lamar Alexander of Tennessee touted the panel's quick passage Tuesday of seven bills designed to spur medical innovation as an example of rare bipartisan cooperation. But some of his colleagues predicted that a debate over funding would ultimately derail the whole process.

The seven bills that the committee reported favorably without amendment included a measure designed to make it easier for medical providers to use federal electronic health records (S 2511), which was adopted by 22–0. The rest, approved by voice vote, included a bill (S 2014) to support young researchers at the National Institutes of Health (NIH) and another (S 1622) that would aim to improve the Food and Drug Administration's (FDA) review process for devices.

The approvals mark the start of the Senate's consideration of legislation to mirror the 21st Century Cures bill (HR 6) that the House passed last summer.

However, the specter of how to agree on funding loomed large. Alexander said that offsets to pay for the measures could be addressed later on the Senate floor when the bills and other measures would be debated. He plans two more markups to debate about 40 more bills over the next two months, hoping to meld them into one cohesive measure.

But others didn't share his optimism.

"There's not going to be an innovation bill," Sen. Richard M. Burr, R-N.C., said during Tuesday's HELP meeting.

Burr was referring to the fact that committee Democrats, led Ranking Member Patty Murray, don't appear eager to go along with any medical innovation packages that won't include mandatory funding to support research at the NIH. Some Democrats are also skeptical about bills that might, in the words of Senator Elizabeth Warren of Massachusetts, "neuter" the FDA's oversight of drugs and medical devices.

The package, said Murray, "must include mandatory investments in the NIH and FDA and must uphold the gold standard of FDA approval."

Warren said she would not support any legislation that didn't include mandatory funding. "Real innovation starts with funding for basic research," she said. She also criticized the overall approach: "A handful of smaller targeted changes like we're voting on today won't get us where we need to be," she said.

Despite the differences over funding, Alexander sought to convince his bickering committee members that it was too early to predict the demise of a final package.

"Proceeding step by step in the right direction is one good way to get where you want to go," he said.

Despite the pessimism from Burr and Warren over the committee's inability to move forward with a single comprehensive piece of legislation, other senators praised Alexander's approach.

Sen. Susan Collins, R-Maine, described the legislation advanced on Tuesday as "important bills that will make a real difference to American families."

While many members spoke of constituents whose lives would be positively impacted by Tuesday's legislation, one bill, which aims at improving NIH research into medical rehabilitation, might make a difference on an even more personal level for one committee member.

"This bill comes from my time recovering from a stroke in Chicago," said Sen. Mark S. Kirk, R-Ill., who missed a year of work in the senate after suffering a stroke in 2012. Among stroke victims, he said, 75 percent "will not return to work as I have been able to do." Kirk expressed hope that this bill could improve that statistic.

Despite the panel's divisions, Alexander has a record of bringing people together. He has touted his committee's work on last year's education bill (PL 114-95) as an example of bipartisanship. Alexander is convinced he can achieve similar results with the innovation bill.

"With this bipartisan action in committee today, we've shown the Senate's potential to be the vehicle that turns these groundbreaking ideas into law this year to help improve the lives of nearly every single American," Alexander said after the markup.

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