Update on Pre-Recess Congressional Frenzy
Passed: Welfare, Health Insurance Reform,
Safe Drinking Water
Pending: FDA Reform
August 7, 1996
The House and Senate spent the two-week period before the Aug. 2nd recess in a frenzy of activity, passing several pieces of major legislation, while leaving VA/HUD and L/HHS appropriations -- as well as several AIDS-related non-appropriations bills such as FDA reform -- to be dealt with after they return from recess in September. This Info Alert highlights some of AIDS-related bills that passed during this period, as well as the FDA bills that stalled -- in some ways much to our relief. AIDS Action's Aug. 12th mailing will include a more detailed analysis of many of the bills reported on in this Alert.
Bills Passed:Welfare Reform
The Personal Responsibility and Work Opportunity Reconciliation Act of 1996, known as Welfare Reform, passed the House July 31, by a vote of 328-101. The Senate on August 1, passed the bill 81-21. The President has said he would sign the measure into law, fulfilling his promise to "change welfare as we know it." The welfare reform bill includes a number of provisions that will effect some people's eligibility for Medicaid, the program upon which more than half of all people living with HIV and AIDS now rely for basic health care. For example, the bill terminates Medicaid coverage for cash-assistance recipients who fail to comply with work regulations, and bars legal immigrants from eligibility for Medicaid until they have worked in the United States for 10 years.
Insurance Reform The Health Coverage Availability and Affordability Act of 1996 was passed by the House August 1,421 votes for and 2 against. The Senate passed the bill August 2, with a unanimous vote of 98-0. President Clinton has said he will sign the bill. Among the bill's modest health insurance reform provisions are: limits on pre-existing condition exclusions, guaranteed availability and renewability of insurance, anti-discrimination rules, and tax breaks and consumer protections related to accelerated death benefits (viatical insurance). The bill includes a number of objectionable provisions as well, however, that may adversely affect health care consumers, including people living with HIV and AIDS. These include implementation of a "demonstration" project on MSAs (medical savings accounts) that may not provide adequate scrutiny or assessment of the impact of MSAs and "administrative simplification" provisions that do not sufficiently protect the privacy of patient information.
Safe Drinking Water Originally drafted as an extreme deregulatory measure which would have allowed states and localities to opt out of many of the most important provisions protecting the purity of drinking water, the final version of the Safe Drinking Water Act (SDWA) actually improves on the original Act.
This is especially true with regard to protections for vulnerable populations including people living with HIV/AIDS. Important provisions include:
Requiring water systems to supply consumer right-to-know reports with substantive information on the content, quality, and source of their drinking water. These reports will empower individuals, especially those with weakened immune systems, with the information they need to decide if they need to find alternatives to tap water.
Establishment by CDC, NIH, and EPA of waterborne disease surveillance studies, health effects research on microbial and chemical contaminants, and research into the identification of contaminant sources. This research will be especially important in identifying and providing guidance on cryptosporidiosis and giardia.
Unfortunately, Congress passed the bill two hours after a statutory deadline had expired that would have freed a $725 million appropriation for a state revolving fund to assist communities to meet the requirements of the Act. This could prove especially crucial to small communities whose water revenues are insufficient to employ new technologies. When Congress returns, they will have to act affirmatively to reauthorize this fund.
DoD Authorization - HIV+ Service Members The Dornan provision discharging service members with HIV has been deleted from the House/Senate Conference Report of the FY 1997 Defense Authorization Bill. The House approved the Conference report on August 1st and the Senate is expected to pass the Conference report in September. Dept. of Defense officials report that the President is likely to sign this bill. We hope this will be the end of hateful attempts to discharge HIV+ service members once and for all.
Still Pending:FDA Reform
The Senate FDA reform bill remains stalled. Senate leadership has suggested that the bill will be considered by the full Senate only IF a deal can be made with the Administration and Senate opponents. While Senate Labor Committee staff assure us that changes are being made, no compromise language has surfaced. We maintain our STRONG opposition to the Senate bill especially on provisions imposing arbitrary deadlines on the Agency, allowing dissemination of incomplete and/or inadequate information to market drugs for unproven off-label uses, and permitting third-party review of drugs and medical devices.
The House bill is being redrafted over the August recess as Commerce committee staff and the Administration continue to negotiate. A discussion draft was released in July which moderated some of the most dangerous provisions in the bill as introduced. However, this draft still includes provisions on off-label use, third party review, pre-emption of states' authority to regulate food, drugs, and tobacco, and other issues which make it likely that we will be opposed to the revised bill as well.
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This article was provided by AIDS Action Council.