Capitol Hill Report: Neurology's Congressional Champions Threatened

March 23, 2012


By Mike Amery, Legislative Counsel, Federal Affairs, (202) 506–7468,

Members of Congress are starting to lose their seats. And this may affect supporters of neurology.

It isn't just Mitt Romney and Rick Santorum battling for primary voters. Due to redistricting, primary elections across the country are determining the fate of incumbent members of Congress who are often running in new districts.

Two champions for neurology on the Democratic side of the aisle are facing tough elections in 2012, one in a member-versus-member primary and another in the general election. We had a chance to speak with both of them this week.

Missouri's new congressional district lines are just about final barring one more court hearing. Reapportionment cost the state one congressional seat, throwing Rep. Russ Carnahan (D-MO), who serves as co-chair of the congressional MS caucus, into the same St. Louis-based district as fellow incumbent Rep. William Lacy Clay, Jr. (D-MO). Rep. Carnahan has been a key player for neurology in advocating first for the inclusion of neurology in the primary care bonus of the ACA, and then later in our efforts to promote cognitive care specialties.

I talked with Rep. Carnahan, who is disappointed that he has to run against a fellow incumbent but is well prepared for the fight as he has been in competitive districts since he was first elected in 2004. The Missouri congressional primary is in August and the winner of Democratic contest is almost certain to be reelected.

In Colorado, redistricting has made Rep. Ed Perlmutter's (D) district slightly less Democratic. This encouraged beer magnet Joe Coors to jump into the race on the Republican side. Coors is likely to self-fund what is going to be a very expensive congressional race. Perlmutter, who was first elected in 2006, has a daughter with epilepsy and has been a champion for neurology since arriving in Congress.

The first bill that Perlmutter introduced as a freshman in 2007 was to create Epilepsy Centers of Excellence within the VA. This legislation ultimately became law, and the centers are now up and running and doing great work in caring for veterans with epilepsy and providing research to the greater community. Rep. Perlmutter told us that he is confident that he can hang on to his seat, especially since he has run tough races before in worse political climates (six-point victory in 2010) and that he truly appreciates the support of the neurology community.

The Academy's political action committee, BrainPAC, is supporting both of these candidates. As Election Day nears, Capitol Hill Report will continue to highlight key races for Congress and how they might impact support for neurology and patients with neurologic conditions.

Speaker John Boehner and Derek Brandt, AAN's Congressional Affairs Representative

Another way to stay informed is by following the AAN's DC team on twitter at @AANMember or by checking out #AANDC. Derek Brandt and I post regular updates regarding our interactions with Congress, including visiting congressional offices and attending fundraisers. If you haven't already, I encourage you to start following us today.

Earlier this week Derek Brandt tweeted the following with this picture at right: Spoke to Speaker John Boehner tonight, reinforced the need for neurologists and other cognitive care providers.

House Votes to Repeal IPAB

There is always a lot of politics going on in Washington, but with the primaries upon us, everything revolves around politics, even the policy issues where we thought we had some agreement like IPAB. The hot health care issue last week was the effort by House Republicans to repeal the Independent Payment Advisory Board (IPAB) which passed on a vote of 223-181. The board was created by the Affordable Care Act (ACA) and is designed to limit Medicare expenditures. The AAN feels a board like this could have some merit, but as designed the IPAB has several significant flaws that are detailed in a previous Capitol Hill Report.

The key sentence in the previous paragraph was "effort by House Republicans." Repeal of the IPAB had been a bipartisan bill that had attracted several votes from Democrats including Frank Pallone (D-NJ), ranking member of the Health Subcommittee of the House Energy and Commerce Committee. The final vote included just 7 Democrats in favor and had 10 Republicans in opposition.

The Congressional Budget Office (CBO) scored the IPAB repeal bill at a cost of $3.1 billion. Needing an offset House Republicans attached medical malpractice liability reform which the CBO has scored as a savings of $58 billion. Talk about killing a fly with a sledgehammer.

The AAN strongly supports both IPAB repeal and medical malpractice reform. But we had been working along with many other physician specialty groups to make IPAB repeal a bipartisan effort that might actually have a chance of passing the US Senate. With the addition of the "poison pill" of liability reform, House Republicans were still able to pass IPAB repeal, but lost most of their Democratic support.

I can't blame Republicans for attaching liability reform to IPAB, as President Obama has threatened a veto even if a repeal bill did get through the Senate. It allows them to score political points on two key issues for physicians, but it was disappointing turn of events after all the work that had been done to create a bipartisan bill to now have it pass in a form that has little chance of passing the Senate. Politics, politics, politics.