Capitol Hill Report: A Meeting with the Referee

March 30, 2009


By Mike Amery, Legislative Counsel, Federal Affairs, (202) 349-4299,

The mission of the Academy is to be "indispensable to its members." One way the Academy fulfills this mission is by representing of neurology in the halls of Congress. Capitol Hill Report presents regular updates on legislative action and how the AAN ensures that the voice of neurology is heard on Capitol Hill. The Academy's legislative counsel in Washington, DC, Mike Amery, offers weekly updates on advocacy for neurology and neurologic concerns.

First off, Academy Board member Bruce Sigsbee, MD, FAAN, will testify at the House Energy and Commerce Health Subcommittee this Thursday, which I mentioned last week. Sigsbee will speak about his experience as a practicing neurologist and describe the consequences of the current Medicare fee schedule. As of this writing, we don't believe any other physician is currently scheduled to testify. Look for his statement to appear on later this week.

Secondly, the seventh annual Neurology on the Hill (NOH) was a great success. More than 100 members from 34 different states advocated for neurologic care to members of Congress. If you have not yet joined your colleagues on Capitol Hill, I hope you will consider joining us in March 2010 for this great event.

Just after NOH, I had the opportunity to meet with the House Majority Leader Steny Hoyer (D-MD) to discuss health care reform, along with several other specialty groups. As Majority Leader, Hoyer sets the schedule for the House, which allows him a great deal of input into how congressional committees operate. With health care reform jurisdiction spread over several committees, Hoyer told us that he would "referee" the efforts of the House Energy and Commerce Committee, the House Ways and Means Committee, and the House Education and Labor Committee in drafting a comprehensive health reform bill. He also stated that he expects to spend a lot of time working with the committees, rather than imposing his own views.

Hoyer was optimistic the physician reimbursement cut of 21 percent scheduled for January 1, 2010, will again be averted. In its place, a comprehensive health care reform bill should be passed that permanently eliminates the flawed Sustainable Growth Rate formula that annually requires Congress to step in to prevent federal Medicare cuts. (Read more about the Academy's position on this issue.)

On some key issues, Hoyer told us that he believes mandates (which require US residents to buy health insurance) will be part of the plan and that a public option will be necessary. The details of reform are still coming together, and he encouraged the Academy to meet for discussion of specific proposals. I hope to hold a meeting with his staff next week.

Hoyer also spent time talking about the House schedule for health care reform. The hope is to have bills passed from committee and on the House floor before the annual congressional recess in August. He made it clear that this is a "target" and not a "deadline," stating that the House would make sure there is time for everyone to be heard. This stands in stark contrast with the failed reforms of 1993, which were pushed through quickly.

On the chances of success, Hoyer is concerned about the Senate, which he said has a "Grassley Problem." Sen. Charles Grassley (R-IA), the keynote speaker at the NOH congressional breakfast, is the ranking member of the Senate Finance Committee where he has a close relationship with Chair Max Baucus (D-MT). Hoyer said House members frequently hear from Baucus that "he will check with Grassley" on key health care issues. The (Senate Finance Committee ) has jurisdiction over health care financing, so with the need for 60 votes to move reform in the Senate, Grassley's views will have to be taken into account.

Finally, look for an Academy Alert email very soon, which will ask you to contact your members of Congress regarding sustainable quality improvement. Please take a minute to respond to this request, as this is a vital time to be heard on this extremely important issue.

Read all of Mike Amery's reports on the Capitol Hill Report page.