Capitol Hill Report: House Bill Moves Forward, Academy Focuses on Senate

November 9, 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.

Over the weekend, the US House of Representatives passed a comprehensive health care reform bill, 220 to 215.

In the end, 39 Democrats opposed the bill, and only one Republican voted in favor. A couple of the most interesting votes came from Reps. Joseph Cao (R-LA) and Dennis Kucinich (D-OH). Cao of New Orleans has the distinction of being the Republican representing the district with the highest percentage of registered Democrats. Recognizing his uphill climb to reelection (he defeated Congressman William Jefferson (D-LA), who ended up being convicted of bribery charges), his was the lone Republican vote in favor of the bill. On the democratic side, Kucinich carried through on his threat to vote against the bill if it did not have a "robust" public option. I wonder how Kucinich, one of the more liberal members of the House, would have voted if passage came down to just his vote?

Of particular interest to the Academy was the elimination of the Sustainable Growth Rate (SGR) formula that calls for annual physician cuts in Medicare. Unfortunately, the SGR fix was taken out of the bill due to its $210 billion price tag. The House intends to vote in mid-November on a stand-alone bill to eliminate the flawed formula and its accumulated debt. The Academy sent out an action alert in support this legislation, HR 3961. If you haven't done so, please log on to Vocus to quickly and easily send an email to your member of Congress. An earlier version of this bill failed in the US Senate, an event you can read about in the last Capitol Hill Report.

The Academy also worked very hard to pass an amendment to provide for the inclusion of neurology in the primary care (or, more appropriately, "cognitive care") incentive program. Congresswoman Betty McCollum (D-MN) introduced an amendment to the Rules Committee, which is used by the House to determine what amendments are "in order" for consideration on the House floor. Two days before the Rules Committee meeting, I got a chance to discuss this issue with Majority Leader Steny Hoyer (D-MD), who seemed supportive. Unfortunately, congressional Democrats allowed just two amendments, one known as the "manager's amendment," which makes technical corrections, with the other being the Republican health care reform alternative.

The Academy is now turning our efforts to the Senate, where Sen. Amy Klobuchar (D-MN) has agreed to introduce the amendment to add neurology. The Senate bill is currently being scored by the Congressional Budget Office and senators have been asked to submit amendments. We are hopeful that Sen. Klobuchar will make this amendment a priority. The Senate might begin to debate health care reform the week of November 16, although most expect the debate to begin somewhat later, and perhaps go all the way to Christmas or even into 2010.

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