Capitol Hill Report: Senate Health Reform Moves Forward

December 21, 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.

Senate Democrats have secured their sixtieth and final vote needed to move health reform forward. A final bill is likely to pass on Christmas Eve, even though Republicans are putting up every possible obstacle, including requiring Senate clerks to read entire amendments and the final bill aloud.

Unfortunately for neurology, the "manager's amendment" did not include an amendment that added neurology to the list of providers eligible for the primary care bonus in section 5501 of the bill. (I wrote about the manager's amendment in a November post.) In order for the amendment to be included, it will either have to be adopted on a vote by the Senate or added as part of a Senate–House conference committee that will iron out differences between the bills. Fortunately, the primary care bonus sections in each bill are significantly different, which allows a request like the Academy's "to be conferenceable," meaning it can be considered.

Like a prospective presidential candidate, it felt like I had spent my week in Iowa after attending events for both Iowa senators, Tom Harkin (D-IA) and Charles Grassley (R-IA). Both of these meetings produced results that may help with an amendment or in the conference committee. First, I met with Grassley and his top staff on the Senate Finance Committee minority. This meeting followed a request by AAN member Michael J. Kitchell, MD, of Ames, who asked Grassley to support an amendment for neurology; Grassley introduced the amendment on Friday. It is exactly what we need on the first page, except it goes a little further and includes 28 pages of a medical liability reform language. The neurology part might be acceptable to Democrats, but the liability language never will be. We will continue to work with Grassley, who is a proponent of the inclusion of neurology in the bill.

I talked about the issue the next day with Harkin, who is chair of the Health, Education, Labor, and Pensions Committee (HELP). He was very interested and said he would consider offering the issue in any conference committee, of which he will certainly be a part as HELP's chair. I will work with Kitchell on following up on Harkin's offer.

Lastly, I talked with a good friend of the Academy's, Congressman Ed Perlmutter (D-CO). Perlmutter was the driving force behind the Academy's push for Epilepsy Centers of Excellence at the VA, which was successful in 2008. Perlmutter has supported our efforts from the beginning and reiterated his support, saying he would be the sponsor in the House whether in a conference committee or if we need separate legislation in 2010.

Success is within reach, though we still have a lot of work to do. Perlmutter, Grassley, and Harkin may be our champions in the Congress, and patient groups like the National MS, Parkinson's Action Network, the Epilepsy Foundation, and many others have been very supportive.

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