By Kim Krisberg

Health issues are again at the top of the priority list for federal lawmakers, following the start of a dramatically different Congress in January.

The new Democratic majority in Congress wasted no time scheduling votes on high-profile health care issues, including changes to the Medicare prescription drug program and reversing the prohibition on stem cell research. As the new leadership swung into action, so did health care advocates, many of whom see the new congressional make-up as a fresh opportunity to address the nation's pressing health care problems.

"We're looking forward to working with Congress' new leadership to help move APHA's legislative priorities forward, including efforts to expand access to heath care, enhance the nation's public health infrastructure and close the health disparity gap," said Don Hoppert, APHA's director of government affairs. "As Congress begins its 110th session, APHA will be there to remind policy-makers that efforts to improve the public's health will take a united commitment"

Legislators discuss bipartisan drug importation legislation at a January news conference. From left are Rep. Rahm Emanuel, D-Ill.; Sen. Olympia Snowe, R-Maine; and Reps. Rosa DeLauro, D-Conn.; Jo Ann Emerson, R-Mo.; and Marion Berry, D-Ark. Photo by Joe Raedle, courtesy Getty Images

Shortly after the November elections, Sen. Edward Kennedy, D-Mass., the new chair of the Senate Health, Education, Labor and Pensions Committee, outlined a number of high-priority public health issues the committee would take on in the new Congress. Among those issues are giving the U.S. Food and Drug Administration the authority to regulate tobacco products; strengthening the State Children's Health Insurance Program; promoting the use of health information technology; and creating a new health insurance program for the millions of people living with severe functional impairments, such as those with severe mental or developmental disorders.

Among the first orders of business for the new Congress was addressing costs within the Medicare prescription drug program, Medicare Part D.

On Jan. 12, House members approved the Medicare Prescription Drug Price Negotiation Act, voting 255 to 170 to allow the federal government to negotiate lower prescription drug prices for Medicare beneficiaries.

Currently, federal health officials are prohibited from leveraging Medicare's massive purchasing power to negotiate lower prices with pharmaceutical manufacturers. However, the recent legislation, known in the House as H.R. 4 and Senate as S. 3, would require the U.S. health and human services secretary to negotiate lower Medicare drug prices as well as require the secretary to report to Congress on the progress of such negotiations. As of mid-January, the bill had not come up for a vote in the Senate.

While President Bush has stated he would veto such legislation, many health advocates hope the legislation will bring Medicare drug pricing more in line with the Veterans' Administration, which negotiates drug prices for its beneficiaries.

Just days before the House Medicare vote, Families USA, a health care consumer advocacy organization, released a report showing that prices for the top drugs prescribed to older Americans were almost 60 percent higher for Medicare enrollees than for those with VA coverage. Robert Hayes, president of the national Medicare Rights Center, called H.R. 4 a "positive step forward," but cautioned that it is "not the end of the road for (Medicare) reform" Hayes called on Congress to create a Medicare-administered drug plan option that would compete against Medicare's current prescription drug programs, all of which are administered via private companies.

"A lot of people are having problems (with the Medicare drug benefit) and a lot of people are being treated unfairly," Hayes told The Nation's Health. "It's taxpayers and older Americans on one side and big profits for pharmaceutical companies on the other. I don't think many issues are so clear"

Also in its first weeks of business, House members took on another hot topic: minimum wage. In a bipartisan vote of 316 to 116, House members cast their ballots to increase the federal minimum wage. The Fair Minimum Wage Act of 2007, known in the House as H.R. 2 and Senate as S. 2, would raise the minimum wage to $5.85 an hour beginning the 60th day after the law is enacted, increase to $6.55 a year later and then to $7.25 two years after. If the minimum wage increase is enacted — as is anticipated — it would be the first time the federal government raised the minimum wage in 10 years. APHA passed policy in 2000 supporting raises in the minimum wage, as research has shown that socioeconomic status is a contributing factor to good health. Bill Samuel, director of legislation at AFL-CIO, noted that it is time for Congress to catch up with the states, many of which have raised minimum wage standards on their own.

"At the federal level, it's a huge victory for workers and families who've been suffering at this low wage," Samuel told The Nation's Health. "Raising the minimum wage is the least we can do to help families afford health care"

SCHIP, drug imports, climate on agenda
In coming months, members of Congress also plan to take up reauthorization of SCHIP, which expires in September. The program, which provides health care coverage to 4 million U.S. children and has been credited with helping to reduce children's uninsurance rates, is the most important health care issue arising in the near future, said Ron Pollack, executive director of Families USA. The United States is still home to 9 million uninsured children and reauthorization provides a chance to help states expand their SCHIP programs and cover more kids, Pollack said.

Carol Guthrie, a spokeswoman for Sen. Max Baucus, D-Mont., new chair of the Senate Finance Committee, said SCHIP reauthorization is a major priority for the finance committee and that Baucus hopes to renew SCHIP far in advance of its expiration date.

"In SCHIP, every effort will be made to…ensure continuity of coverage for children," Guthrie told The Nation's Health.

Also on the agenda, policy-makers will finalize funding levels for fiscal year 2007 federal appropriations —†business that was left unfinished from last year's session.

Other new work includes legislation to allow importation of prescription drugs from approved Canadian pharmacies, which was introduced in the House as H.R. 380 and Senate as S. 242 in January. Climate change will also be attracting attention, as House Speaker Nancy Pelosi, D-Calif., announced plans in January to create a special committee that will address global warming.

Congress' attention to health care issues is in line with the concerns of many Americans. According to a national survey released in December and conducted by the Kaiser Family Foundation and Harvard School of Public Health, while the war in Iraq was by far the public's top policy priority, health care and the economy came in second.

For more on health and the new Congress as well as APHA's work on public health legislation, visit www.apha.org/advocacy/activities.