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Healthcare Debate Rages on
By Dr. Mark Lutschaunig, Director of the GRD
The dog days of summer are over, and Congress is set to return from their August recess on September 8. It has been a controversial summer for our elected officials, as witnessed at the many raucous Town Hall meetings throughout the country. Healthcare reform has energized both sides of the debate, resulting in an increase in the number of citizen activists. This is how our democratic process should work. It is an example of the potential for excitement boiling around any issue, especially our own, once our profession becomes more involved in the political process.
The House of Representatives left in August with versions of healthcare reform from three different House committees. Once these three versions are combined, the Democratic leadership will take the bill to the full House, where a rigorous debate will occur. If the Democratic leadership keeps their members in line, the bill will pass easily. However, this is a big "if," as an internal fight between the more conservative Democrats (Blue Dogs) and the liberal branch of the party could scuttle any final bill. In the Senate, the Health, Education, Labor and Pensions (HELP) committee has passed their version of the bill, but the Senate Finance Committee is still trying to develop consensus amongst its members. The Finance Committee bill will help guide the Senate on the spending and funding issues.
The following chart compares the House bill, HELP Committee bill and the proposed Senate Finance bill (although the Finance Committee has not completed their bill):
| |
House Bill |
Senate HELP Bill |
Senate Finance Bill |
| Total Cost |
$1.04 Trillion |
$1.34 Trillion |
Still negotiating-target $900 billion |
| Number of uninsured in 2019 (Currently 47 million) |
17 million |
36 million |
Unknown |
| Government-run insurance (public option) |
Yes |
Yes |
No-The Senate bill would likely create nonprofit, consumer-run insurance cooperatives |
| Individual mandate |
Yes-Individuals must purchase insurance or pay a penalty based on income |
Yes-Individuals must purchase insurance or pay a penalty based on the cost of insurance |
Will likely require individuals to purchase insurance or pay a penalty based on the average cost of insurance |
| Employer mandate |
Yes. Employers must pay 65% of family premiums or pay a penalty based on payroll. Small businesses with less than $500,000 on payroll are exempt. Payrolls up to $750,000 have a reduced contribution |
Yes. Employers must pay 60% of family premiums or pay $750 for each employee who is not offered coverage |
No-will likely include a free-rider provision that would require employers who currently offer coverage to reimburse the government for employees who switch to insurance purchased through an exchange |
| Revenue raisers |
Original proposal: surcharge on families with incomes above $300,000 and individuals with incomes above $280,000
Under consideration: limiting the surtax to singles who earn more than $500,000 and families who earn more than $1 million |
HELP Committee does not have authority over raising revenue |
Considering imposing an excise tax on insurance companies that sell policies in excess of $21,000 a year for family coverage |
| Insurance reforms |
Yes. Bans rejection based on preexisting conditions |
Yes. Bans rejections based on preexisting conditions |
Will likely ban rejections based on preexisting conditions |
| Medicaid expansion |
Yes. Medicaid expanded to cover households earning less than 133% of the federal poverty level |
Yes. Medicaid expanded to individuals earning up to 150% of the federal poverty level |
Will likely expand Medicaid to cover everyone earning under 133% of the federal poverty level |
| Insurance subsidies |
Yes. Available to households earning up to 400% of the poverty level |
Yes. Available to households earning up to 400% of the poverty level |
Will likely be available to households earning up to 300% of the poverty level |
Source: Washington Post Online (www.washingtonpost.com) August 5, 2009
The Governmental Relations Division will continue to monitor the healthcare reform debate, and will monitor potential impacts on small business owners. If you would like to get involved and voice your opinion, the AVMA Government Action Center has contact information for your Representatives and Senators. If you are interested in becoming more involved in the political process, sign up for the Congressional Advocacy Network, and become part of our governmental relations team.
For more information, please contact Dr. Mark Lutschaunig.
Senate Requests GAO Study on Horse Welfare
By Dr. Angela Demaree, Assistant Director of the GRD
Further characterization of the current situation facing many horses across the Country, including abandonment, abuse, and neglect, may be little more than a signature away... the President's, that is. The Senate passed its version of the Agriculture, Rural Development, Food and Drug Administration, and Related Agencies Appropriations Act for FY2010 (H.R. 2997) on August 4, just before adjourning for August Recess. The AVMA is supportive of the proposed GAO study on horse welfare contained in the Senate Appropriations Committee Report.
The House passed its version of the Agriculture Appropriations bill on July 9, also H.R. 2997. Both bills have the same number since the Senate decided to take action on the House-passed version—differences will be reconciled through a Conference Committee comprised of members from both the House and Senate Appropriations Committees. The Conference Committee is expected to meet this week, following the return from Congressional recess.
The Senate Appropriations Committee Report (111-39) that accompanies the Senate-passed bill directs the Government Accountability Office (GAO) to study horse welfare and report back to the Senate Committee on Agriculture by March 2010. (The House version did not contain this language). From the Senate bill:
Horse Welfare.—The Committee directs the Government Accountability Office [GAO] to conduct an investigation on the status of horse welfare in this country as it relates to the cessation of horse slaughter operations. In particular, the Committee believes that GAO should consider, at least, how the horse industry has responded to the closure of U.S. horse slaughter facilities in terms of both the numbers of horse sales, exports, adoptions, or abandonments; the implications these changes have had on farm income and trade; the extent to which horses in the United States are slaughtered for any purpose; any impacts to State and local governments and animal protection organizations; how the Department oversees the transport of horses destined for slaughter in foreign countries, particularly Canada and Mexico; the manner in which the Department coordinates with the Department of the Interior and State governments to assist them in identifying, holding and transporting unwanted horses for foreign export; and general conclusions regarding the welfare of horses as a result of a ban on horse slaughter for human consumption. The Committee expects a report in this investigation by March 1, 2010.
We will continue to monitor action on these bills and by the Conference Committee and will keep you informed of any new developments and their impact on animal welfare.
For more information, please contact Dr. Angela Demaree.
AVMA Releases Response to Pew Report
By Dr. Ashley Shelton, Assistant Director of the GRD
Last month, The AVMA released its response to the Final Report of the Pew Commission on Industrial Farm Animal Production. Pew's widely publicized findings and recommendations are being used to advocate for the passage of H.R. 1549 and S. 619, the Preservation of Antibiotics for Medical Treatment Act (PAMTA), which the AVMA does not support. Veterinarians are the only health professionals that routinely operate at the interface of human and animal health and are already limited in the tools available to protect human and animal health.
In reviewing the April 2008 Pew Report, the AVMA identified points addressing antimicrobial resistance, the environment and animal welfare as the most pertinent to veterinary medicine. While the Association believes there is value in some of the recommendations offered by the Pew Commission, the Commission's sub-points have significant shortfalls and lack in comprehensive idea development or in how the Commission would execute a new plan or program.
In addition, the AVMA contends that the Pew Commission's process for gaining technical expertise in the technical reports was biased and did not incorporate the findings and suggestions of a significant number of participating subject matter experts. Readers of the Pew Report should be cautioned that disparities were found within the report, potentially due to the lack of incorporation of differing interpretations and conclusions offered by subject matter experts. While the Pew Commission criticizes the AVMA for not being "consensus-oriented," our policies are developed based upon impartial, scientifically sound evidence, rather than the consensus of like-minded individuals.
The AVMA hopes that the response will offer thoughtful insight into what we, as veterinarians, assert are critical research and programmatic needs as next steps in promoting the optimal health and welfare of our nation's animals and people. We encourage you to read the full response and accompanying multimedia materials, including podcasts and a video, at www.avma.org/PEWresponse.
For more information, please contact Dr. Ashley Shelton.
Animal Carcass Risk in Disasters Discussed at Symposium
By Dr. Kristi Henderson, Assistant Director of the Scientific Activities Division
Animal Carcass Risk in Natural Disasters is a new AVMA policy that was initiated and developed by the AVMA's Committee on Disaster and Emergency Issues (CDEI) in efforts to dispel public misconceptions concerning the carcasses of animals that have died from injuries, such as those suffered during natural disasters. In April, the Executive Board approved and enacted the new policy, which supports the world public health community's position.
Referenced by the policy is the Pan American Health Organization's Manual on Management of Dead Bodies in Disaster Situations. The manual is considered to be the definitive resource document on this subject by the world public health community, including the World Health Organization and U. S. Centers for Disease Control and Prevention.
The new AVMA policy states:
"Consistent with current scientific literature and the conclusions of the Pan American Health Organization (PAHO), the AVMA recognizes that animals that die from injuries, including massive animal deaths in cases of natural disasters, generally do not represent a health hazard for humans. The presence of dead bodies that result from a disaster, without the presence of another risk factor, is not the cause for the spread of infectious diseases."
(1PAHO Manual, Ch 3, Conclusions; p. 81)
Captain Stephanie Ostrowski, U. S. Centers for Disease Control veterinarian and CDEI member, presented "Why Public Health Officials Need to Understand Carcass Disposal Issues and Options" at the 3rd International Symposium on Management of Animal Carcasses, Tissues, and Related Byproducts, which was held at UC Davis in July. The speech highlighted the crucial need for accurate understanding of human health risks posed by animal carcasses and that inaccurate determinations can and have lead to inappropriate resource assignment, prioritization, and coordination, often in the face of limited resources.
Do you have expertise to offer for AVMA consideration? Send your feedback to the Scientific Activities Division at
ScientificIssues.
GRD Externships Application Deadline October 2
The AVMA is currently accepting applications for ten 2010 Governmental Relations Externships. The deadline for submission is October 2. In just four weeks as an Extern, you'll go from being a bright-eyed visitor to our nation's capital to actually lobbying for your future profession with legislators and staffers on Capitol Hill. For more information and an application, click here.
Join us on Facebook
Join the hundreds of supporters of the Congressional Advocacy Network (AVMA-CAN) – including hundreds of people not affiliated with the veterinary profession – on the popular social networking site Facebook! The AVMA-CAN Facebook page is open to all Facebook users, so we encourage you, your family and friends to join our group to help advance the profession of veterinary medicine. Find AVMA-CAN's Facebook page here.
Back to Business
Members of Congress have been as busy as bees over the past month, trying to drum up support for their respective positions on healthcare reform. I'm sure you've seen all of the impassioned town hall meetings on TV, so we'll spare you the details other than to say that things are definitely getting hot around the nation.
But just as the issues are heating up, the weather is finally starting to cool in our nation's capital as Congress returns from its long summer recess. Congress returned on Tuesday and got back to business. There are so many issues on the table that could take center stage in the next few months that we are looking forward to an exciting autumn.
But it's not always fiery excitement around here. Sometimes we have to get take a moment to slow down and reflect. Two weeks ago, we all paused and mourned the passing of Senator Edward Kennedy. Senator Kennedy was a known lover of animals, and we were happy to have worked with him on several issues. We didn't always agree with Senator Kennedy on every issue, but the AVMA was always treated with respect and our positions with serious consideration. We will miss this American legend.
That's all for this month... now that Labor Day is behind us and all the Members of Congress are back in town, we're looking forward to giving you your fill of DC Scoop in the months ahead. Stay tuned!
Legislative Update
| Issue |
Description |
AVMA Position |
Status |
GRD Comments |
| National Veteriunary Medical Service Act |
Funding |
Active Pursuit |
FY 2010 Presidents Budget: $3M
FY 2010 House Ag ppropriations Bill: $4M
FY 2010 Senate Ag Appropriations Bill: $5M
Conference Committee: Fall 2009 |
Working to get Senate amount ($5M) in the final bill |
| Food Animal Residue Avoidance Databank |
Funding |
Active Pursuit |
FY 2010 Presidents Budget: $0M
FY 2010 House Ag Appropriations Bill: $806,000
FY 2010 Senate Ag Appropriations Bill: $1M
Conference Committee: Fall 2009 |
Working to get Senate amount ($1M) in the final bill |
| National Research Support Project-7 (NRSP-7) |
Seeking authorizing language and appropriations for NRSP-7 |
Active Pursuit |
FY 2010 House Ag Appropriations Bill: $429,000
FY 2010 Senate Ag Appropriations Bill: $0
Conference Committee: Fall 2009 |
Working to get House amount ($429,000) in the final bill |
| HR 503/S. 727 The Prevention of Equine Cruelty Act |
Prohibit the shipping, transporting, moving, delivering, receiving, possessing, purchasing, selling, or donation of horses and other equines to be slaughtered for human consumption. |
Active Pursuit of Defeat |
In Committee |
|
| H.R. 305 The Horse Transportation Safety Act |
Prohibit the transportation of horses in interstate transportation in a motor vehicle containing 2 or more levels stacked on top of one another. |
Active Pursuit of Passage |
In Committee |
|
| Equity in Federal Veterinary Pay |
Improve compensation for federal veterinarians |
Active Pursuit |
2/26/09 Hearing. Senate Subcommittee on
Oversight of Government Management, the Federal Workforce,
and the District of Columbia;
Working with Congress, agencies and the Office of Personel Management to resolve the issue
|
AVMA is working closely with the National Association of Federal Veterinarians to improve federal veterinary pay |
| H.R. 1549/S. 619 Preservation of Antibiotics for Medical Treatment Act |
Phases out use of certain antibiotics for nontherapeutic purposes in food-producing animals. |
Active Pursuit of Defeat |
H.R. 1549 7/13/09 Rules Committee Hearing S. 619 In Committee |
Possible amendment for Healthcare Reform bill or Food Safety bill |
| Pet Insurance as an Eligible Benefit for Treatment under Section 125 of the IRS Code |
Seeking to add pet health insurance as a voluntary benefit inder section 125 of the IRS Code (cafeteria plan) |
Active Pursuit |
Forming coalition (Pet Health Consortium) to support introduction and passage of legislation |
First consortium meeting: September 2009; Fall 2009 seeking sponsor of potential legislation in the House and Senate |
| H.R. 2345 Exemption of Health Care Practices from Red Flags Rule |
Exempt health care practices with 20 or fewer employees from having to comply with the Red Flags Rule. |
Active Pursuit of Passage |
In Committee |
FTC delayed implementation of Red Flags Rule until November 1, 2009 |
| H.R. 2460/S. 1152 Healthy Families Act |
Require employers with 15 or more employees to provide up to seven days of annual paid sick leave for full-time and part-time workers to take care of themselves, family members or anyone else whose close association with the employees is the equivalent of a family relationship. |
Active Pursuit of Defeat |
In Committee |
|
| H.R. 3519 Veterinarian Services Investment Act |
Authorizes a new grant program to advance unique and innovative state-level veterinary workforce programs. |
Active Pursuit of Passage |
In Committee |
Expecting introduction of Senate version in late September |
| Veterinary Medicine Loan Repayment Program (NVMSA) Tax Exemption |
Seeking legislation to amend Section 108 of the Internal Revenue Code of 1986 to exempt loan repayments under the Veterinary Medicine Loan Repayment Program |
Active Pursuit |
|
Seeking Congressional Champion |
| Veterinary Medicine Loan Repayment Program (NVMSA) Implementation |
USDA implementation of loan repayment program |
Active Pursuit |
7/9/09 Interim Final Rule published; 9/8/09 Stakeholder comments on Interim Final Rule due to USDA; September 2009 (expected) Federal Register Notice published to determine shortage situations. |
AVMA working with AAVMC to provide comments on Interim Final Rule |
| H.R. 2999 Veterinary Public Health Workforce and Education Act |
Amends the United States Public Health Service Act to enhance and increase the number of veterinarians trained in veterinary public health |
Active Pursuit of Passage |
In Committee |
|
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