ORGAN ALLOCATION: Lott’s 90-day Delay Passes the House
Although the new organ allocation rules hashed out last week were set to take place this January, a last minute maneuver by Republican Sens. Trent Lott (R-MS) and Don Nickles (R-OK) to extend the delay by 90 days was approved by the House 418-2, the Pittsburgh Post-Gazette reports. Late Wednesday, Lott and Nickles slipped the delay extension into a popular bill that extends research and development tax credits by five years and permits the disabled to keep their health care benefits after returning to work. The previous deal worked out among White House budget chief Jack Lew, Sen. Arlen Specter (R-PA), House Appropriations Committee Chair Bill Young (R-FL), Rep. David Obey (D-WI) and HHS Secretary Donna Shalala enacted the rules after 42 days. And because the House actually voted for both measures, House Commerce Committee Chair Tom Bliley (R-VA) said that whichever bill President Clinton signs last becomes law. Bliley, whose Virginia district includes UNOS, which opposes the deal, said the 42-day measure would be sent first and because it's attached to the appropriations bill, Clinton would have to sign it quickly or shut down the government. The 90-day delay would be sent later and if signed, would become the law. The Post-Gazette reports that Clinton "would not be expected to veto such a popular measure" (McFeatters/Torry, 11/19).
The AP/Philadelphia Inquirer reports that the delay could hold up the rules for at least three months and ensures that Congress will have time to return next year to pass pending legislation that would strip HHS of its power to set organ allocation rules in the first place (Meckler, 11/19). Nickles confirmed that strategy, adding that 44 senators had signed a letter opposing the new regulations. He said, "I don't think the secretary (Shalala) should be legislating. I have a little trouble when I see the administration exerting or assuming legislative authority that they don't have" (Pittsburgh Post-Gazette, 11/19). Bliley cheered the 90-day delay, saying, "The administration's proposed rules on organ transplants are misguided. Patients should not have to deteriorate to the brink of death before being eligible for transplants" (AP/Richmond Times-Dispatch, 11/19). Rep. Rick Lazio (R-NY) who sponsored the disability bill, said that he approved the new organ language. He added that the new delay "gives the committees an opportunity to go out and revisit the situation" (Rovner, CongressDaily, 11/18).
Specter said he was "frankly madder than hell" that the 42-day "ironclad" agreement had been derailed. Specter wrote a letter to Lott, saying, "I do not want to join the chorus of members who make threats to tie up the legislative process, but enough is enough." Lew also expressed his disappointment, saying, "I personally think it's outrageous that there's any change in the policy. I'm of the view that a deal is a deal, and we had a deal. ... We think that lives are on the line." Lew added that the administration is "determined to continue to pursue the organ policy." Sen. Edward Kennedy (D-MA) also entered the fray, arguing that the 90-day delay would "put the lives of tens of thousands of desperately ill people at risk, and it violates basically the fundamental fairness of the bargaining process" (Pittsburgh Post-Gazette, 11/19). He called Lott's amendment "a poison pill ... that does not belong in there" (CongressDaily, 11/18). HHS spokesperson Campbell Gardett said, "We think it is wrong to break a deal that was honorably reached. And it is wrong to force a choice between insurance for disabled people and organs for dying people." Charlie Fiske, director of the National Transplant Action Committee, blasted Lott, saying, "I hope Senator Lott can explain that to patients who get caught in their quagmire" (AP/Philadelphia Inquirer, 11/19).
Cheers in Wisconsin
In Wisconsin -- "the leader in organ donations" -- Gov. Tommy Thompson (R) and organ transplant officials rejoiced in the 90- day delay. Thompson's spokesperson Darrin Schmitz said, "Obviously, the reprieve is a step in the right direction. But the bottom line remains that Wisconsin has one of the best organ donor procurement and transplant systems in America. The governor will do all he can to protect it to benefit the people of Wisconsin." Thompson had lobbied Lott earlier this week to protest the rule change (Jones, Milwaukee Journal Sentinel, 11/18).
AHCPR Moving Forward
CongressDaily reports that because the 90-day delay has passed, the legislation reauthorizing the Agency for Health Care Policy and Research and providing federal aid for teaching expenses in children's hospitals, should also move forward. Bliley had been blocking that legislation to force action on the organ issue, but said yesterday that the AHCPR bill "will be on the floor today, assuming we can finish milking the cows" (11/18).