Congress Shows the Art of the Possible Is Still in Vogue

WASHINGTON, DC - OCTOBER 11: U.S. Sen. Lamar Alexander (R-TN) speaks to members of the media at the Capitol October 11, 2013 on Capitol Hill in Washington, DC. On the 11th day of a U.S. Government shutdown, President Barack Obama spoke with Speaker Boehner on the phone and they agreed that they should keep talking.
National Journal
Billy House and Michael Catalini
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Billy House Michael Catalini
Nov. 18, 2013, 4:37 p.m.

Con­gress this week seems to be en­joy­ing a little bi­par­tis­an calm be­fore the par­tis­an fisc­al storm ex­pec­ted after the Thanks­giv­ing break.

The pre­hol­i­day tone was set Monday with Sen­ate pas­sage of two health-re­lated bills, in­clud­ing one to strengthen safety stand­ards for drug-com­pound­ing phar­ma­cies. The meas­ure — which already had broad sup­port in the House — garnered 97 votes and eas­ily sur­vived a delay­ing tac­tic by Sen. Dav­id Vit­ter, R-La., who sought a vote on his Obama­care amend­ment.

“This is ex­actly how the Sen­ate is sup­posed to work, and when it works best it works this way,” said Sen. Lamar Al­ex­an­der, R-Tenn., rank­ing mem­ber of the Health, Edu­ca­tion, Labor, and Pen­sions Com­mit­tee, which worked for months on the le­gis­la­tion. “Of­ten the most com­plex bills pass as this one did by un­an­im­ous con­sent be­cause we’ve been te­di­ous and la­bor­i­ous and we’ve gone through the whole pro­cess.”

Amid a bri­ar patch of polit­ic­ally thorny is­sues, from the budget and the debt to health care re­form, Con­gress these days finds it nearly im­possible to pass what was once routine le­gis­la­tion. So far this year just 49 laws have been en­acted, most of them fairly non­con­tro­ver­sial.

Pas­sage of the phar­ma­ceut­ic­al bill was partly spurred by a tragedy last year when a com­pound­ing fa­cil­ity in Mas­sachu­setts dis­trib­uted a deadly mix­ture of ster­oid in­jec­tions that caused a na­tion­wide out­break of fungal men­ingit­is and led to 64 deaths.

“Ob­vi­ously one ele­ment of the story is you had tragedy and you had real na­tion­al con­cern about it,” said Sen. Robert Ca­sey, D-Pa., who is also a mem­ber of the HELP Com­mit­tee. “I think that adds ur­gency that you some­times don’t have, even with a bill that has sub­stant­ive bi­par­tis­an sup­port.”

The bill was backed by the U.S. Cham­ber of Com­merce, the Amer­ic­an So­ci­ety of Health-Sys­tem Phar­macists, and the Fed­er­a­tion of Amer­ic­an Hos­pit­als, among about two dozen oth­er out­side or­gan­iz­a­tions. “Whenev­er you can get a lot of those groups on the same page, or close, that ob­vi­ously helps a lot,” Ca­sey said.

Ad­ded Al­ex­an­der: “It al­ways makes a dif­fer­ence if people in the coun­try op­pose or sup­port an im­port­ant piece of le­gis­la­tion.”

The oth­er health bill passed Monday by un­an­im­ous con­sent would reau­thor­ize a glob­al AIDS re­lief pro­gram star­ted in 2003 un­der former Pres­id­ent George W. Bush. Re­pub­lic­an lead­ers in the House have already put the bill on the sus­pen­sion cal­en­dar for this week, mean­ing two-thirds ma­jor­ity sup­port will be re­quired for it to pass — re­flect­ing the ex­pect­a­tion that it will face little op­pos­i­tion.

This would be the second five-year au­thor­iz­a­tion of the pro­gram since it was first en­acted at a time when HIV/AIDS threatened bil­lions of people around the plan­et. The 2008 ver­sion au­thor­ized the pro­gram for an­oth­er five years at $48 bil­lion, and it re­ceived strong bi­par­tis­an sup­port that year as well.

This year’s bill does not in­clude a spe­cif­ic au­thor­iz­a­tion num­ber, nor does it in­clude sums on fund­ing levels for spe­cif­ic pro­grams. That leaves the levels func­tion­ally the same, ac­cord­ing to con­gres­sion­al aides.

Ac­cord­ing to a memo on the bill pre­pared for law­makers, the pro­gram now known as the Pres­id­ent’s Emer­gency Plan for AIDS Re­lief (PEP­FAR) re­mains the largest com­mit­ment by any na­tion to com­bat a single dis­ease in­ter­na­tion­ally.

Un­der the pro­gram, nearly 6 mil­lion people are now re­ceiv­ing life-sus­tain­ing an­ti­ret­ro­vir­al treat­ment. The staff memo also states that more than 11 mil­lion preg­nant wo­men re­ceived HIV test­ing and coun­sel­ing last year while the one-mil­lionth baby was born HIV-free this year as a res­ult of treat­ment through the pro­gram.

PEP­FAR has provided care and sup­port to nearly 15 mil­lion people, in­clud­ing more than 4.5 mil­lion orphans and vul­ner­able chil­dren, the memo states.

Next up in the Sen­ate is the an­nu­al de­fense au­thor­iz­a­tion bill, an­oth­er meas­ure with bi­par­tis­an back­ing — if both sides can agree on the amend­ments that will be con­sidered. Sen­ate Armed Ser­vices Com­mit­tee Chair­man Carl Lev­in, D-Mich., said Monday even­ing he was wor­ried about wheth­er the Sen­ate will be able to have a fi­nal vote on the bill be­fore the Thanks­giv­ing break if the amend­ment pro­cess gets bogged down.

In any case, after the re­cess, tem­per­at­ures are cer­tain to rise in the Cap­it­ol, as a con­fer­ence com­mit­tee on the budget nears the dead­line for mak­ing re­com­mend­a­tions on a spend­ing plan for 2014 and, if pos­sible, bey­ond.

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