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
Michael Catalini and Billy House
Michael Catalini Billy House
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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