The 111th Congress Winds Down
The imminent final adjournment of the 111th Congress will mark the end of a remarkable period of legislative history distinguished by the infusion of economic stimulus funds into the federal budget, the passage of broad health care reform, and tobacco regulation, among other actions.
The 111th Congress convened for the first of its two year-long sessions on January 6, 2009, amid an economic recession and a relatively flat annual appropriations trend for NCI. Among the first laws enacted by this Congress was the American Recovery and Reinvestment Act of 2009 (ARRA; P.L. 111-5, signed into law on February 17, 2009), an economic stimulus package that injected $10 billion into the NIH budget, yielding NCI $1.3 billion to be used over fiscal years 2009 and 2010 for high-impact projects that could be completed within 2 years. ARRA also channeled $1.1 billion to the Department of Health and Human Services to be used for comparative effectiveness research (CER) and authorized a Federal Coordinating Council for CER.
Congressional negotiations on the ARRA legislation unfolded simultaneously with the regular appropriations process for fiscal year 2009. The Fiscal Year Omnibus Appropriations Act (P.L. 111-8, signed into law on March 11, 2009) included an appropriation of $4.97 billion for NCI, representing a modest increase of 2.8 percent over the prior year’s funding. Fiscal year 2010 appropriations were included in the Consolidated Appropriations Act, 2010 (P.L.111-117, became law on December 16, 2009), which provided $5.10 billion to support NCI’s programs.
In the Wake of Reform
Health care reform was one of the most important agenda items for the 111th Congress, and on March 23, 2010, President Obama signed the Patient Protection and Affordable Care Act into law. This broad, landmark legislation incorporated, among its numerous provisions, several separate bills of particular interest to the cancer research community.
For example, the Cures Acceleration Network (CAN) Act, originally championed by Senator Arlen Specter, was incorporated into the enacted law. CAN’s provisions establish a new program at NIH and empower the NIH Director to use a variety of innovative funding mechanisms to support research that bridges the gap between laboratory discoveries and tangible benefits for patients and to rapidly develop “high-need cures.” The law authorized the expenditure of $500 million for the first year; however, according to the law, CAN cannot be launched without a corresponding appropriation specifically targeted to the program. (The Senate version of the bill covering appropriations for NCI for fiscal year 2011 includes $50 million for CAN; the House has not yet introduced its version.)
Additional bills folded into the measure included the Access to Cancer Clinical Trials Act, which prohibits health insurers from denying an individual access to an “approved” clinical trial (including those funded by NIH) and requires coverage for routine patient care costs. Also included was the EARLY Act (Breast Cancer Education and Awareness Requires Learning Young), originally introduced by Representative Debbie Wasserman Schultz and Senator Amy Klobuchar, which directs NIH to fund research to develop and validate novel screening tests and methods for prevention and early detection of breast cancer in young women.
Several comparative effectiveness research provisions found their way into the health care reform legislation, as well. The law established a private nonprofit Patient Centered Outcomes Research Institute (PCORI), run by a 21-member Board of Governors, to advance and fund comparative clinical effectiveness research.
Additional Measures and Efforts
Tobacco regulation was another hot issue for the 111th Congress, as evidenced by the passage of two important tobacco bills. The Family Smoking Prevention and Tobacco Control Act (P.L. 111-31), which became law in June 2009, provided the FDA the authority to regulate tobacco products and to establish the new Center for Tobacco Products. Like many legislative measures, this bill was introduced and debated in multiple Congresses; similar legislation was introduced in March 2000 during the 106th Congress and in each subsequent Congress, eventually gaining enough traction in the current Congress to become law.
The Prevent All Cigarette Trafficking Act of 2009 (P.L. 111-154), which passed in March 2010, was designed to prevent tobacco smuggling to ensure the collection of all tobacco-related taxes and included smokeless tobacco as a regulated substance.
This Congress considered, but has not yet passed, a number of bills that were of special interest to NCI and the cancer research community. It is likely that, if these bills fail to pass in the current Congress, similar legislative measures will be re-introduced and considered in the 112th Congress.
The most high-profile of these measures was the 21st Century Cancer Access to Life-Saving Early Detection, Research and Treatment (ALERT) Act, introduced in the Senate by Senator Edward Kennedy in March 2009 and, in the House, by Representative Lois Capps. Provisions of this bill included a reauthorization of NCI and a requirement for NCI to develop a budget for the entire National Cancer Program for submission to the National Cancer Advisory Board, the President, and Congressional appropriators. The bill directs NCI to report annually on plans and progress regarding research on deadly cancers (defined as those cancers with less than 50 percent survival at 5 years), and cancers with less than 15 cases per 100,000 people or fewer than 40,000 new cases per year. The measure also requires NCI to establish an interconnected network of biorepositories and augment ongoing efforts to support the national collection of tissues for cancer research.
The 111th Congress also attempted to overhaul the Small Business Administration (SBA), which administers the Small Business Innovation Research (SBIR) and Small Business Technology Transfer (STTR) programs at NIH and 10 other participating federal agencies. The SBIR and STTR programs are currently authorized under a temporary extension through January 31, 2011. Congress has extended the SBA programs through several short-term authorization measures since 2008 because House and Senate lawmakers have been unable to forge an agreement. To maintain these programs, the 112th Congress will need to pass another temporary extension and begin negotiations anew.
The House Committee on Energy and Commerce, Subcommittee on Health, took a very active role in considering cancer legislation in this Congress. Most recently, the Subcommittee held a hearing on a series of health-related bills. The Bone Marrow Failure Disease Research and Treatment Act of 2009, the Pediatric Research Consortia Establishment Act, and the Reauthorization of Johanna’s Law were considered at the hearing, which preceded a committee bill mark-up. Before the last recess, the Energy and Commerce Committee referred these bills to the full House for a vote, and they were passed on September 30, 2010. The Senate has not acted on this collection of bills.
The 111th Congress returns to Washington this week to complete the current session before adjourning sine die. Prior to adjourning, this Congress must pass another stop-gap funding bill, or continuing resolution, to keep the federal government operating until fiscal year 2011 appropriations can be negotiated in the next Congress. The current continuing resolution expires on December 3, 2010. No date for the adjournment has been announced.
The 112th Congress will convene on January 3, 2011.
—Stacye Bruckbauer, Jeanette Contreras, and Priyanga Tuovinen
More information about NCI’s legislative activities can be found online.