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110th Congress Tackles Mental Health, Genetic Data Privacy

HealthDay News -- While failing to advance the expansion of children's health insurance, the 110th Congress nevertheless took significant action on a number of health policy issues.

The enactment of a mental health parity law is one of the most important measures to emerge from Capitol Hill, health policy experts noted.

"I think thats incredibly important based on the research we've done at RAND that shows the consequences of limited access to mental healthcare," said Dr. Robert H. Brook, vice president of RAND Corp. and director of the research organization's health unit.

House and Senate lawmakers also passed the Genetic Information Nondiscrimination Act, which prohibits employers and health insurers from discriminating against individuals based on their genetic information. An insurer, for example, may not raise insurance premiums or deny coverage because of a person's genetic profile. "The traditional fear was that your DNA is the ultimate preexisting condition," said John Ford, counsel in the Washington, D.C., office of Sidley Austin LLP and former senior Democratic Health Counsel of the House Energy and Commerce Committee.

Both laws were supported by the American College of Physicians.

Another highlight was the adoption of the Food and Drug Administration Amendments Act of 2007, a measure that significantly raises drug safety oversight.

While it's not certain what the 111th Congress may take up, there may be clues in the next President's fiscal year 2010 budget. "Early each year, the budget is an occasion for an administration to state comprehensively "Here's what we want to spend money on," Ford explained.

One possibility is the State Children's Health Insurance Program, or SCHIP, whose funding is set to expire in March 2009.

"I would say it's unlikely that they would let the program lapse," said Robin Rudowitz, principal policy analyst on Medicaid issues for the Kaiser Commission on Medicaid and the Uninsured in Washington. "I think the program has enjoyed bipartisan support and has been very successful in covering kids who dont qualify for Medicaid and whose families can't afford private insurance."

The future of Medicare physician reimbursement also hangs in the balance. While the last Congress replaced a scheduled 10.6% cut with a 0.5% update through 2008 and mandated a 1.1% increase for 2009, the new Congress will face significant pressure to revamp or replace the "sustainable growth rate" factor upon which annual fee levels are determined.

Pay for primary-care physicians may also become part of the broader healthcare reform debate to help correct an imbalance between generalists and specialists. "Congress needs to address this; otherwise there's going to be actually nobody to provide the kind of comprehensive care that we seem to want in this country," Brook said.

However, he noted that the nation's economic woes remain a real wild card in the debate over expanding access to health insurance and improving healthcare delivery.

"Before all of this really happened, I was hoping that we would keep healthcare change on the agenda for the next 40 years regardless of who got elected and that it would be an issue that people would deal with," he said. "Now if you look at what's happening, I just wonder whether anything could be on the agenda other than just trying to maintain the lid on costs."

November 6 2008
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