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California lawmakers propose health coverage for immigrants

California, flush with cash from an expanding economy, would eventually spend $1 billion a year to provide health care to immigrants living in the state illegally under a proposal announced Wednesday by Democratic lawmakers.

The proposal would eliminate legal residency requirements in California’s Medicaid program, known as Medi-Cal, as the state has already done for young people up to age 19.

It’s part of $4.3 billion in new spending proposed by Assemblyman Phil Ting, a San Francisco Democrat who leads the budget committee. Assembly Democrats also want to expand a tax credit for the working poor, boost preschool and child care, and increase college scholarships to reduce reliance on student loans.

They also would commit $3.2 billion more than required to state budget reserves.

The proposal marks the Assembly’s opening volley in six months of budget negotiations with the Senate and Democratic Gov. Jerry Brown, who has been reluctant to commit to new ongoing spending on social services.

California has significantly reduced its rate of uninsured people since former President Barack Obama’s health care law took effect, but about 7 percent of residents still lack coverage. Many are people living in the country illegally, who are ineligible for U.S.-funded health care assistance.

While federal funds cover at least half — and as much 95 percent — of the cost for citizens and legal U.S. residents on Medi-Cal, the state would have to pick up the cost on its own for people living here illegally.

Expanding access to health care has been a contentious issue for California lawmakers, who targeted last year by protests from liberal activists who want the Legislature to provide state-funded coverage to everyone, regardless of immigration status.

A measure promoting that principle was sidelined when Assembly Speaker Anthony Rendon said it lacked specifics, including a plan for the $400 billion it would cost.

The Assembly’s latest proposal is narrower, only extending the state Medicaid program to all low-income adults.

Brown, who is often more conservative in his own revenue forecast, will release his budget proposal next month.

H.D. Palmer, spokesman for the Department of Finance, said Brown wants to boost state reserves and avoid committing to unsustainable spending.

“We want to be able to provide as much budgetary protection as we can to protect or insulate the state from the potential effects of a downturn in the state’s fiscal fortunes,” Palmer said.

Ting, the head of the Assembly budget committee, said lawmakers were exploring ways to restructure the state tax code if Congress approves a proposed U.S. tax overhaul. California leaders have warned that the measure could harm taxpayers by restricting a federal deduction for state and local taxes, which is especially lucrative in high-tax states like California.

“I’m very concerned that this tax cut is a tax increase for middle-class and working-class Californians,” Ting said. “So we are looking at ways that we can help mitigate that.”

California lawmakers propose health coverage for immigrants

California, flush with cash from an expanding economy, would eventually spend $1 billion a year to provide health care to immigrants living in the state illegally under a proposal announced Wednesday by Democratic lawmakers.

The proposal would eliminate legal residency requirements in California’s Medicaid program, known as Medi-Cal, as the state has already done for young people up to age 19.

It’s part of $4.3 billion in new spending proposed by Assemblyman Phil Ting, a San Francisco Democrat who leads the budget committee. Assembly Democrats also want to expand a tax credit for the working poor, boost preschool and child care, and increase college scholarships to reduce reliance on student loans.

They also would commit $3.2 billion more than required to state budget reserves.

The proposal marks the Assembly’s opening volley in six months of budget negotiations with the Senate and Democratic Gov. Jerry Brown, who has been reluctant to commit to new ongoing spending on social services.

California has significantly reduced its rate of uninsured people since former President Barack Obama’s health care law took effect, but about 7 percent of residents still lack coverage. Many are people living in the country illegally, who are ineligible for U.S.-funded health care assistance.

While federal funds cover at least half — and as much 95 percent — of the cost for citizens and legal U.S. residents on Medi-Cal, the state would have to pick up the cost on its own for people living here illegally.

Expanding access to health care has been a contentious issue for California lawmakers, who targeted last year by protests from liberal activists who want the Legislature to provide state-funded coverage to everyone, regardless of immigration status.

A measure promoting that principle was sidelined when Assembly Speaker Anthony Rendon said it lacked specifics, including a plan for the $400 billion it would cost.

The Assembly’s latest proposal is narrower, only extending the state Medicaid program to all low-income adults.

Brown, who is often more conservative in his own revenue forecast, will release his budget proposal next month.

H.D. Palmer, spokesman for the Department of Finance, said Brown wants to boost state reserves and avoid committing to unsustainable spending.

“We want to be able to provide as much budgetary protection as we can to protect or insulate the state from the potential effects of a downturn in the state’s fiscal fortunes,” Palmer said.

Ting, the head of the Assembly budget committee, said lawmakers were exploring ways to restructure the state tax code if Congress approves a proposed U.S. tax overhaul. California leaders have warned that the measure could harm taxpayers by restricting a federal deduction for state and local taxes, which is especially lucrative in high-tax states like California.

“I’m very concerned that this tax cut is a tax increase for middle-class and working-class Californians,” Ting said. “So we are looking at ways that we can help mitigate that.”

Georgia lawmakers propose tax breaks and fast internet for rural areas

A powerful group of state lawmakers approved sweeping proposals Wednesday designed to encourage people and businesses to move to rural Georgia.

The group voted unanimously to support income tax breaks worth up to $6,000 a year, high-speed internet lines in unconnected areas and better health care access.

The recommendations of the Georgia House of Representatives Rural Development Council could become a reality if enacted by the state Legislature next year. House Speaker David Ralston, R-Blue Ridge, said the council’s initiatives are a high priority as lawmakers try to bolster far-reaching stretches of the state.


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98eb3_newsEngin.20680593_12-13-17-rural-council-1 Georgia lawmakers propose tax breaks and fast internet for rural areas
The Atlanta Journal-Constitution

98eb3_newsEngin.20680593_12-13-17-rural-council-1 Georgia lawmakers propose tax breaks and fast internet for rural areas
The Atlanta Journal-Constitution


The Georgia House of Representatives Rural Development Council unanimously approved suggestions meant to boost the economy in rural areas during a … read more

The efforts are focused on counties losing population and jobs to cities, leaving behind areas with few prospects for economic growth. Of Georgia’s 159 counties, 124 of them had less than 5 percent population growth for five straight years.

“The problems of rural Georgia won’t wait. We’ve got to get to work on them,” Ralston said after addressing the council at Georgia’s Old Capitol Building in Milledgeville, where the Legislature was located until moving to Atlanta in 1868.



The ambitious effort is meant to upgrade the state’s sparsely populated regions so that more jobs will be available, reducing the economic need for locals to move to cities. To encourage businesses to relocate to rural areas, lawmakers say they intend to improve internet service, education and health.

Among the council’s recommendations:

  • An income tax deduction worth up to $3,000 a year for anyone who moves to a rural area. The tax break would double in counties that also give real estate property tax discounts for new residents. The group did not say how much it might cost the state.
  • State funding for internet companies to offer high-speed service in underserved areas. About 16 percent of Georgians lack access to broadband internet.
  • Establishment of a Center for Rural Prosperity and Innovations, possibly at Abraham Baldwin Agricultural College in Tifton, to assist communities in recruiting businesses and identifying growth areas.
  • Elimination of the state’s Certificate of Need regulation for hospitals in populated areas with many health care options, while keeping rules in effect for rural areas, where hospitals are struggling to survive. That would do nothing new for rural hospitals because they already are covered by the state’s CON law, the regulation that restricts private companies’ ability to cherry-pick the profitable functions of hospitals.

The costs of these proposals won’t be made clear until specific bills are introduced and evaluated.

Issues such as the Certificate of Need proposal could be contentious during the 2018 session of the Georgia General Assembly, which starts Jan. 8.

“It’s time we look at things that we’ve left alone and not touched it for a number of years,” said state Rep. Terry England, R-Auburn, a co-chairman of the council. “We realize there’s a need in the state to protect our rural hospitals, but at the same time that’s become extremely burdensome to some other parts of the state.”

The council recommended several ways to extend high-speed internet access to rural areas.

The state could establish a “reverse auction” among internet providers, who would submit bids for how much they could pay to provide service to an area, with taxpayers making up the difference between what the highest bidding company could afford and what internet lines actually cost. Other broadband efforts include standardized fees charged by power companies for internet providers to attach to their poles and a consistent telecommunications tax rate for all providers of the same service, including satellite providers.

High-speed internet is a critical step toward growth in rural areas because without it, businesses and residents might move elsewhere, said state Rep. Patty Bentley, D-Butler.

“You need access to broadband to make all of it work,” Bentley said. “Having access to internet is very critical to attracting industry into your communities.”

None of the proposals are set in stone, and they could be changed through the legislative process.

But the recommendations issued Wednesday are a starting point, and Ralston asked the council’s 26 members to act as ambassadors to build support for the efforts among their colleagues.

Alone, none of the initiatives will make a significant difference in the quality of life in rural Georgia, said state Rep. Jay Powell, a co-chairman of the council. But together, the combination of a professional workforce, fast internet and health care access would create the conditions for business growth, he said.

Powell, who is chairman of the tax-writing House Ways and Means Committee, said the income tax breaks come in the form of deductions that would mostly help people with higher incomes such as doctors and business owners, but they’re the type of leaders that struggling communities need.

“You’re talking about people who are going to be providing services, paying sales taxes, buying property and investing in the community,” said Powell, R-Camilla. “I would think the rural broadband would not be controversial. Giving tax credits for folks to move to a location might be.”



Grand jury looks into Health Department mismanagement as lawmakers widen probe

The state’s multicounty grand jury is looking into allegations of financial mismanagement at the Oklahoma State Department of Health as top officers continue to resign or get forced out in the wake of the agency’s sudden cash crunch.

Officials with Attorney General Mike Hunter’s office, which convenes the multicounty grand jury, declined to comment Thursday. The health department’s chief financial officer, Mike Romero, and its new general counsel, Julie Ezell, were seen leaving the attorney general’s office around lunchtime. Both declined to comment.

The multicounty grand jury recessed until January after its foreman gave a brief update to District Judge Thomas E. Prince at the Oklahoma County courthouse.

Meanwhile, a bipartisan House committee formed to investigate the health department and other agencies will begin meeting Dec. 18. Rep. Josh Cockroft, R-Wanette, the committee’s chairman, sent wide-ranging subpoenas Thursday to top budget officials and aides to Gov. Mary Fallin.

Cockroft said the House committee investigation was not criminal in nature. But he noted the House has broad authority under the state Constitution and House rules to subpoena witnesses, compel testimony and produce evidence.

The committee sent subpoenas to Preston Doerflinger, Fallin’s finance secretary and interim commissioner of the health department; Denise Northrup, acting director of the Office of Management and Enterprise Services; and Chris Benge, Fallin’s chief of staff.

“The committee will focus its investigation into the finances, state appropriations and other financial resources of the Department of Health and how they were managed,” Cockroft said in a news release. “The scope of the committee’s investigation could expand to other agencies.”

In a statement, Gov. Mary Fallin said her office is reviewing the subpoenas but wants to make sure any responses won’t interfere with other investigations and audits by Hunter and State Auditor and Inspector Gary Jones. She said legislative leaders have continued to be briefed about the issues with the health department.

The multiple investigations come as top leaders continue to resign or be forced out at the health department. Earlier this week, Chief Operating Officer Deborah Nichols resigned, and the agency’s human resources director, Jacqueline Pettit, was fired, a spokesman confirmed.

Their departures follow the resignations of former Commissioner Terry Cline, Senior Deputy Commissioner Julie Cox-Kain and Felesha Scanlan, a top lieutenant of Cox-Kain who was business planning director. Former general counsel Don Maisch and another top attorney, Patricia Cantrell, also left the agency. Meanwhile, Internal Auditor Jay Holland is on administrative leave.

Doerflinger earlier said mismanagement at the health department stretches back to 2011 and involved multiple funds being moved around to cover shortfalls and present a balanced budget to lawmakers and state budget officials.

Tobacco trust

contracts

Among other issues, auditors and investigators are looking at the way contracts were drawn up in 2011 that advanced a total of $8.5 million in health department funds to the Tobacco Settlement Endowment Trust. (In a 2000 statewide ballot initiative, voters gave the trust authority to use interest earnings from a national legal settlement with tobacco companies to go toward tobacco prevention, cancer research or health programs.) The health department contract with TSET in 2011 was for the Certified Healthy Communities and Schools grant programs, which require participants to develop healthy policies and strategies.

The contract arrangement to provide such a large amount of money up front is highly unusual in state finance, several officials familiar with contract arrangements told Oklahoma Watch. The first contract was signed in May 2011 and provided $3.5 million for the communities program. The contract was then amended in December 2011 to provide another $5 million for the schools program.

TSET officials referred questions about the contract to the health department but said the Certified Healthy program was passed by the Legislature in 2010. Since 2011, TSET has made $4.9 million in Certified Healthy grants to communities, schools and school districts.

“Criteria for the grant program was created in conjunction with OSDH,” TSET spokeswoman Julie Bisbee said in an email. “TSET promoted, staffed and administered the execution of the program, as TSET’s primary function as a state agency is to make grants to improve health.”

The three-year contract term expired at the end of 2013, but both the health department and TSET continued making grants and providing administrative support for the grant programs until the programs were suspended this year.

Tony Sellars, health department spokesman, conceded the contract was not properly monitored.

“The money was transferred pursuant to the terms of the original contract which called for a ‘pro-forma’ payment,” Sellars said in an email. “The originators of the contract are no longer with OSDH.”

Oklahoma Watch has requested additional financial information and emails regarding the expenditure of grant funds and the TSET contracts, but that information has not been provided, with health department officials saying documents are under legal review.

Health department cash crunch

The cash crisis at the health department reached a critical point in August as former leaders scrambled to find money to make up shortfalls in several internal accounts. Officials canceled recently renewed contracts for child abuse prevention programs and federally qualified health centers. They billed consolidated city-county health departments in Oklahoma and Tulsa counties new charges for sexually transmitted disease testing and medication costs. They also asked for and received about $3 million left in the account at TSET for the Certified Healthy Communities and Schools grant programs.

As it finished an eight-week special session to deal with other budget matters, the Legislature approved a $30 million supplemental appropriation to the health department so it could make its payroll, reimburse funds from restricted accounts and close out accounts from prior budget years. But lawmakers conditioned the emergency funding on a 15 percent cut in the agency’s appropriation for the 2019 fiscal year.

Furloughs are still in effect at the health department for employees making more than $35,000 per year, although a planned reduction in force has been put on hold. The agency has about 2,000 employees.

“The $30 million supplemental appropriation did not eliminate the need for additional actions,” Sellars said in an email Thursday. “No timetable has been established for those actions at this point.”

Grand jury looks into Health Department mismanagement as lawmakers widen probe

The state’s multicounty grand jury is looking into allegations of financial mismanagement at the Oklahoma State Department of Health as top officers continue to resign or get forced out in the wake of the agency’s sudden cash crunch.

Officials with Attorney General Mike Hunter’s office, which convenes the multicounty grand jury, declined to comment Thursday. The health department’s chief financial officer, Mike Romero, and its new general counsel, Julie Ezell, were seen leaving the attorney general’s office around lunchtime. Both declined to comment.

The multicounty grand jury recessed until January after its foreman gave a brief update to District Judge Thomas E. Prince at the Oklahoma County courthouse.

Meanwhile, a bipartisan House committee formed to investigate the health department and other agencies will begin meeting Dec. 18. Rep. Josh Cockroft, R-Wanette, the committee’s chairman, sent wide-ranging subpoenas Thursday to top budget officials and aides to Gov. Mary Fallin.

Cockroft said the House committee investigation was not criminal in nature. But he noted the House has broad authority under the state Constitution and House rules to subpoena witnesses, compel testimony and produce evidence.

The committee sent subpoenas to Preston Doerflinger, Fallin’s finance secretary and interim commissioner of the health department; Denise Northrup, acting director of the Office of Management and Enterprise Services; and Chris Benge, Fallin’s chief of staff.

“The committee will focus its investigation into the finances, state appropriations and other financial resources of the Department of Health and how they were managed,” Cockroft said in a news release. “The scope of the committee’s investigation could expand to other agencies.”

In a statement, Gov. Mary Fallin said her office is reviewing the subpoenas but wants to make sure any responses won’t interfere with other investigations and audits by Hunter and State Auditor and Inspector Gary Jones. She said legislative leaders have continued to be briefed about the issues with the health department.

The multiple investigations come as top leaders continue to resign or be forced out at the health department. Earlier this week, Chief Operating Officer Deborah Nichols resigned, and the agency’s human resources director, Jacqueline Pettit, was fired, a spokesman confirmed.

Their departures follow the resignations of former Commissioner Terry Cline, Senior Deputy Commissioner Julie Cox-Kain and Felesha Scanlan, a top lieutenant of Cox-Kain who was business planning director. Former general counsel Don Maisch and another top attorney, Patricia Cantrell, also left the agency. Meanwhile, Internal Auditor Jay Holland is on administrative leave.

Doerflinger earlier said mismanagement at the health department stretches back to 2011 and involved multiple funds being moved around to cover shortfalls and present a balanced budget to lawmakers and state budget officials.

Tobacco trust

contracts

Among other issues, auditors and investigators are looking at the way contracts were drawn up in 2011 that advanced a total of $8.5 million in health department funds to the Tobacco Settlement Endowment Trust. (In a 2000 statewide ballot initiative, voters gave the trust authority to use interest earnings from a national legal settlement with tobacco companies to go toward tobacco prevention, cancer research or health programs.) The health department contract with TSET in 2011 was for the Certified Healthy Communities and Schools grant programs, which require participants to develop healthy policies and strategies.

The contract arrangement to provide such a large amount of money up front is highly unusual in state finance, several officials familiar with contract arrangements told Oklahoma Watch. The first contract was signed in May 2011 and provided $3.5 million for the communities program. The contract was then amended in December 2011 to provide another $5 million for the schools program.

TSET officials referred questions about the contract to the health department but said the Certified Healthy program was passed by the Legislature in 2010. Since 2011, TSET has made $4.9 million in Certified Healthy grants to communities, schools and school districts.

“Criteria for the grant program was created in conjunction with OSDH,” TSET spokeswoman Julie Bisbee said in an email. “TSET promoted, staffed and administered the execution of the program, as TSET’s primary function as a state agency is to make grants to improve health.”

The three-year contract term expired at the end of 2013, but both the health department and TSET continued making grants and providing administrative support for the grant programs until the programs were suspended this year.

Tony Sellars, health department spokesman, conceded the contract was not properly monitored.

“The money was transferred pursuant to the terms of the original contract which called for a ‘pro-forma’ payment,” Sellars said in an email. “The originators of the contract are no longer with OSDH.”

Oklahoma Watch has requested additional financial information and emails regarding the expenditure of grant funds and the TSET contracts, but that information has not been provided, with health department officials saying documents are under legal review.

Health department cash crunch

The cash crisis at the health department reached a critical point in August as former leaders scrambled to find money to make up shortfalls in several internal accounts. Officials canceled recently renewed contracts for child abuse prevention programs and federally qualified health centers. They billed consolidated city-county health departments in Oklahoma and Tulsa counties new charges for sexually transmitted disease testing and medication costs. They also asked for and received about $3 million left in the account at TSET for the Certified Healthy Communities and Schools grant programs.

As it finished an eight-week special session to deal with other budget matters, the Legislature approved a $30 million supplemental appropriation to the health department so it could make its payroll, reimburse funds from restricted accounts and close out accounts from prior budget years. But lawmakers conditioned the emergency funding on a 15 percent cut in the agency’s appropriation for the 2019 fiscal year.

Furloughs are still in effect at the health department for employees making more than $35,000 per year, although a planned reduction in force has been put on hold. The agency has about 2,000 employees.

“The $30 million supplemental appropriation did not eliminate the need for additional actions,” Sellars said in an email Thursday. “No timetable has been established for those actions at this point.”

Grand jury looks into Health Department mismanagement as lawmakers widen probe

The state’s multicounty grand jury is looking into allegations of financial mismanagement at the Oklahoma State Department of Health as top officers continue to resign or get forced out in the wake of the agency’s sudden cash crunch.

Officials with Attorney General Mike Hunter’s office, which convenes the multicounty grand jury, declined to comment Thursday. The health department’s chief financial officer, Mike Romero, and its new general counsel, Julie Ezell, were seen leaving the attorney general’s office around lunchtime. Both declined to comment.

The multicounty grand jury recessed until January after its foreman gave a brief update to District Judge Thomas E. Prince at the Oklahoma County courthouse.

Meanwhile, a bipartisan House committee formed to investigate the health department and other agencies will begin meeting Dec. 18. Rep. Josh Cockroft, R-Wanette, the committee’s chairman, sent wide-ranging subpoenas Thursday to top budget officials and aides to Gov. Mary Fallin.

Cockroft said the House committee investigation was not criminal in nature. But he noted the House has broad authority under the state Constitution and House rules to subpoena witnesses, compel testimony and produce evidence.

The committee sent subpoenas to Preston Doerflinger, Fallin’s finance secretary and interim commissioner of the health department; Denise Northrup, acting director of the Office of Management and Enterprise Services; and Chris Benge, Fallin’s chief of staff.

“The committee will focus its investigation into the finances, state appropriations and other financial resources of the Department of Health and how they were managed,” Cockroft said in a news release. “The scope of the committee’s investigation could expand to other agencies.”

In a statement, Gov. Mary Fallin said her office is reviewing the subpoenas but wants to make sure any responses won’t interfere with other investigations and audits by Hunter and State Auditor and Inspector Gary Jones. She said legislative leaders have continued to be briefed about the issues with the health department.

The multiple investigations come as top leaders continue to resign or be forced out at the health department. Earlier this week, Chief Operating Officer Deborah Nichols resigned, and the agency’s human resources director, Jacqueline Pettit, was fired, a spokesman confirmed.

Their departures follow the resignations of former Commissioner Terry Cline, Senior Deputy Commissioner Julie Cox-Kain and Felesha Scanlan, a top lieutenant of Cox-Kain who was business planning director. Former general counsel Don Maisch and another top attorney, Patricia Cantrell, also left the agency. Meanwhile, Internal Auditor Jay Holland is on administrative leave.

Doerflinger earlier said mismanagement at the health department stretches back to 2011 and involved multiple funds being moved around to cover shortfalls and present a balanced budget to lawmakers and state budget officials.

Tobacco trust

contracts

Among other issues, auditors and investigators are looking at the way contracts were drawn up in 2011 that advanced a total of $8.5 million in health department funds to the Tobacco Settlement Endowment Trust. (In a 2000 statewide ballot initiative, voters gave the trust authority to use interest earnings from a national legal settlement with tobacco companies to go toward tobacco prevention, cancer research or health programs.) The health department contract with TSET in 2011 was for the Certified Healthy Communities and Schools grant programs, which require participants to develop healthy policies and strategies.

The contract arrangement to provide such a large amount of money up front is highly unusual in state finance, several officials familiar with contract arrangements told Oklahoma Watch. The first contract was signed in May 2011 and provided $3.5 million for the communities program. The contract was then amended in December 2011 to provide another $5 million for the schools program.

TSET officials referred questions about the contract to the health department but said the Certified Healthy program was passed by the Legislature in 2010. Since 2011, TSET has made $4.9 million in Certified Healthy grants to communities, schools and school districts.

“Criteria for the grant program was created in conjunction with OSDH,” TSET spokeswoman Julie Bisbee said in an email. “TSET promoted, staffed and administered the execution of the program, as TSET’s primary function as a state agency is to make grants to improve health.”

The three-year contract term expired at the end of 2013, but both the health department and TSET continued making grants and providing administrative support for the grant programs until the programs were suspended this year.

Tony Sellars, health department spokesman, conceded the contract was not properly monitored.

“The money was transferred pursuant to the terms of the original contract which called for a ‘pro-forma’ payment,” Sellars said in an email. “The originators of the contract are no longer with OSDH.”

Oklahoma Watch has requested additional financial information and emails regarding the expenditure of grant funds and the TSET contracts, but that information has not been provided, with health department officials saying documents are under legal review.

Health department cash crunch

The cash crisis at the health department reached a critical point in August as former leaders scrambled to find money to make up shortfalls in several internal accounts. Officials canceled recently renewed contracts for child abuse prevention programs and federally qualified health centers. They billed consolidated city-county health departments in Oklahoma and Tulsa counties new charges for sexually transmitted disease testing and medication costs. They also asked for and received about $3 million left in the account at TSET for the Certified Healthy Communities and Schools grant programs.

As it finished an eight-week special session to deal with other budget matters, the Legislature approved a $30 million supplemental appropriation to the health department so it could make its payroll, reimburse funds from restricted accounts and close out accounts from prior budget years. But lawmakers conditioned the emergency funding on a 15 percent cut in the agency’s appropriation for the 2019 fiscal year.

Furloughs are still in effect at the health department for employees making more than $35,000 per year, although a planned reduction in force has been put on hold. The agency has about 2,000 employees.

“The $30 million supplemental appropriation did not eliminate the need for additional actions,” Sellars said in an email Thursday. “No timetable has been established for those actions at this point.”

Lawmakers Press Trump Health Official On Marijuana As Opioid Alternative

A bipartisan group of members of Congress is pushing the Trump administration to consider medical marijuana as a safer alternative to opioids.

“As you know, our country is grappling with an opioid epidemic that is now taking 91 lives every single day,” the lawmakers wrote in a letter to Acting Health and Human Services Secretary (HHS) Eric D. Hargan. “Recent studies published by qualified academic researchers suggest that marijuana may prove to be a useful alternative treatment for chronic pain instead of harmful, addictive prescription opioids, and that marijuana may reduce the overall number of opioid overdose deaths.”

After citing a number of studies demonstrating cannabis’s efficacy and that legal marijuana access is associated with reduced opioid issues, the House members lay out a series of questions they want answered:

The evidence that marijuana may have a positive therapeutic warrants additional attention from the federal government. We request that you provide answers to the following questions:

1. Please describe in detail what the Department of Health and Human Services (HHS) is doing to fill the gap in our knowledge about the use, uptake, and effectiveness of medical marijuana as an alternative to opioids for pain treatment in states where it is legal.

a. Please describe in detail any federal efforts to conduct research the impact of state medical and recreational marijuana laws on opioid overdose deaths.

b. Please also describe in detail efforts by other federal agencies under the jurisdiction of HHS.

2. Please describe in detail what HHS and other federal agencies are doing to work with states that have implemented medical marijuana laws to collect data on the impact of these laws on opioid overdose deaths.

3. Is HHS committed to implementing evidence-based policies regarding the use of medical marijuana as an alternative pain treatment in an effort to promote public health?

4. Is HHS committed to making any research on the therapeutic benefits of marijuana available to states including as a more benign alternative to opioids for pain management, so that they can implement evidence-based policies to address the opioid epidemic?

5. Please describe in detail any ongoing efforts to share this research on marijuana’s potential as an alternative pain treatment to addictive and dangerous prescription medications with other federal agencies, including but not limited to the Office of National Drug Control Policy, the Drug Enforcement Administration, and the Department of Justice.

“We should not ignore any information that suggests there may be a tool available to fight the opioid epidemic that we are not using to the fullest extent,” the legislators conclude in the letter, which is dated Tuesday. “While it is clear that more research is necessary, it is equally clear that medical marijuana is an alternative pain treatment that merits the attention of the federal government.”

Congresswoman Tulsi Gabbard (D-HI) posted a series of tweets about the issue on Thursday evening.

The letter comes amid increasingly prominent discussion about marijuana’s potential to reduce opioid overdoses. The federal government’s top health research official was asked about the topic in two separate Senate hearings this week.

Legal Marijuana Tied To Opioid Death Reductions, Federal Health Official Says

Last week, Sen. Elizabeth Warren (D-MA) sent questions about marijuana and opioids to Alex Azar, President Trump’s nominee for HHS secretary.

See the full text of the House lawmakers’ new letter below:

Members of Congress: Marijuana Is An Opioid Alternative by tomangell on Scribd

31cd4_become_a_patron_button Lawmakers Press Trump Health Official On Marijuana As Opioid Alternative

Rockland, Westchester lawmakers push for New York Health Act’s single-payer bill

CLOSE

NY State of Health opens for enrollment Nov. 1. It has more than 4 million customers.
Joseph Spector, Albany Bureau

Rockland and Westchester lawmakers are backing universal health care movements in New York, despite Trump administration efforts to reduce government’s role in health care.

Rockland County’s Legislature voted recently to support state legislation seeking to provide universal government-run health care. It joined county legislatures in Westchester, Sullivan and Tompkins that previously voted to support the bill, according to New York State Nurses Association, a union representing 40,000 nurses statewide.

“The New York Health Act is a blueprint for the reorganization of health care in New York state,” said Rockland County Legislator Lon M. Hofstein, a Republican and minority leader. “The way care is delivered now is increasingly unsustainable, for individuals, families, businesses and government. We must act before the crisis worsens.”

While the number of counties supporting the bill has grown to four out of 62, it has historically failed to gain traction in Albany.

FED: What would Sen. Bernie Sanders’ ‘Medicare-for-All’ bill mean for you?

STATES: Single-payer plans reignited by Obamacare rollback push

STUDY: Affordable Care Act (Obamacare) far from ‘imploding’ in NY

The single-payer legislation, called the New York Health Act, had passed the Democrat-led Assembly three times before 2017. But it repeatedly stalled in the Republican-leaning Senate, which represents more rural upstate New York versus the urban New York City metro area.

The uncertainty surrounding federal lawmaker’s plans for health care, however, has helped sustain efforts by New York, California and other Democrat-majority states to push universal government-run health care legislation.

Further, the political climate in New York seems poised for drastic changes. Democrats have vowed to unify power in the state Senate in 2018, and the move could boost the chances for the New York Health Act being pushed by the nurses union and other powerful labor groups.

“Too many times I see patients having to fight insurance companies to get the care they absolutely need,” said Chinyere Omwumelo, a union nurse who lives in Rockland.

“With the New York Health Act, medical decisions will be made between the doctor, nurse and patient, not a bureaucrat who has no clinical training and has never even set eyes on the patient,” she said.

In addition to the four county legislatures, the health care bill has been supported by five town boards, two upstate city councils and other political groups, according to the nurses union.

Obamacare debate

Opponents of the New York Health Act, including hospital trade groups, have argued the issue should be addressed at the federal level.

They’ve cited concerns that states would face challenges in securing sufficient federal funding to subsidize health care programs, and pointed to cost concerns killing prior efforts to bring state-run health care to Vermont. 

Meanwhile, the politically charged debate over federal government’s role in health care is already addressing similar issues.

In the wake of failed GOP bids in Congress to overhaul the Affordable Care Act, Vermont Sen. Bernie Sanders has built some momentum for federal legislation to create a single-payer, government-run health care system.

Sixteen Democrats — including potential 2020 presidential candidates — have lined up behind his “Medicare-for-All” bill, which would eliminate the role of private insurers in basic health care coverage, USA TODAY reported.

More than 500,000 people across the country have signed a petition as “citizen co-sponsors” of his bill, which he introduced earlier this year in a packed Senate hearing room.

In the House, a record majority of Democrats — 117 — have signed onto similar legislation.

Lawmakers hear about Washington County Health Department’s syringe program – Herald

Maryland Del. Neil Parrott, chairman of the Washington County delegation, right, takes notes on Tuesday while listening to information about the county health department’s syringe-services program. Also pictured, from left, are County Health Officer Earl Stoner, Behavioral Health Services Director Vicki Sterling, Deputy Health Officer Dr. Diana Gaviria, and Washington County Sheriff Doug Mullendore.

Lawmakers making progress in talks on children’s health care

Congressional negotiators are making progress towards a bipartisan deal to reauthorize children’s health insurance and several other important health-care programs, sources say.

Staff from the relevant committees in both parties and chambers met over the Thanksgiving break and are getting closer to an agreement, according to lobbyists and aides.

The package would include funding for the Children’s Health Insurance Program (CHIP) and community health centers, and an extension of a range of other expiring Medicare programs. It could also include a bipartisan bill from the Senate Finance Committee known as the Chronic Care Act that seeks to make Medicare spending more efficient and save money.

The health-care package could be attached to either a short-term government spending bill in early December, or the longer-term government funding bill later in December. Advocates are pushing for it to be included in the earlier, short-term bill.

Negotiators have made progress on a bipartisan agreement to pay for the extension of CHIP and other programs, which has been the main obstacle so far. Staff declined to specify what, exactly, the new offsets would be.

The CHIP funding in particular has led to both parties accusing the other of holding up funds for children’s health care, in part, due to a dispute on how to pay for it.

Earlier this month, the House passed a bill to fund CHIP and community health centers largely on a party-line vote. The Senate Finance Committee passed a bill to reauthorize CHIP, but hasn’t released their plan for how to pay for it.

The deadline to get money to states is rapidly approaching, though, and the year-end bills provide a vehicle for a deal.  

Meanwhile, the Centers for Medicare and Medicaid Services has been redistributing funds to help hold states over while they wait for Congress to fund CHIP, which is jointly paid for by states and the federal government. The agency awarded nearly $607 million in total to states and U.S. territories in October and November.

Five states and Washington, D.C., could run out of funds by the end of December or early January, according to an Oct. 25 report from the Georgetown University Health Policy Institute’s Center for Children and Families.

States have been grappling with whether to send notices alerting families that coverage for their children could end. Nine million low-and middle-income children are covered by the program. On Monday, Colorado began sending out such letters, saying that the program would end in the state by Jan. 31 if federal funding isn’t renewed.

Community health centers are a large source of comprehensive primary care to around 26 million of the nation’s most vulnerable people. They haven’t yet seen reduced funds, but some of their grants first expire at the end of this year.

At issue is a fund Congress let expire Sept. 30 that consists of 70 percent of the centers’ federal grant money. The uncertainty has worried health centers, leading them to make contingency plans. Some have already instituted hiring freezes and are examining scaling back services, laying off staff, reducing hours of operation and more.

A spokesperson for House Ways and Means Committee Republicans confirmed talks on passing policies like the committee’s earlier Medicare “extenders” bill before the end of the year.  

“The Ways and Means Committee is working to build off of the House-passed Medicare Part B Improvement Act, Committee-passed Medicare extenders, and the Ways and Means bipartisan extenders package,” the spokesperson said.

“Working with our Senate counterparts, Committee Republicans and Democrats are discussing the path forward to ensure these important proposals are enacted into law before the end of the year.”

Lawmakers making progress in talks on children’s health care

Congressional negotiators are making progress towards a bipartisan deal to reauthorize children’s health insurance and several other important health-care programs, sources say.

Staff from the relevant committees in both parties and chambers met over the Thanksgiving break and are getting closer to an agreement, according to lobbyists and aides.

The package would include funding for the Children’s Health Insurance Program (CHIP) and community health centers, and an extension of a range of other expiring Medicare programs. It could also include a bipartisan bill from the Senate Finance Committee known as the Chronic Care Act that seeks to make Medicare spending more efficient and save money.

The health-care package could be attached to either a short-term government spending bill in early December, or the longer-term government funding bill later in December. Advocates are pushing for it to be included in the earlier, short-term bill.

Negotiators have made progress on a bipartisan agreement to pay for the extension of CHIP and other programs, which has been the main obstacle so far. Staff declined to specify what, exactly, the new offsets would be.

The CHIP funding in particular has led to both parties accusing the other of holding up funds for children’s health care, in part, due to a dispute on how to pay for it.

Earlier this month, the House passed a bill to fund CHIP and community health centers largely on a party-line vote. The Senate Finance Committee passed a bill to reauthorize CHIP, but hasn’t released their plan for how to pay for it.

The deadline to get money to states is rapidly approaching, though, and the year-end bills provide a vehicle for a deal.  

Meanwhile, the Centers for Medicare and Medicaid Services has been redistributing funds to help hold states over while they wait for Congress to fund CHIP, which is jointly paid for by states and the federal government. The agency awarded nearly $607 million in total to states and U.S. territories in October and November.

Five states and Washington, D.C., could run out of funds by the end of December or early January, according to an Oct. 25 report from the Georgetown University Health Policy Institute’s Center for Children and Families.

States have been grappling with whether to send notices alerting families that coverage for their children could end. Nine million low-and middle-income children are covered by the program. On Monday, Colorado began sending out such letters, saying that the program would end in the state by Jan. 31 if federal funding isn’t renewed.

Community health centers are a large source of comprehensive primary care to around 26 million of the nation’s most vulnerable people. They haven’t yet seen reduced funds, but some of their grants first expire at the end of this year.

At issue is a fund Congress let expire Sept. 30 that consists of 70 percent of the centers’ federal grant money. The uncertainty has worried health centers, leading them to make contingency plans. Some have already instituted hiring freezes and are examining scaling back services, laying off staff, reducing hours of operation and more.

A spokesperson for House Ways and Means Committee Republicans confirmed talks on passing policies like the committee’s earlier Medicare “extenders” bill before the end of the year.  

“The Ways and Means Committee is working to build off of the House-passed Medicare Part B Improvement Act, Committee-passed Medicare extenders, and the Ways and Means bipartisan extenders package,” the spokesperson said.

“Working with our Senate counterparts, Committee Republicans and Democrats are discussing the path forward to ensure these important proposals are enacted into law before the end of the year.”

Lawmakers making progress in talks on children’s health care

Congressional negotiators are making progress towards a bipartisan deal to reauthorize children’s health insurance and several other important health-care programs, sources say.

Staff from the relevant committees in both parties and chambers met over the Thanksgiving break and are getting closer to an agreement, according to lobbyists and aides.

The package would include funding for the Children’s Health Insurance Program (CHIP) and community health centers, and an extension of a range of other expiring Medicare programs. It could also include a bipartisan bill from the Senate Finance Committee known as the Chronic Care Act that seeks to make Medicare spending more efficient and save money.

The health-care package could be attached to either a short-term government spending bill in early December, or the longer-term government funding bill later in December. Advocates are pushing for it to be included in the earlier, short-term bill.

Negotiators have made progress on a bipartisan agreement to pay for the extension of CHIP and other programs, which has been the main obstacle so far. Staff declined to specify what, exactly, the new offsets would be.

The CHIP funding in particular has led to both parties accusing the other of holding up funds for children’s health care, in part, due to a dispute on how to pay for it.

Earlier this month, the House passed a bill to fund CHIP and community health centers largely on a party-line vote. The Senate Finance Committee passed a bill to reauthorize CHIP, but hasn’t released their plan for how to pay for it.

The deadline to get money to states is rapidly approaching, though, and the year-end bills provide a vehicle for a deal.  

Meanwhile, the Centers for Medicare and Medicaid Services has been redistributing funds to help hold states over while they wait for Congress to fund CHIP, which is jointly paid for by states and the federal government. The agency awarded nearly $607 million in total to states and U.S. territories in October and November.

Five states and Washington, D.C., could run out of funds by the end of December or early January, according to an Oct. 25 report from the Georgetown University Health Policy Institute’s Center for Children and Families.

States have been grappling with whether to send notices alerting families that coverage for their children could end. Nine million low-and middle-income children are covered by the program. On Monday, Colorado began sending out such letters, saying that the program would end in the state by Jan. 31 if federal funding isn’t renewed.

Community health centers are a large source of comprehensive primary care to around 26 million of the nation’s most vulnerable people. They haven’t yet seen reduced funds, but some of their grants first expire at the end of this year.

At issue is a fund Congress let expire Sept. 30 that consists of 70 percent of the centers’ federal grant money. The uncertainty has worried health centers, leading them to make contingency plans. Some have already instituted hiring freezes and are examining scaling back services, laying off staff, reducing hours of operation and more.

A spokesperson for House Ways and Means Committee Republicans confirmed talks on passing policies like the committee’s earlier Medicare “extenders” bill before the end of the year.  

“The Ways and Means Committee is working to build off of the House-passed Medicare Part B Improvement Act, Committee-passed Medicare extenders, and the Ways and Means bipartisan extenders package,” the spokesperson said.

“Working with our Senate counterparts, Committee Republicans and Democrats are discussing the path forward to ensure these important proposals are enacted into law before the end of the year.”

Protect all people with health care laws, Pope Francis tells lawmakers

He also reiterated Vatican teaching that says “not adopting, or else suspending, disproportionate measures, means avoiding overzealous treatment. From an ethical standpoint, it is completely different from euthanasia, which is always wrong.”

Trump urges lawmakers to end health mandate, cut top tax rate

WASHINGTON (Reuters) – Congressional Republicans pushed ahead on Monday on a U.S. tax code overhaul as a Senate panel considered the issue, but risks lay ahead with major intraparty disputes unsettled and President Donald Trump returning soon from Asia as the debate heats up.

While overseas at a leaders conference, Trump tweeted some tax bill suggestions early on Monday that were starkly different from the two Republican plans being considered in the U.S. Senate and House of Representatives.

He called on lawmakers to add a highly risky provision to their tax effort: repealing the individual mandate included in the 2010 Obamacare health insurance law that requires Americans to have health coverage or pay a tax to Washington.

Neither of the two Republican plans includes such a politically divisive measure. Efforts by Republicans to dismantle Obamacare, formally known as the Affordable Care Act, collapsed dramatically months ago.

Trump has pushed hard for adding the mandate repeal to the tax-cut package. He tweeted the same suggestion on Nov. 3 just before he departed for his multi-nation Asian tour.

In his latest tweet, he also urged slashing the top tax rate for high earners to 35 percent from 39.6 percent, despite criticism from Democrats that the Republican tax bills are deficit-expanding giveaways to the rich and corporations.

The House retains the existing top tax rate in its bill, while the Senate proposes cutting it slightly to 38.5 percent.

Trump is set to return to Washington on Tuesday. A White House aide confirmed that the president would speak to House Republicans on Thursday ahead of their expected tax bill vote.

“I am proud of the Rep. House Senate for working so hard on cutting taxes { reform.} We’re getting close!” Trump wrote in his Monday Twitter post.

“Now, how about ending the unfair highly unpopular Indiv Mandate in OCare reducing taxes even further? Cut top rate to 35% w/all of the rest going to middle income cuts?” he added.

CLOCK IS TICKING

Since taking office in January, Trump has not scored a major legislative accomplishment, while frequently shifting positions and confusing lawmakers on Capitol Hill on various issues.

Many Republicans view a win on overhauling the tax code as crucial to avoiding having to go to the voters in 2018’s congressional elections with no achievements to show for a year in control of the White House and both chambers of Congress.

The clock is ticking for them. The House is expected to vote soon, perhaps on Thursday, on a tax bill approved last week at the committee level. House tax committee Chairman Kevin Brady said he was confident Republicans had the votes for passage.

Brady told reporters in a Capitol hallway that including a repeal of the Obamacare individual healthcare mandate in the tax bill “remains under consideration.”

The Senate tax committee will debate its tax plan all week before heading home for the U.S. Thanksgiving Day holiday.

When both chambers return near the end of November, they will have only 12 legislative days before the end of 2017.

In that time span, Republicans hope to iron out differences between the two tax plans over the deduction for state and local taxes, the timing of a corporate tax rate cut and the future of the estate tax on inheritances.

Each of the Republican tax plans would add about $1.5 trillion to the federal deficit over the next decade, another issue causing dissension among Republicans.

Senate Republican leader Mitch McConnell said he hoped to have a tax bill ready in the week after Thanksgiving. Between now and then, an army of lobbyists will be pressuring lawmakers to protect favored special-interest tax breaks.

On Dec. 8, a three-month extension of the spending authority for the federal government expires, requiring congressional action that could divert lawmakers from the tax overhaul.

A lengthy amendment introduced on Monday to the Senate tax plan by Republican Orrin Hatch, chairman of the tax panel, would remove a provision that lets working Americans over 50 make tax-free catch-up contributions to their retirement plans.

Democrats have kept up steady criticism of the Republican tax bills and how they were drafted. Democratic leader Chuck Schumer said the Senate measure was developed in secret by a small group that held no public hearings and ignored Democrats.

“And the reason for such reckless haste is all too obvious: the product is a wretched one … it is focused on the wealthy to the exclusion of the middle class,” he said in a statement.

Additional reporting by Susan Cornwell; Editing by Kevin Drawbaugh and Peter Cooney

Lawmakers to consider school finance, computer science bills at Tuesday meeting – Casper Star

Whenever Seth Klamann posts new content, you’ll get an email delivered to your inbox with a link.

Email notifications are only sent once a day, and only if there are new matching items.

Trump to lawmakers: cut health mandate, top tax bracket

WASHINGTON (Reuters) – U.S. President Donald Trump urged lawmakers on Monday to slash the top tax rate paid by the wealthy and end the Obamacare individual healthcare mandate, even as he praised their work so far on tax reform in the Republican-controlled Congress.

Members of the U.S. House of Representatives and Senate were debating their respective plans this week before heading home for the U.S. Thanksgiving Day holiday.

Republicans are aiming to achieve a significant overhaul of the U.S. tax code and hand Trump his first major legislative victory. The two chambers hope to resolve their differences in time to enact the legislation by the end of the year.

“I am proud of the Rep. House Senate for working so hard on cutting taxes { reform.} We’re getting close!” Trump wrote in a Twitter post.

Trump has repeatedly pushed for the tax reform bill to include a repeal of the Affordable Care Act mandate that all Americans purchase health insurance or else pay a fine. Neither House nor Senate proposals include such a provision.

“Now, how about ending the unfair highly unpopular Indiv Mandate in OCare reducing taxes even further? Cut top rate to 35% w/all of the rest going to middle income cuts?” he added.

Republican tax plans in the House and Senate would each add about $1.5 trillion to the federal deficit over the next decade, but lawmakers will have to iron out differences including the treatment of the deduction for state and local taxes, when to start a cut in the corporate tax rate and whether to scrap the estate tax on inheritances.

The House is expected to pass its tax bill this week, while the Senate debates its proposal. Senate Majority Leader Mitch McConnell said the Senate hoped to have its version ready to be considered the week after Thanksgiving.

The two plans have some different details but are “similar conceptually,” McConnell said in his home state of Kentucky.

Senators began tweaking their proposal on Monday. An amendment introduced by Republican Senator Orrin Hatch would remove the provision that currently lets working Americans over 50 make tax-free catch-up contributions to their retirement plans.

The prospects for the provisions Trump pushed were uncertain.

The Senate proposal calls for keeping seven tax brackets but cutting rates, including the top tax rate for the highest earning taxpayers, to 38.5 percent from 39.6 percent. The House wants to reduce the number of brackets, but leave the 39.6 percent top rate alone.

The Congressional Budget Office said last week that repealing the Obamacare individual mandate would increase the number of uninsured Americans by 13 million by 2027 and reduce the federal budget deficit less than it originally forecasted.

Trump and some Republicans favor including a repeal of the mandate in tax overhaul legislation. But lawmakers, Republican aides and lobbyists have said it would be difficult to include a repeal in a tax effort complicated by intraparty differences and intense business lobbying.

The Trump administration is trying to drum up support for the tax reform effort in U.S. towns and cities as well as on Capitol Hill.

Treasury Secretary Steve Mnuchin and Trump’s daughter Ivanka, a presidential adviser, touted the Republican tax initiatives as good for economic growth and for families in an appearance at a Bayville, New Jersey, fire station.

Reporting by Doina Chiacu; Editing by Jeffrey Benkoe and Lisa Shumaker

Lawmakers defend ‘unprecedented’ Pentagon health panel, which could undermine FDA


65b6e_ Lawmakers defend 'unprecedented' Pentagon health panel, which could undermine FDA

Under a new defense policy bill, the Pentagon also could ignore FDA’s advice as necessary. | Getty Images

FDA currently has sole authority to authorize drugs and devices for emergency use.

11/06/2017 01:09 PM EST

Updated 11/06/2017 08:02 PM EST


The Defense Department — and not FDA — would have the power to approve drugs and medical devices under the defense policy bill that’s being hammered out by a conference committee, alarming congressional health staff and HHS who say it would undermine medical safety and potentially put soldiers at risk.

But the lawmakers backing the bill, including House Armed Services Chairman Mac Thornberry (R-Texas), say the measure is necessary and even overdue.

Story Continued Below

“The FDA has denied freeze-dried plasma to troops in the field for 10 years,” House Armed Services spokesperson Claude Chafin said, referencing a still-unapproved medical product that the Pentagon says is necessary to save the lives of military personnel. “The chairman has perfect moral clarity on this provision, and there is no doubt in his mind that it is the right thing to do for the troops.”

FDA officials counter that creating a new pathway to approve drugs is both risky and — in the specific case cited by Thornberry — not needed. “FDA has been working closely with DoD to bring freeze-dried plasma to our troops and anticipates that these products will be fully approved for safe and effective use for our armed forces as early as 2018,” an FDA official told POLITICO.

Section 732 of the Senate’s version of the National Defense Authorization Act creates a new regulatory structure that would allow the Pentagon to sign off on unapproved devices and drugs for emergency use on military personnel and others in harm’s way. The bill is in conference committee with final language expected as early as this week.

FDA currently has sole authority to authorize drugs and devices for emergency use.

“It’s unprecedented,” said one Democratic aide who works on medical safety issues. “We’ve never had a process for where an individual agency could [approve] drugs and devices … for its own use” and outside of the FDA. “It’s a massive shift.”

The language states that DoD would be able to approve “emergency uses for medical products to reduce deaths and severity of injuries caused by agents of war.” For instance, DoD could approve the use of freeze-dried plasma, which the department has repeatedly said can save the lives of military personnel who have suffered blood loss on the battlefield. While a small number of elite soldiers currently are deployed with access to freeze-dried plasma, the product is still awaiting full FDA approval, which hadn’t been expected until 2020.

“Traditional pathways to [FDA] approval and licensure of critical medical products, like freeze dried plasma, for battlefield use are too slow to allow for rapid insertion and use of these products on the battlefield,” according to the Senate Armed Services Committee’s conference report, defending its recommendation of the provision. “The committee believes this provision could lead to even higher survival rates from severe battlefield wounds suffered by servicemembers.”

But because the report language is so broad — for instance, “agents of war” isn’t a legal definition — staff say that it would open the door for the military to approve a wide range of products and treatments. For instance, DoD could plausibly approve a vaccine for soldiers who come down with the flu while deployed, one congressional aide said.

The conference language would create two safeguards. First, a new DoD committee of health care experts, appointed by the Defense secretary, would need to recommend emergency use of an unapproved drug or device. Second, the assistant secretary of Defense for health affairs would need to authorize the drug’s or device’s use after consulting with FDA.

But congressional aides and HHS staff say those standards don’t measure up to current safety practices. Rather than base a drug or device approval on years of safety and efficacy evaluations, it “leaves the decision up to a five-man committee,” said one individual with knowledge of how the DoD committee would be staffed. The Pentagon also could ignore FDA’s advice as necessary.

Staff on congressional committees with health jurisdiction say they were blindsided by the language, backed by Senate Armed Services Chairman John McCain (R-Ariz.), and have fought to remove it. But the provision is expected to remain, one individual with knowledge of the deliberations said on Monday afternoon. A Senate aide noted that it has bipartisan support from defense lawmakers.

Congressional staff involved in crafting the NDAA also defended the process of preparing the conference report. Three House Energy and Commerce Committee members — Chairman Greg Walden (R-Ore.), ranking member Frank Pallone (D-N.J.) and Texas Republican Joe Barton — were appointed to help negotiate Section 732, among other provisions in the bill that affect their jurisdictions.

HHS has warned Congress that the provision would undermine decades of existing protections and processes. For instance, DoD wouldn’t have access to FDA’s data, which means a decision could be made based on limited information provided by a drug or device manufacturer. DoD also wouldn’t be collecting safety and efficacy data in the same way as FDA.

FDA offered an alternative proposal, which would have expedited drug and device reviews and approval upon a DoD request, but the language wasn’t accepted.

FDA would not comment on the agency’s reported concerns with the bill. “The FDA does not generally comment on pending or potential legislation,” spokesperson Jen Rodriguez said.

Connor O’Brien contributed to this report.

Lawmakers defend ‘unprecedented’ Pentagon health committee, which could undermine FDA


2e6f2_ Lawmakers defend 'unprecedented' Pentagon health committee, which could undermine FDA

Under a new defense policy bill, the Pentagon also could ignore FDA’s advice as necessary. | Getty Images

FDA currently has sole authority to authorize drugs and devices for emergency use.

11/06/2017 01:09 PM EST

Updated 11/06/2017 04:59 PM EST


The Defense Department — and not FDA — would have the power to approve drugs and medical devices under the defense policy bill that’s being hammered out by a conference committee, alarming congressional health staff and HHS who say it would undermine medical safety and potentially put soldiers at risk.

But the lawmakers backing the bill, including House Armed Services Chairman Mac Thornberry (R-Texas), say the measure is necessary and even overdue.

Story Continued Below

“The FDA has denied freeze-dried plasma to troops in the field for 10 years,” House Armed Services spokesperson Claude Chafin said, referencing a still-unapproved medical product that the Pentagon says is necessary to save the lives of military personnel. “The chairman has perfect moral clarity on this provision, and there is no doubt in his mind that it is the right thing to do for the troops.”

Section 732 of the Senate’s version of the National Defense Authorization Act creates a new regulatory structure that would allow the Pentagon to sign off on unapproved devices and drugs for emergency use on military personnel and others in harm’s way. The bill is in conference committee with final language expected as early as this week.

FDA currently has sole authority to authorize drugs and devices for emergency use.

“It’s unprecedented,” said one Democratic aide who works on medical safety issues. “We’ve never had a process for where an individual agency could [approve] drugs and devices … for its own use” and outside of the FDA. “It’s a massive shift.”

The language states that DoD would be able to approve “emergency uses for medical products to reduce deaths and severity of injuries caused by agents of war.” For instance, DoD could approve the use of freeze-dried plasma, which the department has repeatedly said can save the lives of military personnel who have suffered blood loss on the battlefield. While a small number of elite soldiers currently are deployed with access to freeze-dried plasma, the product is still awaiting full FDA approval, which isn’t expected until 2020.

“Traditional pathways to [FDA] approval and licensure of critical medical products, like freeze dried plasma, for battlefield use are too slow to allow for rapid insertion and use of these products on the battlefield,” according to the Senate Armed Services Committee’s conference report, defending its recommendation of the provision. “The committee believes this provision could lead to even higher survival rates from severe battlefield wounds suffered by servicemembers.”

But because the report language is so broad — for instance, “agents of war” isn’t a legal definition — staff say that it would open the door for the military to approve a wide range of products and treatments. For instance, DoD could plausibly approve a vaccine for soldiers who come down with the flu while deployed, one congressional aide said.

The conference language would create two safeguards. First, a new DoD committee of health care experts, appointed by the Defense secretary, would need to recommend emergency use of an unapproved drug or device. Second, the assistant secretary of Defense for health affairs would need to authorize the drug’s or device’s use after consulting with FDA.

But congressional aides and HHS staff say those standards don’t measure up to current safety practices. Rather than base a drug or device approval on years of safety and efficacy evaluations, it “leaves the decision up to a five-man committee,” said one individual with knowledge of how the DoD committee would be staffed. The Pentagon also could ignore FDA’s advice as necessary.

Staff on congressional committees with health jurisdiction say they were blindsided by the language, backed by Senate Armed Services Chairman John McCain (R-Ariz.), and have fought to remove it. But the provision is expected to remain, one individual with knowledge of the deliberations said on Monday afternoon. A Senate aide noted that it has bipartisan support from defense lawmakers.

Congressional staff involved in crafting the NDAA also defended the process of preparing the conference report. Three House Energy and Commerce Committee members — Chairman Greg Walden (R-Ore.), ranking member Frank Pallone (D-N.J.) and Texas Republican Joe Barton — were appointed to help negotiate Section 732, among other provisions in the bill that affect their jurisdictions.

HHS has warned Congress that the provision would undermine decades of existing protections and processes. For instance, DoD wouldn’t have access to FDA’s data, which means a decision could be made based on limited information provided by a drug or device manufacturer. DoD also wouldn’t be collecting safety and efficacy data in the same way as FDA.

FDA offered an alternative proposal, which would have expedited drug and device reviews and approval upon a DoD request, but the language wasn’t accepted.

FDA would not comment on the agency’s reported concerns with the bill. “The FDA does not generally comment on pending or potential legislation,” spokesperson Jen Rodriguez said.

Connor O’Brien contributed to this report.

Lawmakers Have the Internet in Their Sights

I was in the room last week when lawyers for Facebook Inc., Google and Twitter Inc. went in front of U.S. lawmakers to try and explain how Russian agents used their social networks in campaigns designed to influence the 2016 election. The most striking statement, in my view, came from Senator Dianne Feinstein, a Democrat from California.

“I don’t think you get it,” she said. “You bear this responsibility. You created these platforms, and now they are being misused. And you have to be the ones who do something about it.” Feinstein paused. “Or we will.”

The specter of new rules governing the places we hang out and connect online is getting bigger as governments around the world wake up to the awesome power wielded by companies like Facebook and Google. China is shutting down virtual private networks that people use to get around censorship for accessing YouTube or Facebook. U.S. Federal Communications Commission Chairman Ajit Pai is working to undo the landmark net neutrality rules that came in under President Barack Obama. In Europe, where competition authorities have already forced fines and changes from Google, strict new rules on data privacy are coming into effect.

As my colleague Shira Ovide wrote last week, big tech’s honeymoon seems to be ending. With that in mind, we got a signal last week that internet giants are ready for more compromise. The Internet Association, which lobbies for Facebook, Google, Twitter and other online companies, said it would now support a proposed U.S. law to make online platforms bear some responsibility for sex trafficking that’s facilitated on their networks. Before, they had argued any change to the immunity they get as supposedly neutral platforms could grease a slippery slope that would end the internet as we know it.

At the hearings, Twitter’s acting general counsel, Sean Edgett, said his company was open to the “general idea” of another law that would require social networks to record and disclose who pays for the political ads they sell and what audience each ad is targeted at. That bill, called the Honest Ads Act, is picking up steam. It’s sponsored by senators on both sides of the aisle, and after the hearings, more lawmakers said they think the bill makes sense and would consider pledging support.

Lawmakers Have the Internet in Their Sights – Bloomberg

I was in the room last week when lawyers for Facebook Inc., Google and Twitter Inc. went in front of U.S. lawmakers to try and explain how Russian agents used their social networks in campaigns designed to influence the 2016 election. The most striking statement, in my view, came from Senator Dianne Feinstein, a Democrat from California.

“I don’t think you get it,” she said. “You bear this responsibility. You created these platforms, and now they are being misused. And you have to be the ones who do something about it.” Feinstein paused. “Or we will.”

The specter of new rules governing the places we hang out and connect online is getting bigger as governments around the world wake up to the awesome power wielded by companies like Facebook and Google. China is shutting down virtual private networks that people use to get around censorship for accessing YouTube or Facebook. U.S. Federal Communications Commission Chairman Ajit Pai is working to undo the landmark net neutrality rules that came in under President Barack Obama. In Europe, where competition authorities have already forced fines and changes from Google, strict new rules on data privacy are coming into effect.

As my colleague Shira Ovide wrote last week, big tech’s honeymoon seems to be ending. With that in mind, we got a signal last week that internet giants are ready for more compromise. The Internet Association, which lobbies for Facebook, Google, Twitter and other online companies, said it would now support a proposed U.S. law to make online platforms bear some responsibility for sex trafficking that’s facilitated on their networks. Before, they had argued any change to the immunity they get as supposedly neutral platforms could grease a slippery slope that would end the internet as we know it.

At the hearings, Twitter’s acting general counsel, Sean Edgett, said his company was open to the “general idea” of another law that would require social networks to record and disclose who pays for the political ads they sell and what audience each ad is targeted at. That bill, called the Honest Ads Act, is picking up steam. It’s sponsored by senators on both sides of the aisle, and after the hearings, more lawmakers said they think the bill makes sense and would consider pledging support.