Dear ASN Members:
When congressional conferees return in the fall, they will try to reconcile differences between the House and Senate versions of the Labor, Health and Human Services (HHS) and Education Appropriations and Medicare Reform Bills. Both bills will have a significant impact on kidney disease research and patient treatment, as well as ESRD management.
The ASN is extremely concerned that the proposed funding levels for the National Institutes of Health (NIH), which passed the House and Senate, drastically reduce medical research. The ASN, in cooperation with the Coalition for Health Funding, the Ad-Hoc Group for Medical Research, and Research!America, is urging House and Senate Labor-HHS and Education conferees to add a minimum of 8.5 percent for the NIH in FY04.
Although progress has been made, the war on disease, particularly kidney disease, is far from over. For example, the House recommended FY04 NIH budget increase is a mere 2.5 percent. Funding at this level will dramatically lessen the translation of discoveries from “bench to bedside”—discoveries that too many of our patients are desperately waiting to receive.
Additional fallout from a significant drop in NIH support will include a diminished level and longevity of individual grant support; a drastic reduction in new grants; and severe discouragement among our youngest and brightest investigators about the prospects for success in an already highly competitive field. Slow growth to the NIH budget will also devastate the area of clinical research, where the fruits of our investment in medical research are applied to improving the health of the American people.
No single budget line item can compare with the return on investment that comes from NIH-sponsored research. Aside from human costs associated with the prevention of disease and disability, research funding saves critical health care dollars and contributes significantly to local and state economies. For example, it is estimated that kidney disease will cost the Medicare End Stage Renal Disease program $28 billion by 2010.
The ASN remains hopeful that the Administration and Congress will agree to add more funding for the NIH later in the FY04 appropriations process.
Sincerely yours,
Paul Smedberg
Appropriations Update
At this time, it appears that the Senate Labor-HHS Education appropriations bill will not reach the Senate floor until September. The biomedical research community is strongly advocating for an overall increase to the NIH funding level in the Senate bill.
In addition to these advocacy efforts, Senator Dianne Feinstein (D-CA) is working on an amendment to add an additional $1.3 billion to the Senate Labor-HHS bill for NIH. Health community organizations are urging Senators to support the Feinstein amendment and are seeking Republican Senators to consider cosponsoring the amendment. If the Feinstein amendment is accepted, it will bring NIH funding to $29.282 billion – an increase of 8.5 percent.
Medicare Reform
Beyond reconciling appropriations bills, Congress will be busy attempting to finalize a proposal for Medicare Reform which will then be sent to the President for his signature. An important part of the respective House and Senate Medicare Reform proposals are provisions for the treatment and management of End Stage Renal Disease (ESRD).
The Senate Medicare Reform proposal highlights significant changes to the ESRD composite rate. The composite rate would be increased by 1.6 percent for services furnished in 2004 and 2005. This is the first time the ESRD composite rate would be set for a period of more than one year. These payment amounts, methods, and adjustments would not be subject to administrative or judicial review under the statutory appeals processes.
Despite the significance of the proposed ESRD changes, some in Congress and the renal community are disappointed with the initial proposals and are working closely with key congressional allies to improve the ESRD provisions.
