The U.S. House of Representatives on a vote of 226-203 on June 19, 2019 approved a four-bill spending package (H.R. 2740). The Minibus included the fiscal year (FY) 2020 Labor, Health and Human Services, Education, and Related Agencies (Labor-HHS) appropriations bill, along with spending for Defense; Energy and Water; and State and Foreign Operations. This legislation specifies all the particulars regarding amounts of money to allocate for a wide range of programs. A prime example is the National Institutes of Health, which stand to benefit by an increase of more than two billion dollars in the upcoming fiscal year that begins this October 1, which is a larger increase than what has been provided in three of the previous four fiscal years.

The Agency for Healthcare Research and Quality (AHRQ) has been slated on several occasions for extinction, including in the current Administration’s budget proposal for FY 2020. Based on action by the House, however, the Agency will continue to exist. Its eventual fate will be determined once the Senate takes action by approving its own spending legislation. Members of that chamber have not yet officially established a timeline for consideration of its FY 2020 appropriation levels.

An ongoing concern in Congress is the steady rise in health care costs. A growing overall population in the U.S. and increases in the number of individuals aged 65 and older, many of whom have multiple chronic health problems, provide assurance that unless some constructive action is taken, costs will increase rather than stabilize or decrease any time soon. Apart from providing appropriations for necessary programs in the health and education spheres, Congress plays a valuable role by conducting hearings to obtain information and guidance on steps that can be taken to respond effectively to various social challenges. An example is that the Senate Health, Education, Labor, and Pensions (HELP) Committee on June 18, 2019 held a hearing on the Lower Health Care Costs Act of 2019 (S. 1895) to examine matters involving a benchmark payment rate for providers. At issue is a concern by representatives from the hospital industry that arbitrary, government-dictated reimbursement could result in significant unintended consequences for patients and create a disincentive for insurers to maintain adequate provider networks.

Except for major figures in Congress, such as House Speaker Nancy Pelosi (D-CA), and Senate Majority Leader Mitch McConnell (R-KY), the 535 elected members of the two chambers may be the equivalent of a giant blur to anyone who does not work for a living as a lobbyist. A fascinating group with a wide range of personal experience and ideological beliefs, legislators are confronted with the challenge of doing their best to represent the constituents who sent them to the nation’s capital as well as act effectively on behalf of the interests of the nation as a whole. An unintended consequence of this duality is that meeting the needs of the voters back home may not always correspond exactly with how the nation itself would benefit.

Members of Congress come from all walks of life, including as health professionals. A head count indicates that four Senators are from the following professions (surgery, optometry, gastroenterology, and ophthalmology). In the House, 26 Representatives are from several professions, including a rehabilitation therapist from Pennsylvania, 13 physicians, and five dentists.

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