Health IT Legislative Outlook

December 3, 2007

With a limited amount of time left before legislators adjourn for the year and officially close the 110th Congress, the future of health IT legislation still remains unclear. Senate leaders may make a third possible attempt to pass the Wired for Health Care Quality Act this coming week.

The Wired for Health Care Quality Act of 2007 (S.1693)

Introduced on June 26, the Wired Act was voted unanimously out of the Senate Committee on Health, Education, Labor and Pensions Committee (HELP) on June 27. Following its passage out of Committee, the bill has undergone intense scrutiny by the Department of Health and Human Services (HHS) as well as the private sector. As a result, revisions have been made to the language surrounding the American Health Information Community (AHIC), and to the provisions related to the Partnership for Health Care Improvement-Standards and Technology.

Barriers to passage have included jurisdictional conflicts with the Senate Finance committee regarding quality measure provisions, objections from privacy advocates that the bill doesn't go far enough, and a recent letter outlining concerns signed by representatives of the physician community. These factors have hindered the bill's chances of progressing.

Senator Patrick Leahy (D-VT), Chair of the Senate's powerful Judiciary Committee, has expressed a desire to include significant privacy provisions from a bill he had previously introduced with HELP's Chairman, Senator Edward Kennedy (D-MA). These privacy provisions have been seen as a significant hurdle to the bill's chances of passage.

The Senate HELP committee has attempted twice before to pass the bill through unanimous consent and may attempt to pass it again as early as Tuesday December 3rd, without Senator Leahy's privacy additions. Some insiders speculate the bill could be attached to a larger Medicare bill scheduled to be considered before the end of 2007; however, that prospect is seen as unlikely.

The Promotion of Health IT Act (H.R. 3800)

Congresswoman Anna Eshoo (D-CA), a member of the House Committee on Energy and Commerce, introduced H.R. 3800 on October 10th of this year. The bill is nearly identical to the version of the Wired Act that was voted out of the HELP committee in June.

Eshoo's office has been working on increasing the number of co-sponsors for H.R. 3800, in order to increase the likelihood that the bill will receive a hearing in the Energy and Commerce Subcommittee on Health. The chairman of that committee, Frank Pallone (D-NJ), has not signed onto the bill as a cosponsor and has not made any indication that he will schedule the bill for a hearing before the end of the year.

Healthcare Information Technology Enterprise Integration Act (H.R. 2406)

Sponsored by Congressman Bart Gordon (D-TN), Chairman of the House Science and Technology Committee, H.R. 2406 would authorize the National Institute for Standards and Technology (NIST) to increase its role "in support of the integration of the healthcare information enterprise in the United States." The bill has been met with mixed reviews since its introduction on May 21st. Congressman Gordon held a hearing on the bill in September, which was then passed by the committee with significant amendments on November 15th.

The bill seeks to integrate the efforts of NIST into the standards setting process for the health IT infrastructure that will eventually lead to the "network of networks" concept envisioned by the Department of Health and Human Services (HHS). Many industry organizations have complained that the bill would create unnecessary jurisdictional conflicts in this area and would slow the process of standards setting and certification of health IT products. Significant amendments have been made to the bill in order to improve its chances of passing.

Congressman Gordon, who is also a member of the House Energy and Commerce Committee, has expressed a desire to include his bill in The Promotion of Health IT Act sponsored by Congressswoman Anna Eshoo (D-CA).

Outlook

The likelihood of any of these bills passing on their own is growing more remote, although Congressman Gordon's standards bill could be voted on by the full House. With many of the nation's largest spending bills still waiting to be approved, the focus of Congress is divided. The Senate's Wired Act stands a better chance of passage in terms of the two more comprehensive health IT bills, due to the amount of attention it has received since its introduction and its previous passage in 2005. However, the strong objections voiced from the physician community and privacy advocates, as well as the potential amendment by Senator Leahy, significantly reduce the chances of that bill's passage this year.