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When a majority is not enough to get even popular medical legislation passed

Michael Teitelbaum, CQ-Roll Call on

Published in Political News

WASHINGTON -- Sometimes even popular bills just don't move in Congress.

Consider the legislation to get Medicare coverage for a condition called lymphedema, which causes fluid retention and swollen tissues when the lymphatic system is damaged or blocked. It's a common side effect for cancer patients -- especially breast cancer survivors -- whose lymph nodes are harmed or removed.

An estimated 1.5 million to 3 million Medicare beneficiaries suffer from the disease, according to Illinois Democratic Rep. Jan Schakowsky, who sponsored a bill last year. For many, treatment requires special compression garments that can cost from $80 to $1,000 and that need replacement every six months. Without adequate treatment, the disease can cause infections and potential disability. The treatments are covered by the Veterans Affairs Department, TRICARE, many commercial insurers and, as part of their Medicaid programs, 44 states and the District of Columbia. But not by Medicare.

The Congressional Budget Office has not officially weighed in on the potential cost of Schakowsky's bill, but many of its provisions were included in House-approved drug-pricing legislation that roughly estimated Medicare coverage would total less than $1 billion over 10 years.

The absence of coverage "is one more challenge on top of the monumental battle of fighting cancer," Schakowsky said.

Six consecutive Congresses have attempted to get Medicare coverage for the treatment, bolstered by advantages that usually help push a bill through: huge co-sponsorship numbers (374 are behind Schakowsky's bill), a celebrity advocate (actress Kathy Bates), low cost (in Washington terms) and sponsors who sit on key committees. Yet the legislation continues to stall.

 

Washington Democrat Maria Cantwell attempted to get her Senate companion bill with 70 co-sponsors added to an end-of-year health care package late last year, but Congress did not take it up.

Former Rep. Dave Reichert, a seven-term Republican from Washington who left office in early 2019, worked for several years to push through legislation that would authorize Medicare coverage for the treatments, with increasing levels of support each time.

In Congress, despite significant support among members, the leadership felt that expanding the definitions for one disease would create a precedent for others, Reichert said.

"It boiled down to money and the worry that we would be opening a Pandora's box for other disease changes," Reichert said.

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