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House Backs Controversial Delay of New Organ Allocation Policy

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Nov. 19, 1999 (Washington) -- The fate of the nation's organ allocation system exploded into a full-fledged fight between Republican lawmakers and the Administration, as Congress took decisive steps yesterday towards adjourning for the year. As part of a package that the House overwhelmingly approved yesterday to both extend certain tax breaks and allow the working disabled to keep federal health benefits, GOP leaders included additional delays in the implementation of a new Administration organ allocation system.

With the support of many of the nation's transplant doctors and centers, the action would delay implementation of the policies for 90 days, allowing Congress to reopen the issue next year and consider legislation that would strip the government of much of its current authority over the program.

White House health advisor Chris Jennings blasted the GOP's action, calling it "totally unacceptable" and a "bad-faith move." He said that President Clinton was "dismayed" at the delay.

The delay provision, slipped in Wednesday night by Senate Majority Leader Trent Lott (R, Miss.), flew in the face of a 42-day delay that Health and Human Services (HHS) Secretary Donna Shalala negotiated with congressional appropriators last week. That measure would have put the Administration's transplant policy rewrite into action before lawmakers return next year.

The shorter delay also passed the House yesterday, in separate legislation. However, Republicans intend the longer measure to actually take effect, since they could force Clinton to sign the second bill after the first.

Sen. Edward Kennedy (D, Mass.) charged, "By breaking that agreement, [Republicans] put the lives of tens of thousands of desperately ill people at risk."

The Administration's proposed transplant rules would require that centers develop plans to more broadly share organs and use standard medical urgency criteria for patients, in an attempt to reduce regional disparities in the relative health of who gets transplants. The rules were slated to go into effect over a year ago, but Congress blocked them and called for an Institute of Medicine review of the situation. The Administration recently announced revisions to its rules, which it said put them closely in line with the institute's recommendations.

About 68,000 Americans are waiting for a transplant, and 5,000 people die each year during the wait. But transplant centers, led by the United Network for Organ Sharing (UNOS), believe the new rules could put small facilities out of business, possibly jeopardizing patients.

An otherwise-deadlocked Senate has yet to pass either of the measures the House approved, and the organ controversy could contribute to further chaos before it can adjourn for the year.

Several key senators wrote saber-rattling letters to Lott pressing both sides of the issue. "We will do everything in our rights as senators" to ensure that only the 42-day delay holds, a bipartisan group of five wrote yesterday. Sen. Arlen Specter (R, Pa.), who chairs the Senate's appropriations panel for HHS and supports the new rules, wrote Lott separately to warn, "I do not want to join the chorus of members who make threats to tie up the legislative process, but enough is enough." But Sen. Jeff Sessions (R, Ala.) also wrote Lott to promise a full-court press against the Administration rules.

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