All Politics Remain Local...

...and are key to the continued success of AST and the field of solid organ transplantation

As we all know, in just under 30 days, American voters will determine the fate of all 435 members of the U.S. House of Representatives, over half of the U.S. Senate, and who will serve as our 45th president in the White House.  Unquestionably, there is much at stake in this historic election cycle; from determining the next inhabitants of 1600 Pennsylvania Avenue, to choosing who will and will not return to Capitol Hill in 2017, in addition to policy agendas and priorities for the next 115th Session of Congress and White House Administration.

Although the national focus and policy landscape may run fluid and change from election to election (including topics such as the economy, foreign policy, the environment and healthcare), there has always been one constant that has remained true from the very first election.

All politics are local. Nothing motivates or drives elected officials into action more than local issues impacting local constituencies. 

Local Issues & Pressure Drive Action by Members of Congress

Years ago, when asked about the political motivations of his colleagues, former Speaker of the House, Tip O'Neill (D-MA) replied, “all politics are local.” Never has there been a more true statement made regarding politics and what motivates members of Congress to act on a particular issue of concern. 

Although AST and many of our sister & brother stakeholder organizations maintain a strong government relations presence in Washington, nothing conveys a stronger public policy message or mobilizes elected officials more than a local constituent communicating directly with their elected representatives on Capitol Hill. 

Although national issues make headlines and are the fodder of Sunday political talk shows, they rarely carry the day or provide secure job security for most members of Congress. To the contrary, it is local healthcare, education, transportation, infrastructure, resources and economy that generally drive the electorate to seat or unseat their national representatives.  Members of Congress understand this reality and are ultimately motivated to act based largely on communications from these core constituencies and voter blocks within each of their congressional districts and states.

Where Is Congress now and are there opportunities for them to act in 2016 on issues of importance to the organ transplant community?

As you may know, the current Congress has not adjourned for the year. Instead, this 114th Congress has recessed to return to their local states and congressional districts to run for re-election and will later return to Capitol Hill following the November national elections for what is commonly referred to as a "lame duck" session. Upon returning to Capitol Hill, members will work to complete action on the 2017 appropriations bill to fund the operations of the U.S. federal government through the end of 2017. Currently, federal funding only runs through December 9, 2016, as Congress passed a short term stop-gap temporary funding measure before recessing a few weeks ago.

Following the November elections, members of Congress will return to Washington to address federal funding and potentially any legislation that remains active and pending before the U.S. House of Representatives and U.S. Senate.

NIH Funding

Both the House and Senate Appropriations Committees have recommended increases of 2 billion dollars for biomedical research and the National Institutes of Health (NIH) in 2017.  AST has strongly advocated for significant increases at NIH throughout this current session of Congress including providing congressional testimony, direct lobbying of Appropriations Committees, joint advocacy letters, testimony and lobbying of Congress with transplant and medical research stakeholder community.

Comprehensive Immunosuppressive Drug Coverage for Kidney Patients Act of 2016

Three weeks ago, Congressmen Dr. Michael Burgess (R-TX) and Ron Kind (D-WI) re-introduced this important legislation to ensure that every kidney transplant recipient—regardless of age or socioeconomic level—can access necessary lifesaving immunosuppressive medications. Under current law, there remains a patient gap preventing some from coverage of these necessary immunosuppressive drugs. Congressmen Burgess and Kind have worked closely with AST and others for many years to address this broken Health Human Services (HHS) Medicare program policy and have reintroduced legislation to garner Congressional support now and into the next session of Congress in 2017. Any co-sponsors that can be secured now will place the AST at an even greater advantage when the bill is again offered in 2017. 

Living Donor Protection Act (LDPA)

The Living Donor Protection Act (LDPA) was introduced 7 months ago by Congressmen Jerold Nadler (D-NY) and Dr. Michael Burgess (R-TX) in an effort to protect kidney transplant donors from economic discrimination at the insurer and employment levels. The legislation was also introduced in the U.S. Senate by Mark Kirk (R-IL) and Kirsten Gillibrand (D-NY); both House and Senate bills have gained steady bipartisan support. The AST and the kidney transplant stakeholder communities have aggressively educated and mobilized support behind these very important policy measures.

What can I do as an AST member between now and the end of 2017 to help promote and advance these still active transplantation policy measures?

As previously stated, all politics are local—meaning, you have the ear of your elected officials and you can make a difference, particularly when they are in a recess period and working primarily out of their local district and state offices.

Although by comparison, solid organ transplantation is not the biggest medical subspecialty or constituency lobbying Congress on a daily basis, I have heard many legislators and congressional staff describe our advocacy community as "swimming in the deep end of the pool" and "boxing a good two or three levels above our weight class."  Proof of this positive presence, visibility and impact is the fact that transplantation has multiple patient-focused legislative bills still active deep into the final days of this current session of Congress.  

Call to Action -  Grassroots Support Effort Needed

As the president of AST, I encourage each of you to take a moment to access the public policy section of the AST's website to identify and connect with your two senators and one member of the House of Representatives, requesting their co-sponsorship and support for the legislation outlined above, prior to adjourning the 114th session of Congress. Our Congressional champions have asked for our grassroots support on these issues now, both before and after the November 8 election, and again when the bill is reintroduced in the 115th Congress (Jan 2017). Any momentum we build now will carry over into the new year.

Yours in service,
Anil Chandraker 


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