Heart on the Hill - March 2015

Heart on the Hill 

Dietary Guidelines Advisory Committee Recommends Changes to the American Diet

On February 19, a federal advisory panel issued its report of recommended changes to the U.S. Dietary Guidelines. The Dietary Guidelines Advisory Committee, a group of 14 of the nation’s top nutrition experts, based its recommendations on an 18-month review of the latest nutrition science.

The committee recommended significant changes to the typical American diet, including reductions in the amount of sodium, saturated fat, and added sugars. The report describes a healthy diet as one “higher in vegetables, fruits, whole grains, low- or non-fat dairy, seafood, legumes, and nuts; moderate in alcohol; lower in red and processed meat; and low in sugar-sweetened foods and drinks and refined grains.” In a statement following the release of the committee’s report, association President Elliott Antman, M.D., said, “Although the American Heart Association and the Dietary Guidelines Advisory Committee differ on the ultimate target levels for sodium, saturated fats, and added sugars, the Committee’s recommendations are a shift in the right direction…”

The report will be used by the U.S. Departments of Agriculture (USDA) and Health and Human Services (HHS) to develop the 2015 Dietary Guidelines for Americans, which are expected to be released later this year. The guidelines serve as the basis for federal nutrition policy, such as setting nutrition standards for school meals, child care centers, and food assistance programs.

The American Heart Association is currently reviewing the Advisory Committee report and will submit detailed comments to USDA and HHS in the coming weeks. USDA and HHS are accepting public feedback on the report until April 8.

Contact: Susan K. Bishop

Congressional Women “Go Red”

This year, nearly 50 women – a record number from both sides of the aisle – participated in the third annual Congressional Wear Red Day photo in early February. The participating lawmakers also helped the American Heart Association and Go Red For Women promote National Wear Red Day on February 6 by sharing the photo on their social media channels.

Contact: Stephanie Mohl


USDA Plans to Update Nutrition Standards for Child and Adult Day Care Centers

In mid-January, the U.S. Department of Agriculture (USDA) unveiled proposed changes to the Child and Adult Care Food Program (CACFP). The program provides meals to 3.3 million children and 120,000 adults each day in child care centers, day care homes, afterschool care programs, emergency shelters and adult day care centers.

Under the USDA’s proposal, meals and snacks served to CACFP participants would include more whole grains and a greater variety of fruits and vegetables, as well as less sugar and fat. The proposed rule prohibits CACFP providers from serving fruit juice or cheese to infants, using frying as an onsite preparation method, or using food as a reward or punishment.

In upcoming comments to the USDA, the association will express overall support for the proposed rule while recommending several changes, such as limiting the amount of juice that can be served to children and adults, eliminating flavored milk for children under five years of age, and restricting the amount of added sugars in yogurt and flavored milk.

Contact: Susan K. Bishop

The 113th Congress Wraps Up

After a slow year, Congress managed to get a lot accomplished in the last couple of weeks and days of its 113th session, including numerous provisions of interest to the association.

On December 16, President Obama signed the 1,600-page, $1.1 trillion FY 2015 Omnibus Appropriations bill that funds the federal government through September 2015. Congress also passed a bill that will extend for 2014 only about 45 business and individual tax breaks, including the so-called charitable IRA rollover.

The association was very pleased that in the final hours of the session, Congress confirmed Dr. Vivek Murthy as the 19th Surgeon General of the United States. The association supported Dr. Murthy’s who is a staunch advocate for many of our prevention priorities. In addition, the House and Senate passed the Newborn Screening Saves Lives Reauthorization Act, which renews federal initiatives that assist state newborn screening programs.

There are certain provisions in the bill that preview some of the significant battles we are likely to face in the 114th Congress, such as: more scrutiny over the National Institutes of Health (NIH) research portfolio; a higher level of accountability and outcomes demanded for federal involvement in state and community chronic disease prevention efforts; and extreme antipathy towards regulations (particularly if they impose a financial burden on companies) and tax reform.

To read more about our most significant wins and losses, along with a more detailed explanation of provisions of interest to the association, click here.

Contact: Sue Nelson

President’s Budget for FY 2016

In early February, President Obama submitted his proposed FY 2016 budget to Congress. The budget provided $31.3 billion for the National Institutes of Health (NIH), nearly $1 billion over the previous year’s budget.

In a statement following the release of the budget proposal, American Heart Association President Elliott Antman, M.D., described the NIH-funding level as “a welcome change after many years of flat funding,” and urged Congress to approve this increase with the hope that part of it will be directed toward more cardiovascular research. Additionally, the association applauded the proposed budget’s inclusion of $215 million to launch a precision medicine initiative that will accelerate the ability to improve health outcomes and better treat diseases.

The budget also contained:

  • $130 million for CDC’s Division for Heart Disease and Stroke Prevention.
  • $4 million for Million Hearts®, a public-private partnership to prevent 1 million heart attacks and strokes by 2017.
  • $21.170 million for WISEWOMAN to help uninsured, underinsured low-income women avoid heart disease and stroke.

All of these programs are level funded from the previous year. In addition, the president proposed the elimination of all funding for HRSA’s Rural and Community Access to Emergency Devices (AED) Program.

Contact: Kevin Kaiser

Leadership Meets with FDA Commissioner and NIH Directors

On January 12, American Heart Association-elected volunteer leadership met with Food and Drug Administration (FDA) Commissioner Margaret Hamburg, M.D. The group also met separately with National Heart, Lung, and Blood Institute (NHLBI) Director Gary Gibbons, M.D. and National Institute of Neurological Disorders and Stroke Acting Director Walter Koroshetz, M.D.

In addition to strengthening the mutually beneficial relationships among these three groups, the meetings served as an opportunity to discuss areas of mutual interest and identify areas for future collaborations.

American Heart Association participants included: Chairman of the Board Bernard Dennis; President Elliott Antman, M.D.; President-elect Mark Creager, M.D.; Immediate Past President Mariell Jessup, M.D.; American Heart Association Stroke Council Chair Joseph Broderick; M.D.; American Stroke Association Advisory Committee Chair Mary Ann Bauman, M.D.; Chief Executive Officer Nancy Brown; Chief Science and Medical Officer Rose Marie Robertson, M.D.; and Executive Vice President for Advocacy and Health Quality Mark Schoeberl.

Contact: Susan K. Bishop (FDA) or Claudia Louis (NIH)

FDA Unveils New Drug Trials Snapshots

In January, the association submitted comments to the Food and Drug Administration(FDA) on the agency’s new Drug Trials Snapshots website. The initiative is part of the FDA’s Action Plan which makes publicly available information about how newly approved drugs work by sex, age, race and ethnicity. The website also includes the results of the efficacy and safety studies and, if known, differences in efficacy and side effects among sex, race and age subgroups.

We continue to collaborate with the FDA on the implementation of its Action Plan to Enhance the Collection and Availability of Demographic Subgroup Data. The plan was enacted as a result of the association’s leadership efforts and our long-time work on the HEART for Women Act. The new Snapshots site is a positive step forward, and the association will continue our work to improve the availability of this type of information.

Contact: Stephanie Mohl


Child Nutrition Programs

Last year, the American Heart Association worked tirelessly to protect the nutrition standards for school meal programs. We were successful in keeping a blanket waiver for schools to opt out of the standards, as well as a complete dismantling of the program out of the final funding legislation. However, the bill did contain language on sodium and whole grains that are cause for concern.

The legislation prohibits the United States Department of Agriculture (USDA) from moving on to the second and third levels of sodium reduction until the latest science shows there is a benefit in sodium reduction for children. The science is clear that sodium needs to be reduced for all populations, but especially children. Delaying cuts in sodium could mean that more children will develop high blood pressure and be at risk for heart disease and stroke before they become adults. The bill also gives states the option to waive the 100 percent whole grain enriched requirement.

The association is concerned that politicians, ignoring the best evidence-based guidance from nutrition experts, are making nutrition policy that undermines the integrity of existing programs and the law. These efforts began in 2011 when Congress declared that pizza sauce counted as a serving of vegetables under new federal child nutrition program regulations.

With Congress set to address the reauthorization of child nutrition programs (including school meals) this year, the association will focus on protecting our hard-fought gains and tremendous progress to provide children with nutritious food choices at school, which will set them on the path to life-long healthy habits. The improvements to school foods is an important public health victory that will contribute to reducing childhood obesity.

To bring further awareness to this important issue, the association recently launched a microsite dedicated to child nutrition. The site houses a variety of valuable resources, including an interactive map that breaks down child nutrition efforts by state, success stories, calls to action and information on the Healthy Hunger-Free Kids Act. This new resource will be updated consistently with news articles and updates from both the American Heart Association and allied groups on child nutrition.

Contact: Kristy Anderson

American Cures Act Endorsement

For a second year in a row, the association has endorsed the American Cures Act. The legislation would increase funding for the National Institutes of Health, Centers for Disease Control and Prevention, Department of Defense Health Program, and Veterans Medical and Prosthetics Research Program at the rate of inflation plus 5 percent. The bill establishes a budget cap adjustment so this additional funding would not be made at the expense of other programs. This measure was introduced by Senator Richard Durbin (D-IL), the Senate Minority Whip and a co-chair of the Congressional Heart and Stroke Coalition.

Contact: Claudia Louis

Laboratory Developed Tests

In January, Dr. Christopher Newton-Cheh, a cardiologist at Massachusetts General Hospital and assistant professor at Harvard Medical School, represented the association on a panel with other public and nonprofit stakeholders during a two-day FDA public workshop on the agency’s risk-based proposal to phase-in oversight of laboratory developed tests (LDTs). Dr. Newton-Cheh applauded the FDA for moving forward with its plans to oversee these tests, which are being used more and more to predict, detect, or guide therapy decisions for patients with certain diseases even though they have not been approved by the FDA for use. He urged the FDA to require test manufactures to submit certain information so that healthcare professionals and patients can evaluate LDTs.

Later in January, the association submitted comments to the FDA, which reinforced our support for oversight of these tests and highlighted the need for the agency to review claims about testing accuracy, safety and effectiveness for certain cardiovascular diseases – particularly tests that pose the highest risk to patients.

The association also submitted comments to the House Energy and Commerce Committee, urging Congress to allow the FDA to act swiftly to finalize its guidance and phase-in its regulation. The committee held a hearing in September to solicit stakeholder feedback on FDA’s proposal; it is currently considering input on how Congress should address this issue as part of its 21st Century Cures initiative, which seeks to modernize the drug development and approval process.

We will continue to urge the FDA and Congress to support oversight of LDTs to ensure that groundbreaking advances in research can be translated into effective diagnostic tools and treatments that improve outcomes for cardiovascular patients.

Contact: Kevin Kaiser

Elementary and Secondary Education Act (ESEA)/ Physical Education Program (PEP)

On January 13, Senator Lamar Alexander (R-TN), chairman of the Senate Health, Education, Labor and Pensions (HELP) Committee, released a discussion draft of legislation to reauthorize the long overdue Elementary and Secondary Education Act (ESEA). While the association was pleased to see the proposal list physical education as an acceptable use in a consolidated grant program, it is disappointed that physical education program (PEP) grants – the only dedicated federal funding for physical education – was eliminated.

The association submitted a letter in response to Sen. Alexander’s request for public feedback on his proposal, which highlighted the importance of physical education in keeping children healthy and improving their academic achievement and behavior in school. The letter also noted that PEP grants work and are so popular that only 10 percent of the thousands of applicants are able to secure funding.

The association will monitor the progress of the ESEA reauthorization and collaborate with Congressional champions to protect physical education and support the reintroduction of FIT Kids, a bill that focuses on making continued improvements to physical education in America’s public schools.

Contact: Kristy Anderson

Affordable Care Act

Open enrollment for the Health Insurance Marketplaces ended on February 15. Approximately 11.4 million people selected plans for the first time or were automatically re-enrolled in health insurance coverage through the federal and state-based marketplaces. The association continues to help spread the word about new coverage options to the uninsured, defend the law, and work on improving the law for patients with heart disease and stroke.

Here are some highlights of our work:

  • An additional 10.1 million Americans were enrolled in Medicaid and the Children’s Health Insurance Program (CHIP) as of November 2014 – a 17.5 percent increase over the average monthly enrollment for July through September of 2013.
  • The association joined the American Cancer Society, the American Diabetes Association, and the National Multiple Sclerosis Society in filing an amicus brief in the Supreme Court case, King v. Burwell, defending the availability of the Affordable Care Act’s premium tax credits in states using the federal health insurance marketplace. The Supreme Court will hear oral arguments in this case on March 4; a decision is expected to be handed down in late June.
  • We continue to submit comments advocating for regulatory improvements to the Affordable Care Act that will ensure the new health insurance coverage is meeting the needs of patients with heart disease and stroke. The association is also working with the National Association of Insurance Commissioners to update their model legislation related to health plan network adequacy.
  • Findings from the Commonwealth Fund’s Biennial Health Insurance Survey released in January, found that for the first time in the survey’s history, the number of adults who did not receive health care because of cost issues declined from 80 million people (43 percent) in 2012 to 66 million (36 percent) in 2014. The number of adults who reported problems paying their medical bills declined from an estimated 75 million people in 2012, to 64 million people in 2014.

Contact: Stephanie Mohl

Association Holds First Meet and Greet

The American Heart Association joined the American Cancer Society Cancer Action Network and the American Diabetes Association to host its first meet and greet with new members of Congress. For this kickoff event, the three associations met with Republican freshman Rep. Earl “Buddy” Carter (R-GA-01), the only pharmacist in Congress, to briefly discuss his health priorities and interests for the 114th Congress.

The forum provided Rep. Carter with an opportunity to build relationships with the three largest non-profit health organizations. Collectively, cardiovascular disease, including stroke, cancer, and diabetes account for approximately two thirds of all deaths in the United States, and about $700 billion in direct and indirect economic costs each year.

In addition, the association met with Republican freshman Rep. Mimi Walters (R-CA-45) on Capitol Hill, who represents the Republican Freshmen Class on the House Republican leadership. During this meeting she discussed her priorities for the 114th Congress and we highlighted the federal advocacy work of the American Heart Association.

Contact: Claudia Louis

Reauthorization of Federal Newborn Screening Law

Before the 113th session adjourned, Congress passed the Newborn Screening Saves Lives Reauthorization Act, which President Obama signed into law on December 18, 2014. This law renews federal initiatives for five years that assist state newborn screening programs, support parent and provider education, and ensure the accuracy and quality of newborn screening tests for five years.

The association applauds Congress and the many patient advocacy organizations for their hard work to reauthorize this critical law that has already touched the lives of more than 4 million infants born in the United States. The act has also helped identify newborns with metabolic, hormonal, genetic, and developmental disorders – including critical congenital heart disease – to make sure newborns get prompt treatment when they need it most.

Contact: Kevin Kaiser

On January 22, New Orleans unanimously passed an ordinance prohibiting smoking in most indoor public places, including bars, restaurants and casinos. The law improves on the Louisiana Smoke-Free Air Act of 2007, and creates smoke-free indoor public spaces in New Orleans, known for its entertainment and convention business. In addition to the city’s residents, the ruling will protect the millions of tourists who visit each year.

American Heart Association CEO Nancy Brown praised the New Orleans City Council on the passage of this monumental law.

Contact: Chris Sherwin

Pennsylvania and Indiana Expand Access to Quality Healthcare

State health officials in Pennsylvania and Indiana worked closely with the American Heart Association, hospitals and other stakeholders to create unique programs that will provide health insurance coverage to low-income adults in their states. As a result of these efforts, an additional 500,000 Pennsylvanians and 350,000 Indiana residents will now have quality healthcare coverage.

Contact: Lucy Asdourian

North Carolina Approves New Stroke Center Designation Rules

On January 15, the North Carolina Rules Review Commission unanimously approved new stroke center designation rules. The rules include: designation for Comprehensive, Primary, and Acute Stroke Ready facilities, and also recognize the American Heart Association/American Stroke Association in the regulations as a national accrediting body.

North Carolina is the second state in the country to achieve a policy victory which recognizes all three tiers of stroke centers and requires Emergency Medical Services (EMS authorities) to create transport protocol plans and procedures.

Contact: Douglas Dunsavage

Newborn Screening Victories in Four More States

Pennsylvania, Nebraska, Iowa, and Virginia have all passed public policy to require pulse oximetry screening for newborns. With these new victories, 37 states now require this lifesaving screening for congenital heart defects.

Contact: Lucy Asdourian

Minnesota Expands Coverage for Preventive Benefits

The Minnesota Department of Human Services recently added coverage for preventive benefits for all Medicaid enrollees. Minnesotans who participate in Medicaid will now have access to all screenings and treatments with an A or B recommendation from the United States Preventive Services Taskforce, helping them to live healthier lives.

Contact: Lucy Asdourian

Tobacco Cessation Win in Georgia

On November 14, the Centers for Medicare and Medicaid Services approved the Georgia Department of Community Health’s Medicaid State Plan Amendment’s inclusion of comprehensive tobacco cessation coverage. The amendment also covers private counseling and all seven FDA-approved medications.

Contact: Lucy Asdourian

District of Columbia Sets Healthier Food and Beverage Procurement Standards

The District of Columbia now requires that foods and beverages sold through vending machines on government property, as well as all government purchased and served food, must meet healthy standards. This action by the D.C City Council was part of a Worksite Wellness Act, which also includes a provision tasking each District agency with achieving the American Heart Association’s Fit Friendly gold-level designation.

Contact: Ashley Bell

New Mexico and Florida Take Steps to Improve School Nutrition

The New Mexico Public Education Department and the Florida Department of Agriculture have adopted state rules on competitive foods that fully align with the USDA’s Smart Snacks in School nutrition guidelines. These rules comply with the federal standards which require all foods sold in schools to be primarily whole grains, fruits, vegetables, dairy or a protein. Each state has staff and training plans in-place to work directly with schools to implement the new standards.

Contact: Stephanie Tama-Sweet

Shared Use Win in Ohio

On December 19, the governor of Ohio signed HB 290 into law, clarifying the state’s shared use liability provisions for schools across the state. This removes a barrier for schools interested in opening their facilities after hours for additional physical activity opportunities in the community.

For more than two years, the association has been working to address this issue in Ohio, and was supported by a grant from Voices for Healthy Kids. Efforts to back shared use implementation in Ohio will continue with coalition partners.

Contact: Tim Vaske

Media Advocacy Contacts

Retha Sherrod
Director, Media Advocacy
(202) 785-7929

Samantha Carter
Associate Communications Manager, Media Advocacy
(202) 785-7935

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