Federal Advocacy Successes Timeline

Updated:May 1,2017

The American Heart Association had a lead role in championing and/or developing these federal initiatives:

Nutrition Provisions in the Farm Bill (2014)
The farm bill advanced nutrition provisions supported by the American Heart Association, designed to increase healthy food consumption. These provisions included  authorizing the Healthy Food Financing program, which establishes grocery stores in food deserts, providing access to healthier food and often boosting local economies. The bill also fully funding SNAP-Ed, a program that helps low-income Americans make healthy choices on a limited budget and expanded the program to include physical activity.

Medicare Coverage of Cardiac Rehabilitation for Heart Failure Patients (2014)

At the request of AHA and three other cardiovascular organizations, the Centers for Medicare & Medicaid Services (CMS) expanded Medicare coverage for cardiac rehabilitation service to include beneficiaries with chronic heart failure.

Comprehensive Nutrition Standards for All Foods Sold in Schools (2013)

For the first time, foods and beverages sold in a la carte lines, vending machines, school stores, and snack bars will be subject to strong nutrition standards that include limits for calories, fat, sodium, and sugar.  Schools were required to meet the standards by July 1, 2014.

HEART for Women Provision (enacted as part of FDA Safety and Innovation Act) (2012)
A key piece of the HEART for Women Act has been signed into law as part of the Food and Drug Administration’s (FDA) user fee reauthorization legislation It requires the FDA to submit a report on the extent to which clinical trial participation and safety and effectiveness data reported by demographic subgroups include sex, age, race and ethnicity when the agency approves new drugs and medical devices for public use. The FDA is also required to develop an action plan for improving the quality and availability of this data by demographic subgroups.

Family Smoking Prevention and Tobacco Control Act (2009)
Gave the Food and Drug Administration (FDA) authority to regulate the manufacturing, marketing and advertising of tobacco products. Candy-flavored cigarettes will be banned and new large warning labels will be mandated. Billboard advertising near schools are also banned, and there will be new restrictions on advertising in convenience stores and magazines with high youth readership. Tobacco companies will no longer be able to alter their products to make them more addictive or to make misleading health claims.

Preventative Benefits in Medicare Bill (2008)
American Heart Association successes included language to help identify and eliminate health disparities among minority and female Medicare beneficiaries. This legislation also included a number of provisions supported by the association that will improve Medicare’s coverage of preventative services, address health disparities among Medicare beneficiaries, and assure continued access to Medicare outpatient therapy services.

Genetic Information Nondiscrimination Act (2008)
Protects individuals from discrimination based on their genetic information by employers or healthcare providers.


Safe Routes to School and Active Transportation in MAP-21 (2012)
Safe Routes to School and other active transportation policies were in serious danger of being eliminated in the 2012 transportation reauthorization, MAP-21. This legislation ended up making significant changes to funding for bicycling, walking and Safe Routes to School, and while cut funding, ultimately kept the programs under a new consolidated program called Transportation Alternatives Program (TAP).

AHA Joins Million Hearts Initiative (2011)
 On Tuesday, September 13, American Heart Association CEO Nancy Brown, HHS Secretary Kathleen Sebelius, CDC Director Thomas Frieden, and CMS Administrator Donald Berwick were joined by key business, nonprofit, and government officials, to announce the Million Hearts Initiative to fight heart disease, the leading cause of death in the United States. The initiative will strategically focus on various healthcare reform efforts planned and currently underway to prevent 1 million heart attacks and strokes by 2016.

12 Cardiovascular Conditions on the Compassionate Allowances List (2011)

The Social Security Administration (SSA) added 12 forms of cardiovascular disease to the Compassionate Allowances list. Patients with one of these severe forms of cardiovascular disease will have their applications for disability benefits fast tracked.


Medicare Coverage for Intensive Behavioral Therapy for Obesity (2011)

The Centers for Medicare and Medicaid Services (CMS) added a new obesity prevention benefit to the Medicare program. Beneficiaries with a body mass index of 30 or more are eligible for intensive behavioral counseling and behavioral therapy to promote sustained weight loss through diet and exercise interventions.


Medicare Coverage for Intensive Behavioral Therapy to Reduce Risk of CVD (2011)

The Centers for Medicare and Medicaid Services (CMS) added a new cardiovascular disease prevention benefit to the Medicare program. Medicare beneficiaries are eligible for annual counseling about aspirin use to prevent CVD; screening for high blood pressure; and intensive behavioral counseling to promote a healthy diet for beneficiaries with hyperlipidemia, hypertension, advancing age, and other known risk factors for cardiovascular- and diet-related chronic disease.

AHA Administer $2 million fund for childhood obesity prevention (2011)

The American Heart Association (AHA) has been selected to administer $2 million in funding from the Robert Wood Johnson Foundation (RWJF) to help implement state and local public policy initiatives to reduce childhood obesity. The objective of the two-year "Childhood Obesity Rapid-Response Fund" is to improve nutrition and increase physical activity among children before, during and after school as well as at home and in their communities through public policy issue advocacy campaigns.


Healthy, Hunger-Free Kids Act (2010)

This federal law updated the school meal nutrition standards for the first time in a generation, and also required regulations to  cover competitive foods and all foods sold in schools outside of the meal program to ensure that only healthier products are sold. In addition, AHA led a successful effort to include in the law a requirement that schools develop, implement and evaluate policies on nutrition and physical activity, and are held accountable for doing so. The law also increased the reimbursement rates for free and reduced-priced lunches for schools that meet the new nutrition requirements.


Prevent All Cigarette Trafficking (PACT) Act (2010)

The PACT Act impacts public health in two ways:

·         Restricting access to tobacco products through the Internet to minors

·         ensure that purchasers pay the full price of tobacco products, including the taxes

Patient Protection and Affordable Care Act (ACA) (2010)

Includes many patient-centered provisions advocated for by the American Heart Association, such as the ban on denying coverage or charging higher premiums to patients with pre-existing medical conditions, expands coverage to millions of uninsured Americans, requires Medicare and most private health plans to cover preventive services with no cost-sharing, creates the Prevention and Public Health Fund, and includes the Congenital Heart Futures Act, among many more provisions.


Menu Education and Labeling Act (enacted as part of ACA) (2010)

The menu labeling provision requires restaurants or similar food establishments that are part of a chain (defined as 20 or more locations with the same name) to make caloric information visible before the purchase decision is made.  Specifically, calories must be posted both in menus or menu boards, as appropriate, and other nutritional information must be available upon request.


Medicare Coverage of Counseling to Prevent Tobacco Use (2010)

The Centers for Medicare and Medicaid Services (CMS) added a new tobacco cessation preventive benefit. Beneficiaries who use tobacco, regardless of whether or not they have signs of a tobacco-related disease, are eligible for up to 8 cessation counseling sessions per 12 month period.


NIH Funding in Economic Stimulus Bill (2009)

Congress and the President passed the 2009 Economic Stimulus Bill which included $10 Billion of funding for the National Institutes of Health (NIH) over two years. The bill also included $1 billion for the Prevention and Wellness Fund, $19 billion to spur the widespread adoption of health information technology, and $1.1 billion for comparative effectiveness research. As part of this budget, heath and stroke research and prevention spending received solid budget increases.


Children’s Health Insurance Program Reauthorization Act (2009)

The Children's Health Insurance Program (CHIP) provides health coverage to nearly eight million children in families with incomes too high to qualify for Medicaid, but can't afford private coverage. Signed into law in 1997, it was a major victory in 2009 when Children’s Health Insurance Program Reauthorization Act (CHIPRA) reauthorized the program and added an additional $100 million in funding between FY 2009 and FY 2013.

V Code to Identify Stroke “Drip and Ship” Patients (2008)

At the request of AHA/ASA and the American Academy of Neurology, the Centers for Medicare and Medicaid Services (CMS) created a new V code to identify acute stroke patients who receive tPA in an emergency room (drip) and are then transferred to another hospital’s stroke center for subsequent care (ship).

Nutrition Provisions in Farm Bill (2008)
American Heart Association supported the Commodity Quality Incentive Program, the Federal Food Assistance Program, the Expansion of the Fresh Fruit and Vegetable Program, and the reauthorization of the nutrition monitoring program.

New Division for Heart Disease and Stroke Prevention at CDC (2005)
Elevated CDC’s Cardiovascular Branch to a Division for Heart Disease and Stroke Prevention to focus and consolidate its efforts to improve the nation’s cardiovascular health.

Safe Routes to School (2005)
This program provides funds to states to substantially improve the ability of primary and middle school students to walk and bicycle to school safely, increasing daily physical activity among children. States are scheduled to receive $612 million from 2005-09.

 New DRG559 for Medicare Reimbursement of t-PA (2005)

At the urging of the AHA/ASA, the Centers for Medicare and Medicaid Services (CMS) created a new Diagnosis Related Group (DRG) 559 to reimburse hospitals for the costs of treating acute stroke patients with thrombolytic therapy. (DRG 559 was later split into three separate MS-DRGs: 61, 62, and 63).

Cardiovascular Screening Added to Medicare (2003)
The Medicare Cholesterol Screening Coverage Act signed into law as part of the Medicare Prescription Drug and Modernization Act of 2003. Provides seniors with cholesterol and other cardiovascular screenings.

Community AED Act (2002)
Authorized the expenditure of funds to establish public access defibrillation programs. Communities receiving grants would purchase and place automated external defibrillators (AEDs) in public places where cardiac arrests are likely to occur.

NIH Funding Doubled (2002)
In FY 2003, Congress completed its five year effort to double funding at the National Institutes of Health (NIH), increasing annual funding from $13.6 billion to over $27 billion.

Physical Education for Progress Act (2000)
The PEP program was created in 2001 as a competitive grant program to help local school districts upgrade physical education programs and equipment. In FY 2003, $60 million was appropriated to implement this program.

Paul Coverdell National Acute Stroke Registry Established (2000)
Secured funding for the Centers for Disease Control and Prevention (CDC) to design and test prototypes to track and improve the delivery of care to patients with acute stroke in four sites across the country. In 2002, the registry was expanded to an additional four sites.

Rural Access to Emergency Devices Act (2000)
Authorized the expenditure of funds in rural areas to purchase lifesaving AEDs and train individuals in their use. In FY 2003, $12.5 million was appropriated to implement this program.

Cardiac Arrest Survival Act (2000)
Directed the federal government to issue guidelines for the placement of automated external defibrillators (AEDs) in federal buildings and extended the "Good Samaritan" protections to those both using and purchasing AEDs.

Women's Cardiovascular Diseases Research and Prevention Act (1998)
As the result of AHA's work, legislation was signed into law to create a program to advance the fight against heart disease, stroke and other cardiovascular diseases in women. Specifically, this law provided funding to expand heart and stroke research in women and create additional information and educational programs for women patients and healthcare providers on heart disease and stroke risk factors.

State Heart Disease and Stroke Prevention Program (1998)
With support from Congress, the Centers for Disease Control and Prevention (CDC) created the State Heart Disease and Stroke Prevention Program to meet state needs to prevent and control heart disease, stroke and other cardiovascular diseases. In FY 2003, $43.2 million was appropriated to implement this program.

FDA Jurisdiction Over Tobacco (1996)
Led the effort to urge the Food and Drug Administration (FDA) to claim jurisdiction over tobacco products. FDA issued final regulations providing for jurisdiction over the advertising, promotion and manufacturing of tobacco products.

Healthy Meals for Healthy Americans Act (1994)
Amended the national school lunch program to require that schools serve meals that meet dietary guidelines for Americans, which included limits on total fat and saturated fats.

Nutrition Labeling and Education Act (1990)
Provided for comprehensive nutritional labeling of packaged food products and for the regulation of health claims.

Ban on Smoking on Airlines (1988)
Banned smoking on all commercial airliners.

Comprehensive Smokeless Tobacco Health Education Act (1986)
Required all smokeless tobacco packages and advertisements carry rotating warning labels.

Comprehensive Tobacco Prevention and Education Act (1984)
Required rotating warning labels on cigarette packages and advertisements including a label stating, Surgeon General's Warning: Smoking causes lung cancer, heart disease, emphysema, and may complicate pregnancy.

Federal Cigarette Excise Tax Increased From 8 to 16 Cents Per Pack (1982)
It was the first increase in 31 years.

National Institute of Neurological Diseases and Blindness Changes Its Name to the National Institute of Neurological Diseases and Stroke (1968)

President Lyndon B. Johnson Designates February as “Heart Month” (1963)

National Heart Institute is Formed (1948)
Congress established the National Heart Institute in June 1948. It became the National Heart and Lung Institute in 1969 and the National Heart, Lung, and Blood Institute in 1976. It is one of only 27 institutes and centers at the National Institutes of Health (NIH).



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