Smallpox Compensation Law Stalls

Published May 1, 2003

Despite a recent floor defeat, House Republicans say they have not given up on a bill to create a federal compensation program for those harmed by the smallpox vaccine.

“We’re looking at other options,” House Majority Leader Tom DeLay (R) told reporters at a press briefing.

Among those options is attaching the proposal to an emergency spending bill for the war effort, now moving through both the House and Senate. The smallpox compensation plan, riding as an amendment, would provide a lump-sum benefit of $262,100 to those who are permanently disabled by the vaccine or to the survivors of vaccine victims who die, and up to $75,000 in lost wages annually.

DeLay blamed the Bush administration for the bill’s defeat. House Republican leaders introduced the measure under a fast-track procedure known as “suspension,” which bars amendments. But measures introduced that way also require a two-thirds majority to pass. The bill failed to receive even a simple majority, and went down to defeat 206-184. “The White House wanted us to put it on the suspension calendar. We warned them this could happen,” DeLay said.

In Opposition

Democrats, 21 Republicans, and groups representing nurses and other “first responders” said the plan was not generous enough to ease the fear of health care workers, who worry they may not be adequately compensated if they suffer severe side effects from the vaccine. Experts estimate between 15 and 50 people of every 1 million vaccinated for the first time will face life-threatening complications, and one or two will die.

Democratic leaders urged Republicans not to try to attach the measure to the war spending bill. “I would hope they would not put their ill-advised bill that didn’t even get a majority into a must-pass bill” like the spending measure, House Majority Leader Nancy Pelosi (D-California) told reporters. But Pelosi and House Majority Whip Steny Hoyer (D-Maryland) also said they thought the tactic could work, since most Democrats plan to vote for the bill to provide additional spending for the war and other homeland security efforts.

A Senate committee is scheduled to continue debate on its version of a smallpox compensation program. Despite weeks of negotiating, Health, Education, Labor and Pensions Committee Chairman Judd Gregg (R-New Hampshire) has been unable to reach agreement with Edward M. Kennedy (D-Massachusetts).

“There’s some basic issues we can’t agree on,” said a spokesperson for Gregg. A Kennedy spokesman said the senator planned to offer amendments to make funding for the program automatic, rather than subject to annual appropriations; to eliminate the Senate-proposed $50,000 cap on lost wages; and to allow workers to collect lost wages even if they are out of work for fewer than five days.

Compensation Conundrum

Some Democrats want more generous compensation. Kennedy said the bill is a “tin cup response to a major kind of health threat, and it insults first responders in this country.” Gregg said the $262,100 lump sum death benefit is equal to the amount paid to survivors of police officers killed in the line of duty, and more than the $256,000 paid to survivors of fatally wounded soldiers.

Gregg also pointed out, “This is not a legal issue. This is not a health issue. This is a national security issue. We are at war. The passage of this legislation is vital to the safety of the American people.”

Republicans believe approving a compensation bill would substantially increase participation in the administration’s plan to vaccinate 450,000 health care workers. While 350,000 military personnel have been vaccinated, according to the April 7 issue of U.S. News & World Report, as of April 4, only 25,000 health care workers have received the vaccine.

“We’ve got to get this program in place to immediately lower the barriers” to participation, said Senate Majority Leader Bill Frist (R).

Conrad F. Meier is managing editor of Health Care News. His email address is [email protected].

For more information …

on the failure of the smallpox program to reach its goals for vaccinating first-responders, see “Thumbs Down on Smallpox Vaccine Program,” Health Care News, April 2003, available on the Web site of The Heartland Institute at