WASHINGTON _ On your Mark. Get Set. Go. Competitive runnersand swimmers know exactly what to do when they hear these words.On Capitol Hill, political athletes know that the "Chairman's Mark" isthe starting line for legislative races. In the next few weeks,understanding this term will be critical to understanding the health carereform debate.What is the Chairman's Mark? It is the text or outline of proposedlegislation put forward by the chairman of a Senate or Housecommittee (or subcommittee). "The Mark is the starting point,"explained Charles Tiefer, solicitor of the House of Representatives andauthor of the 1,000-page volume, Congressional Practice andProcedure.Today, Sen. Edward Kennedy (D-Mass.) will circulate the text of hisMark as chairman of the Senate Labor and Human ResourcesCommittee, thus formally firing the starting gun for the Senate healthcare reform race. Although an outline has been available sinceMonday, the full text will reveal all-important details.The Chairman's Mark circulates among committee members for a time,and then the "mark-up" sessions begin. Mark-up is the formal processof writing and voting on a law. In mark-up, committee membersattempt to change the Mark through piecemeal amendments and/orfull-blown attacks. For Kennedy's Mark, mark-up begins on May 18.Tiefer points out that it's usually not possible to alter a Chairman'sMark to the extent that it becomes "an entirely opposite philosophicalapproach." Thus the Mark takes on great significance. "The startingpoint is critical because it tells you a lot about where you're likely toend up," Chuck Ludlam, vice president of governmental affairs for theBiotechnology Industry Organization, told BioWorld.The chairman of a committee, in drafting his or her Mark, sets theparameters of debate. The chairman uses the inherent tyranny of afully-formed idea. Committee members trying to pick apart the Markhave limited resources in terms of time, energy and ideas. Because ofthis, the basic tenets of a Mark have a good chance of surviving mark-up.At the same time, the Mark can only move out of committee, become aformal piece of legislation and be voted on by the full Senate or Houseif the chairman can win over a majority of committee members.Consensus and compromise are therefore essential tools of thechairman."One very important consideration is whether the Mark is formulatedin a partisan or bipartisan way," said Tiefer. In the House, Marks aregenerally partisan and in the Senate, they are bipartisan. Obviously, aMark that has been carefully crafted to reflect a consensus amongmany committee members will have smoother sailing in mark up.A chairman can draft his or her own legislation for the Mark, adopt abill introduced by another lawmaker or use a bill from a previoussession of Congress. In addition, different committees have differenttraditions about the form a Mark takes. In the House Ways and MeansCommittee, for example, the Chairman's Mark is a set of concepts, notthe text of a bill.Kennedy has already made clear that he believes that PresidentClinton's health care reform plan represents a "solid foundation forCongress to build on." But sources say biotechnology industryadvocates concerned about what they perceive to be price controlsshould not be dismayed by Kennedy's Mark. This race definitely can'tbe called until a bill crosses the finish line. Sources say Kennedy willmake sure that the concept of a breakthrough drug review board isdeleted from final legislation in his committee.Of course, the Senate Labor and Human Resources Committee is onlyone of five House and Senate committees with primary legislativeauthority over health care reform. Each of the five committee chairmenwill produce a Chairman's Mark. And each of those Marks, in turn,will serve as the point of departure for that committee's approach tohealth care reform. In the end, all five will have to be reconciled if thetwo chambers are to produce a bill to send to the President.
-- Lisa Piercey Washington Editor
(c) 1997 American Health Consultants. All rights reserved.