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Executive Summary

VACCINE INJURY COMPENSATION PROGRAM WILL NOT BE TERMINATED even if insolvent, under provisions of the Health Information, Health Promotion, and Vaccine Injury Compensation Amendments of 1991 (HR 3402), signed into law Nov. 26. The measure allows the National Vaccine Injury Compensation Program, established by a congressional act in 1986, to continue operations, despite projections by the Health Resources and Services Adminstration's Advisory Commission on Childhood Vaccines that the program would become insolvent in early 1992 ("The Pink Sheet" Sept. 16, T&G-6). The statutes establishing the compensation program directed that it be terminated if it lacked sufficient funds to continue. The current amendments, without providing any additional appropriations, simply delete this language from the original act. The bill was sponsored in the House by Reps. Waxman (D-Calif.) and Bliley (R-Va.), where it was voted on under a suspension of House rules on Nov. 5. The bill was passed in the Senate by unanimous consent Nov. 12. At a June 20, 1991 meeting of the Advisory Commission on Childhood Vaccines, the commission finalized and submitted to HHS Assistant Secretary for Health James Mason, MD, 10 recommendations for reforming the compensation program. At a Sept. 12 meeting, Mason promised to present the recommendations to HHS Secretary Sullivan as legislative proposals before the beginning of fiscal 1992 on Oct. 1. However, HRSA's Division of Vaccine Injury Compensation indicated that the recommendations were never officially presented to Congress. HR 3402's vaccine-related provisions closely resemble three of ACCV's original 10 recommendations: the suspension of the subsection of the original act automatically terminating the program upon depletion of funds; an extension on the period for which a special master may suspend review of preenactment injury claims cases (from 180 to 540 days); and an extension of the Jan. 1, 1992 deadline for the submission by the HHS secretary of an evaluation of the program. That evaluation now is due in 1993. Notably, however, the amendments do not grant the commission's request for a 180-day moratorium on all payments or its request to eliminate the 25% excise tax currently taken from the trust fund that was established to pay for postenactment (post-1988) vaccine injury compensation claims. The trust fund is derived from a surtax on vaccine purchases. At a Nov. 26 meeting of the National Vaccine Advisory Committee, ACCV Chairman Martin Smith, MD, argued that an excise tax of the trust fund is particularly inappropriate for vaccines, since the government purchases the bulk of vaccines, and thus is supplying most of the trust fund. He noted that "we're still working on" the excise tax reform.

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