After five-year odyssey, Rep. Anna Eshoo’s cancer bill nears the finish line

It was her friend Barbara Boxer’s birthday party, but Anna Eshoo only planned to stay five minutes.

The occasion at the senator’s home last month came on a critical day for the congresswoman. After more than five years working on the issue, Rep. Eshoo (D-Calif.) had defied the odds and succeeded in pushing her cancer-research bill through the Republican-led House.

But the measure risked getting lost in the Senate’s lame-duck agenda and dying alongside other pending bills when the session expired. 

More importantly, the measure faced a hold from Sen. Tom Coburn (R-Okla.) — the main thing on Eshoo’s mind as she arrived at Boxer’s (D-Calif.) door that night.

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“I had just gotten off the phone with him,” Eshoo said of Coburn, “and I knew when I hung up that he wasn’t going to budge.”

Eshoo now reflects on that evening as the turning point in her bill’s pathway through the Senate.

After a series of nail-biting procedural moves last week, the cancer measure became an amendment to the defense authorization bill passed Tuesday night, all but ensuring that it will become law. 

The strategy was hatched after an unexpected encounter between Eshoo and the bill’s lead Senate sponsor, Sheldon Whitehouse (D-R.I.), at Boxer’s birthday gathering.

“It was one of those fortuitous moments,” Eshoo said.

“I told Sheldon, ‘I talked with Tom Coburn, and he’s sticking with it. We need a new strategy.’ And Sheldon said, ‘We need to get this bill onto something else.’ ”

The Recalcitrant Cancer Research Act is the kind of modest bill whose passage would go relatively unnoticed were it not for a unique back-story.

The measure sprang from a simple goal: more federal research on pancreatic cancer.

Eshoo was motivated by the death of her friend, diplomat Richard Sklar, from pancreatic cancer in 2009. Sklar was a well-known public servant in San Francisco who helped rebuild Bosnia and served as an ambassador to the United Nations in the 1990s.

“He wasn’t one to ever ask for anything,” Eshoo said. “But he did say to me, ‘Something needs to be done about this, about pancreatic cancer.’ ... People wonder why they never hear about the disease. It’s because all the victims are dead.”

Eshoo first introduced the bill in fall 2008 and spent the ensuing years in a protracted, daily battle for co-sponsors.

Five years ago, the legislation attracted one co-sponsor. In the last Congress, it received the backing of 247 members. And now it has 294 supporters, including lawmakers from the right and left.

That didn’t happen by accident.

Eshoo buttonholed members on the House floor and in the elevators. She would “bird-dog, cajole and call” Majority Whip Kevin McCarthy (R-Calif.) and Energy and Commerce Committee Chairman Fred Upton (R-Mich.), making herself “gum stuck to their shoe.” 

Securing leadership’s backing was only one of many obstacles Eshoo had to overcome.

Federal health officials and some Republican lawmakers launched a counteroffensive against the first version of the bill.

Some, like Coburn, argued that Congress should not inject priorities into federally sponsored medical research. Others said Eshoo’s push would pave the way for a “disease Olympics.”

By the time Eshoo and Whitehouse conferred in mid-November, Coburn had been threatening to filibuster the bill for two months, since the day a watered-down version passed the House.

His hold was thwarted by a series of subtle negotiations related to the defense bill last week.

According to sources familiar with the talks, Senate Armed Services Committee Chairman Carl Levin (D-Mich.) and ranking member John McCain (R-Ariz.) agreed to bring up a Coburn amendment to the defense bill in exchange for allowing the modified cancer legislation to come to the floor.

It wasn’t immediately clear that the gambit would work. While Eshoo had dinner with friends, staff kept watch as Whitehouse and Coburn remained on the Senate floor.

The lead outside advocate on the bill, Julie Fleshman of the Pancreatic Cancer Action Network, was watching C-SPAN from a Washington hotel room.

She saw the bill brought up and was “elated” when Coburn agreed to a voice vote, transforming the measure into an amendment to the defense bill. The last-ditch strategy had worked.

Eshoo was still at dinner when her cellphone rang. It was Whitehouse.

“The meal turned into a celebration,” she said. There was cake in the office the next day.

On Friday, a beaming Eshoo noted that she had spoken with key advocates for the bill, one of whom cried that morning.

“When you begin something, you don’t know if it’s going to be a decade-long effort, or a year or 15 months,” she said.

The cancer bill will almost definitely become law, but it is vastly different from what Eshoo and the cancer advocates first intended.

The exclusive focus on pancreatic cancer is gone, and so is the bill’s money.

The provisions also were softened to create less of a burden on federal scientists. The National Cancer Institute (NCI) will now be required to create frameworks for addressing deadly cancers rather than sponsor new research.

NCI Director Harold Varmus, who formerly headed the National Institutes of Health (NIH), had balked at Eshoo’s initial bill. Earlier this year, he said it represented a “slippery slope” that would prompt demands from every disease advocate.

On Thursday, Coburn, a doctor, expressed ongoing concern with bills that “micromanage” research at the NIH.

He said that Eshoo’s measure is scientifically unsophisticated and will ultimately delay the cure for pancreatic and other deadly cancers.

“We no longer look to cure diseases by looking at the base disease,” Coburn said on the Senate floor.

“What we’re actually going to do with this bill is force the NIH to do things that are not going to benefit the outcome of these diseases.”

Supporters of Eshoo’s bill say it takes a cue from AIDS legislation, which first targeted the disease with federal money in 1983.

Backers point to pancreatic cancer’s extraordinarily low survival rate. The disease claims most victims within a year of diagnosis, in part because there are no early detection methods.

Advocates for Eshoo’s bill, including patients with little time left, highlighted the lethality of the disease by distributing morgue toe-tags on Capitol Hill.

The Pancreatic Cancer Action Network also called for members’ support with large Metro ads showing the feet of a corpse on an autopsy table.

Whitehouse sometimes tells the story of losing his mother to pancreatic cancer. She died just two months after being diagnosed.

“I called my doctor and I said, ‘I just heard from my mom that she’s been diagnosed with something called pancreatic cancer. Is that serious?’ ” Whitehouse said at a press conference on the bill.

“The thing I remember most about that call is how long the pause was before I got an answer, as my doctor tried to figure out how to tell this to me.

“Finally, he just said, ‘I’m so sorry, Sheldon.’ And that told me everything I needed to know.”