HealthCare Roundtable e-News – April 2, 2019

House Health Panel Approves Prescription Drug Legislation

A House health panel met last week to discuss elements of prescription drug legislation and strategies for lowering prescription drug prices, including the CREATES Act, Blocking Act, and bans on “pay for delay” deals. The Roundtable-supported CREATES Act aims to protect generic drug manufacturers by prohibiting brand-name drug companies from withholding product samples and encouraging biosimilar competition in the industry, while the Blocking Act aims to discourage gaming of the current exclusivity system. 

Republicans urged that the proposed ban on “pay for delay” deals should not affect existing settlements. Rep. Fred Upton (R-Mich.) introduced an amendment that would prevent the policy from having a retroactive impact, though the amendment ultimately did not pass. 

House E&C Chair Frank Pallone (D-NJ) described the current healthcare market as “monopolistic,” and suggested that something “has to be done to make sure a competitive marketplace exists…It’s a progressive thing to do to preserve the marketplace and preserve generic competition as a real factor in lowering drug prices.” According to Pallone, generics and biosimilars have saved patients and government $265 billion since 2017.

Justice Department Files Notice Invalidating ACA, Supports Federal Judge in Texas Case

The Trump administration filed a notice last week stating that it supports a Texas federal judge’s decision to invalidate the Affordable Care Act. Previously, the Justice Department had said it was looking into invalidating parts of the law; however this notice implies the administration now agrees the law should be tossed out entirely.

Since its passage, the Affordable Care Act has significantly reduced the number of uninsured individuals in the United States and has survived many legal challenges in federal courts and Congress. The law guarantees individuals cannot be denied coverage based on existing and pre-existing medical conditions, a topic that has been heavily debated in recent years.

While experts are concerned that individuals covered by the Affordable Care Act will lose their protections, there is no reason for anyone to anticipate any immediate changes to current ACA policies.

“Essentially, everybody who has insurance through the Affordable Care Act directly which is well over 10 million people through Medicaid and another 10 or 11 million through the ACA exchanges. That all stays the same because this is a legal case that is going to wind its way through the courts and probably eventually get to the Supreme Court,” says NPR health correspondent Alison Kodjak.

Several Democratic Attorneys General have filed petitions to intervene in the case and defend the ACA. California Attorney General Xavier Becerra has claimed the administration “is choosing to neglect the rule of law and play politics with the health care of tens of millions of Americans.”

E&C Health Subcommittee to Consider Six ACA-Focused Bills

Six pieces of legislation related to the Affordable Care Act have been approved by the House Energy & Commerce Committee last week, just days after the Trump Administration called for invalidating the law. (InsideHealthPolicy)

“While some of them have catchy titles, they are pretty partisan and do little to address the underlying problem which is access to affordable health care,” said Energy & Commerce ranking Republican Greg Walden (R-OR).

Among the bills that have stirred the most controversy between parties is the State Health Care Premium Reduction Act (H.R. 1425), introduced by Reps. Angela Craig (D-MN) and Scott Peters (D-FL), which would provide $10 billion annually for states to set up reinsurance programs. A topic for debate among Republican lawmakers and critics is that the bill doesn’t explicitly include Hyde protections. (InsideHealthPolicy).

Finance and HELP Committee Leaders Look to Lower Health Costs by June

Senate Health and Finance committee leaders announced last week that they are working together to lower health care costs by June, according to health committee chair Lamar Alexander (R-TN). Ranking Democrat Patty Murray (D-WA) will work alongside Alexander, Finance chair Chuck Grassley and ranking Democrat Ron Wyden (D-OR) to revisit proposals on Medicare Part D and other areas.

“We will see where we go, but our goal is by June to hopefully have a bill on the HELP committee, a bill on the Finance committee that represents some significant ways to reduce health care costs, and we will see where those are,” Alexander said. (InsideHealthPolicy). 

Last week, Grassley indicated that he would support expanding several areas of the Trump Administration’s proposal to move rebates for Medicare Part D and Medicaid managed care. Sen. Susan Collins (R-ME), who is also a member of the health subcommittee, suggested Alexander would take the initiative to build on the proposal. (InsideHealthPolicy).