HealthCare Roundtable e-News – December 4, 2018

Senate Leaders Look to Negotiate ACA Legislation in 2019

Last Wednesday, Sen. Patty Murray (D-WA) of the Senate HELP committee called for bipartisan conversations on healthcare legislation in 2019, with the help of Sen. Lamar Alexander (R-TN). Murray spoke of her opposition to past standoffs that resulted in poor conversations, and Alexander also acknowledged past difficulties between the parties to come to terms on negotiations. Alexander suggested that there are packages on the table that he sees having potential for discussion, particularly the issue of healthcare costs, according to The Hill.

One major challenge will be negotiating provisions around providing states flexibility to bypass some requirements of the law that were not written into the Affordable Care Act. It will also be up for debate if Democrats are willing to vote on prohibitions on the federal funding of abortion. (InsideHealthPolicy).

Democrats will also be likely to call for bolder action expanding ObamaCare’s financial assistance in the new Congress, which many believe will be hard for most Republicans to support. Still, Alexander and Murray have not sat down to reopen negotiations and it is unclear what each side will advocate for in these early stages.

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FDA’s Orphan Drug Program Faulted for Inconsistencies In GAO Investigation

Federal officials revealed in a report published last Friday that the Food and Drug Administration failed to ensure that drugs given prized rare-disease status met qualifications during the review process. Reviewers of the drugs were unable to show they had checked how many patients could be treated by a drug being considered for orphan drug status. Instead, reviewers appeared to trust the information given to them directly from drugmakers.

The Orphan Drug Program, which was created to spur development of drugs for diseases afflicting fewer than 200,000 people, has been the subject of a Government Accountability Office investigation for over a year after a request from three high-profile Republican senators in the wake of a KHN investigation.

Among the details that were uncovered in the investigation include incomplete and inconsistent reviews early in the drug review process, where certain medicines were designated as qualified for the program. According to the GAO’s report, FDA reviewers had often failed to show that their analyses from the drug review was independent from drugmakers’ claims. The FDA responded with a statement, in which it agreed with the report’s recommendations regarding appropriate documentation and declined requests for interviews. (Kaiser Health News).

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Bipartisan Group Looks to Delay Suspension of ACA Health Insurance Tax

After a turbulent election cycle, the House returned to Washington last week with Republicans aiming to push must-pass bills during the lame duck session.

A bipartisan group of senators are urging leadership to extend a delay of the Affordable Care Act’s health insurance tax before the end of the lame-duck session. The issue of Obamacare’s hidden health insurance tax has been widely debated in recent years, but the upcoming deadline for the current suspension — beginning in 2019 — has increased the urgency for a delay. 

“Looking ahead to 2020 and beyond, it is important for Congress to continue to focus on lowering health insurance premiums,” wrote Senators John Barrasso (R-WY), Cory Gardner (R-CO), Jeanne Shaheen (D-NH) and Doug Jones (D-AL). (The Hill).

The tax, which has been suspended for the coming year, has been criticized by both Republicans and Democrats for driving up premiums on drug costs. The House passed a bill in July to suspend the tax further into 2020 and 2021, although House Democrats were not convinced that the bill, which was not paid for, would have any impact on lowering premiums. 

Further delaying the tax would also be a win for the insurance lobby, America’s Health Insurance Plans. More plans to push for a delay will likely come before the end of the lame duck session.

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Grassley Looks to Tackle Medicaid Rebate Bill, Outlines Agenda on the Floor

Senator Chuck Grassley (R-IA), incoming Senate Financial Chair, recently announced his agenda on the floor and highlighted initiatives that include tightening up regulation of Medicaid drug rebates, based on results produced from his investigation.

Grassley initially began his investigation when it was discovered that the price of the Epipen had inflated over 400% in a decade, and has since been determined to shine a light on similar cases. While the investigation into the Medicaid rebates program is winding down, a source says the Senator is not planning to drop the probe entirely. (InsideHealthPolicy).

“He has a history of being unafraid to flip over rocks,” said Rodney Whitlock, a consultant at ML Strategies who has worked for Grassley as acting health policy director for the Finance Committee. “Any stakeholder that has a role in drug pricing should assume he’s going to be asking questions.”

Grassley, who will be returning to the helm of the Finance Committee since his last run from 2003 to 2007, is well known in Washington as a steadfast investigator. Drugmakers lost an ally in the Senate with Grassley’s appointment, after taking over for Sen. Orrin Hatch (R-UT), an advocate for drugmakers and lobbyists. (The Hill).

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