HealthCare Roundtable e-News – February 19, 2020

CBO Reviewing Budget Impact of Changes to Senate Drug Pricing Bill

The Congressional Budget Office is in the process of reviewing changes made to the Senate Finance Committee’s proposed drug pricing legislation, which was introduced last year by Committee Chair Chuck Grassley (R-Iowa). Last week, Grassley said that he would consider some revisions to the plan in order to garner more Republican support for the bill. Ranking Finance Committee member Sen. Ron Wyden (D-Ore.) did not comment on any Democrat involvement in the discussion on bill changes.

Senate Democrats have pushed for the inclusion of inflationary rebates to the bill, which would require drug companies to pay the government back when they raise prices faster than inflation. Inflationary rebates have been a key controversial point in the policy for Republicans, and while a Grassley spokesperson said policies on inflationary rebates remain it is one of the areas that will require more Republican support before Sen. Mitch McConnell (R-Ky.) will hold a Senate vote. (InsideHealthPolicy).

“I think everybody agrees that prescription drug prices are too high,” Sen. McConnell said. “The dilemma is how do you get there, and we have divisions within the Republican Party on that and with the Democrats on that. So, yeah, we’re going to be talking about it. Whether we can all pull together and get a solution, I’m not prepared to predict today.”

The White House has shown some varying support for the bill in recent months. HHS Secretary Alex Azar told reporters last week that the president’s budget request endorses the Finance Committee’s bill, but not everyone at the White House is on board with Azar’s assertion. (InsideHealthPolicy)

House Committees Look to Tackle Surprise Billing with Competing Legislation Proposals

Last Wednesday (Feb. 12), the House Ways and Means Committee voted unanimously to pass legislation protecting patients and further preventing surprise medical bills. Committee Chairman Richard Neal (D-Mass.) addressed criticisms surrounding the bill’s inclusion of arbitration and noted that the committee will look to negotiate with the other House committees that have each passed surprise billing legislation. The other committees are expected to meet this week to mark up their competing surprise billing proposals. (InsideHealthPolicy)

“We think we have a bridge to a solution with the Senate. So, there’s going to be some give and take. I assume we’ll begin to reconcile the differences almost immediately and then I think there will be an effort to move forward with support from the Speaker,” Neal told reporters.

In analyzing the differences between each committee’s proposals, the House Ways & Means Committee’s bill is most in line with the hospital-backed approach of negotiating prices, whereas the Education & Labor Committee’s bill is mostly in line with the bipartisan bill negotiated by the House Energy & Commerce and Senate health committees’ insurer-backed approach.

The White House had opposed the Ways & Means committee’s bill, with White House spokesperson Judd Deere saying the president worries that “relying heavily on arbitration would increase health care costs.” Despite the opposition, the president tweeted his congratulations to the committee on passing their proposal. Trump is relying on House lawmakers to come to an agreement in negotiating surprise billing legislation, which the president had accounted for in his fiscal 2021 budget request. A portion of the $4.8 trillion budget assumes that Congress will pass a drug pricing bill that saves $135 billion. (InsideHealthPolicy).

Azar Calls ACA Repeal and Replacement Scenarios ‘Hypotheticals’ in Q&A with Finance Committee Democrats

Last Thursday, Health and Human Services Secretary Alex Azar fielded questions from Senate Finance Committee Democrats on matters relating to Texas v. United States and President Trump’s $4.8 trillion budget request for fiscal 2021. Notably, the president’s budget request included protections for patients with pre-existing conditions as a priority, but did not include specifics or a call to repeal and replace the Affordable Care Act. (InsideHealthPolicy).

Sen. Bob Menendez (D-N.J.) asked what Azar’s plan is “if the ACA is struck down tomorrow,” but Azar responded that it would be years before a final judgment which would likely have to come from the Supreme Court.

“There is a very long process to go to even see whether the statute is struck down or even part is struck down by the Supreme Court. These are hypotheticals at this point. We are faithfully administering the ACA now,” Azar told Menendez. (InsideHealthPolicy)

Sen. Sherrod Brown (D-Ohio) suggested to Azar that the next time he’s in a cabinet meeting with the President that he should correct him when he says that he’s “supporting the consumer protections for preexisting conditions.”

“He’s trying to take them away with the Texas lawsuit, he tried to take them away legislatively. I assume it won’t change, he’ll still go on the campaign trail and talk about how he supports preexisting conditions, but if someone of your stature tells him he’s lying, maybe that would be helpful,” Brown said.

Trump’s Budget Request Gives $46 Million Increase To FDA

After the White House revealed last week President Donald Trump’s fiscal 2021 budget request, many patient advocacy groups expressed their support for a $46 million increase in the FDA’s funding. In the president’s budget proposal, the White House is requesting $6.2 billion to support the FDA — an overall increase of $265.4 million to the agency’s budget from fiscal 2020.

Steve Grossman, deputy executive director at the Alliance for a Stronger FDA, stated via email that the agency is “pleased that the Administration’s commitment remains strong, even while many other worthwhile agencies are proposed for cuts.” (InsideHealthPolicy)

While the Alliance said they appreciate the president’s budget request, the group commented that the requested amount might not be enough. The budget increases funding for what the agency calls “urgent priorities,” including artificial intelligence, novel technologies to promote device safety, regulatory work for cannabis and cannabis-derived products, necessary infrastructure improvements, and advancement of the influenza vaccine. (InsideHealthPolicy).