HealthCare Roundtable e-News – May 7, 2019

Congressional Budget Office Releases Analysis of Trump Administration Rebate Proposal Showing Increased Costs to Medicare, Medicaid

Last week, the Congressional Budget Office released two new analyses of key federal health care proposals: the Trump Administration proposed rule to eliminate rebates in Medicare Part D and Medicaid managed care and a single-payer proposal put forward by House Democrats.  

The CBO claims that Medicare spending would climb by $187 billion and Medicaid by $7 billion over the next decade if the CMS finalizes a rule to get rid of the safe harbor for rebates for Part D drugs, dealing a significant blow to the Administration.  

CBO anticipates that the inflation of Medicare spending will be a result of an increase in premiums for Part D plans and utilization of prescription drugs by Part D beneficiaries. The CBO claimed that the rule would ultimately boost Part D premiums and federal spending, saying that beneficiaries, “who do not fill some of their prescriptions because their current out-of-pocket expenses are high would be more likely to fill them and to better adhere to their prescribed drug regimens if their costs were lower, as they would be under the proposed rule.”

Trump Administration Calls on Sens. Alexander, Murray to Revisit ACA Legislation

The Trump administration called on Senators Lamar Alexander (R-Tenn.) and Patty Murray (D-Wash.) last week to revisit a bill designed to fix the Affordable Care Act (ACA). The Senators spent most of their time in 2017 developing the bill, also known as the Alexander-Murray legislation, which looked to expand ACA cost-sharing reductions and create a nationwide reinsurance program. (InsideHealthPolicy) 

Both sides ran into disagreements over the abortion provision of the bill, known as the Hyde Amendment. Alexander said he was “extremely disappointed our legislation didn’t become law,” noting that he would welcome the opportunity to discuss the bill if Democrats were willing to reconsider their position on the amendment. Murray expressed that she would go back to the bill when Republicans agreed to remove the amendment. (InsideHealthPolicy). 

Senate Finance Committee Chairman Chuck Grassley (R-Iowa) and others aren’t convinced the bill will be revisited during this term as requested by the Trump administration. Grassley noted that only if the Federal judge in the case of Texas vs. Azar struck down the ACA would the Alexander-Murray bill be revisited. (InsideHealthPolicy).

House Judiciary Approves Four Bipartisan Bills Supporting Biosimilars

The House Judiciary Committee recently approved four new bills designed to boost generic drug competition. Among the bills approved is the CREATES Act, which looks to enforce more a competition-friendly market with penalties for drugmakers who withhold samples from their rivals. The panel also reviewed and approved of the STALLING Act, which will monitor any abuse of the FDA’s petition process to block generics and a separate bill to require the FTC to study anticompetitive behaviors among pharmacy benefit managers.  

The bipartisan pay-for-delay bill, sponsored by Judiciary Chair Jerry Nadler (D-NY), was also approved by the panel. The bill is supplemental to another piece of legislation sponsored by Sen. Amy Klobuchar (D-Minn.) and Senate Finance Committee Chair Chuck Grassley (R-Iowa). 

The House is also expected to vote on two additional drug pricing bills, which will look to make information on drug patent exclusivity more accessible for generic and biosimilar companies. The Congressional Budget Office doesn’t anticipate that either bill would yield any additional federal government savings, according to a recent report from the Office.

New Polling Data Shows Increased Support of Drug Price Regulation in Swing Districts

New polling data from several swing states was released last week showing key trends in voter perceptions of federal drug pricing proposals. Most notably, the new polling data confirms that issues of skyrocketing prescription drug prices has been steadily growing as a top concern for many Americans. 

The polls were conducted by Public Policy Polling on behalf of the left-leaning groups Social Security Works, Progressive Change Campaign and the Business Initiative for Health Policy. The primary districts targeted include New Hampshire’s 1st congressional district, South Carolina’s 1st congressional district and Iowa’s 4th congressional district. 

Among some of the statistics noted in the data are the results from an Iowa district represented by conservative Republican Steve King, where 83 percent of voters said they would support ending a company’s monopoly on a drug and letting other manufacturers produce the product if the government determines the company abused its position and raised prices beyond a patient’s ability to pay. This data compares to the 2016 Presidential election results, where a slightly smaller 81 percent of those who voted for President Donald Trump supported the idea, compared to 88 percent of those who voted for Former Secretary Hillary Clinton.