HealthCare Roundtable e-News – October 20, 2020

Registration is now open!

Roundtable members and friends may now register for the Roundtable’s 2020 Virtual Annual Conference. 

This year’s theme – Working Together… In a Disconnected Time – sums up our goal for this year’s gathering. Although we won’t be in the same room, we’re planning an agenda that will prepare all of us for what promises to be a very active period in Federal health care programs, policymaking, and engagement.

Registration details are provided at

Should you have any questions, please don’t hesitate to contact me at

Introducing Our Congressional Panel – Tuesday, November 10th

Dr. Wendell Primus

Tuesday, November 10th

Wendell Primus is the Senior Policy Advisor on Budget and Health issues to Speaker Nancy Pelosi.  In that capacity, he was the lead staffer in developing the Affordable Care Act.  He also played a major role in the SGR legislation in 2015 and various budget agreements.  

Prior to this appointment in March, 2005, Dr. Primus was the Minority Staff Director at the Joint Economic Committee. He has also held positions at the Center on Budget and Policy Priorities, served in the Clinton Administration at the Department of Health and Human Services and also served as Chief Economist for the House Ways and Means Committee and Staff Director for the Committee’s Subcommittee on Human Resources.  Dr. Primus received his Ph.D. in economics from Iowa State University.

Brett Baker

Tuesday, November 10th

Brett Baker is a Senior Health Policy Advisor on the staff of the Committee on Finance, United States Senate.  His focus is on Medicare payment policy, including the Part D prescription drug benefit.  Brett previously served as professional member on the staff of the Subcommittee on Health, Committee on Ways and Means, United States House of Representatives (2011-2015), where he focused on a similar set of issues.  Brett has worked on many of the major pieces of health legislation during his time on Capitol Hill, most notably the Medicare Access and CHIP Reauthorization Act (MACRA).

Prior to working in the United States Congress, Brett worked for the American College of Physicians (1995-2011), where he advocated on behalf of internists for payment and delivery system changes, including advancing the patient centered medical home as a method to improve quality of care and decrease overall costs.  Brett holds a BS in Health Policy and Administration from the Pennsylvania State University. 

In Confirmation Hearings, Supreme Court Nominee Barrett’s Views on ACA Severability May Indicate Position on Validity of the Law

Supreme Court nominee Amy Coney Barrett was questioned during her confirmation hearings last week on her views regarding an essay she wrote in 2017 criticizing Chief Justice John Roberts’ ruling to uphold the Affordable Care Act due to Congress’ power of taxation.

In the 2017 essay for Notre Dame Law School, Barrett suggested that Roberts’ position “stretched beyond the plausible meaning of the law” in order to save the statute. Barrett had repeatedly stated during the confirmation hearings that her statement on the case was not relevant because the Chief Justice’s ruling was not being questioned in the current case against the ACA. However, Barrett’s comments that the case is about severability are ignorant of the fact that the case is also about the ACA’s constitutionality. During the hearing, Sens. Chris Coons (D-DE) and Marie Hirono (D-HI) noted that the court will still weigh the constitutionality of the toothless mandate.

“It bothers me that she says the issue in Texas is severability, which seems to assume that standing and constitutionality are not issues in the case,” health policy and legal expert Tim Jost told Inside Health Policy, who is a keynote speaker at next month’s Roundtable Annual Conference. “Of course, you don’t get to the question of severability until you have resolved the questions of the plaintiff’s standing and the constitutionality of the mandate after the tax bill. Is Judge Barrett saying that she has already decided these issues?”

When asked by Sen. Cory Booker (D-NJ) whether she could empathize with people worried about potentially losing the benefits of the ACA, Barrett said that she does empathize with those worried about access to care. She also commented that if the mandate is not constitutional, the judges would be tasked with determining whether Congress would have passed the law without the mandate. (InsideHealthPolicy)

Trump, Republicans Appear on Different Paths for COVID-19 Stimulus Negotiations After Town Hall

During his town hall last week, President Trump shared that he is “ready to sign a big, beautiful stimulus,” but the president appears to be at odds with his own party’s position on delivering a package before Election Day. Trump has gone back and forth on negotiations between House Speaker Nancy Pelosi (D-Calif.) and Secretary of the Treasury Steve Mnuchin but said during the town hall that Republicans would back a larger COVID-19 relief package if he asked them to. When asked by The Hill about negotiations just before the town hall, Senate Majority Leader Mitch McConnell (R-Ky.) confirmed he’s only focused on bringing a smaller $500 billion plan to the floor.

“Republicans do not agree that nothing is better than something for working families. The American people need Democrats to stop blocking bipartisan funding and let us replenish the [Paycheck Protection Program] before more Americans lose their jobs needlessly.”

Senate Republicans offered a $1.1 trillion coronavirus package in late July but McConnell warned at the time that up to 20 GOP senators could vote “no.” They then unveiled a smaller bill in September that authorized about $500 billion that 52 of the 53 GOP senators supported. (InsideHealthPolicy)

According to a study published by the Federal Reserve Bank of New York, Americans appear to be using their stimulus check to pay down debt and save money for another rainy day. The Fed claimed the results “indicate that households expect to consume even smaller shares of a potential second round of stimulus payments, while they expect to use a higher share to pay down their debt.”

KFF October Poll Finds Voters Have More Trust in Biden Over Trump on Health Policy Issues

According to the latest health tracking poll from the Kaiser Family Foundation, a majority of Americans are showing that they trust Former Vice President Joe Biden over President Donald Trump to lower drug costs. KFF found that 50% of respondents said they trust Biden to lower drug costs compared to 43% for Trump, a shift from last month when the president was more trusted by 46% to 42%. KFF reported that the poll was conducted after the president announced he was giving out $200 prescription drug cards to Medicare enrollees.

Notably, Biden has the advantage over Trump on all health policy issues that were polled by the foundation, including at least a 20 percentage point advantage on who voters think has the better approach (Biden or Trump) to make decisions about women’s reproductive health choices and services (57% v. 34%) and maintaining the protections for people with pre-existing health conditions (56% v. 36%).

The poll also gauged voters’ stances on the Affordable Care Act as its constitutionality is being questioned in the court case California vs. Texas. According to the poll results, six in ten adults do not want to see the Supreme Court overturn ACA, up 10 percentage points from one year ago. Three-fourths of Republican voters who contributed to the poll still want to see the ACA overturned, while most Democrats (89%) and Independents (66%) do not want the law overturned.

Private-Equity Companies Responsible for Majority of Surprise Air Ambulance Bills, Study Shows

Last week, Supreme Court justices listened to oral arguments on a case surrounding a 2015 law passed in Arkansas that prohibits pharmacy benefit managers from reimbursing pharmacies at a lower rate than the cost it takes to dispense the drug. Also being reviewed is a component of the law that allows pharmacies to refuse to sell a drug if the maximum allowable cost for a product, or the upper limit that a plan will pay for drugs, is too low.

The case is significant in that it could determine whether states may regulate pharmacy benefit managers to lower drug prices. Several of the justices listening on the case expressed skepticism that the states have such authority. During the hearings, Chief Justice John Roberts told Arkansas Solicitor General Nicholas Bronni that, while the law may have an impact on drug prices, he believes the core of the case is more focused on ERISA preemption. (InsideHealthPolicy)