HealthCare Roundtable e-News – September 18, 2019

House Democrats Optimistic as Leaked Pelosi Drug Pricing Bill Steadily Gains Support

A leaked draft of a Medicare drug price negotiation plan from House Speaker Nancy Pelosi (D-Calif.) that had circulated Capitol Hill last week has exposed a unique leftward shift in drug pricing policy amongst lawmakers, analysts say. Since leaked, the proposal has received support from the White House, and typically vocal House Republicans have remained silent.

While an updated version of the bill is expected to be formally released in the coming weeks, the bill itself leaves Pelosi and House Democrats optimistic that the support from voters, both Democratic and Republican, who favor the bill will encourage GOP lawmakers to acknowledge their support as well. Wary of the shifting dynamics, House Republican leadership told their party to keep quiet on the policy that Republicans have for decades boisterously opposed while they determine whether President Trump will follow through on his desire for government drug price negotiation or lose interest. (InsideHealthPolicy)

The bill has also moved insurers on the issue. America’s Health Insurance Plans President Matt Eyles declined to say whether there is opposition from the organization to drug price negotiation, even though PhRMA has gone on record to strongly oppose the plan. According to experts, AHIP’s shift from being a strong opponent of negotiation without conditions implies a change in tune for the group; it had previously opposed a similar negotiation plan proposed by Hillary Clinton and Sen. Bernie Sanders (I-Vt.) back in 2015. (InsideHealthPolicy).

White House Shifts Focus Away from Seeking Formal Affordable Care Act Replacement

In recent weeks, the Trump administration has been shifting its focus from working on an overhaul of the Affordable Care Act to “smaller-scale” legislation to tackle health pricing, according to White House officials. Advisors to the President have encouraged him not to focus his 2020 campaign strategy on taking down Obamacare while it is still popular amongst voters; instead, the President will focus on small-but-strategic wins to gain popularity amongst voters.

“Discussions with the administration are more on what we can do to lower health care premiums, drug pricing and preexisting conditions,” former House Freedom Caucus Chair Mark Meadows (R-N.C.).

CMS Administrator Seema Verma had also acknowledged the administration’s agenda heading into 2020, noting the President’s support for policies tackling drug pricing transparency and short-term plans. The agency has not confirmed whether they have been working with the administration on a formal plan to replace ACA. (InsideHealthPolicy).

Grassley to GOP: “Do Something About Drug Pricing”

In an effort to win the support of more Republican opponents of the drug pricing package, Sen. Chuck Grassley (R-Iowa) is ramping up pressure on other members of the GOP by encouraging lawmakers to consider the political consequences of not getting involved in the conversation around drug costs early. Grassley’s sense of urgency comes as Democratic lawmakers continue to show strength heading into election season; last week, the office of House Speaker Nancy Pelosi (D-Calif.) leaked a six-page proposal in an effort to unite Democrats on key drug pricing legislation.

“With Republicans in the Senate, every one of them are hearing just like I do: They’ve got to do something about drug pricing,” Grassley told reporters. “So I hope that Republican leadership will listen to me now.”

Many Republican members in the Senate Finance Committee, of which Grassley is Chair, voted against advancing a joint-plan from Grassley and Sen. Ron Wyden (D-Ore.) this past summer, but those who did support it note that the particular challenges of the bill come from gaining the support of Senate Majority Leader Mitch McConnell. With a lack of support from McConnell, Grassley will look to President Trump’s support of the package before introducing it next month. (InsideHealthPolicy).

State Lawmakers in California Pass First Pay-For-Delay Bill

Last week, California state lawmakers passed the first-of-its-kind bill created to eliminate pay-for-delay activity amongst drug manufacturers in the state. The bill, which targets agreements that enable brand-name drug manufacturers to pay other drug makers to refrain from producing a generic version after the drug’s patent expires, has been sent to Gov. Gavin Newsom (D) who has until October 13th to sign or veto the bill. (InsideHealthPolicy).

“By shifting the burden to the drug companies that are party to these settlement agreements, AB 824 protects everyone who pays for prescription drugs, including the state, employers and health care consumers,” said Assembly member Jim Wood (D), who wrote the bill.

Drug manufacturers had opposed the bill over concerns state legislation could disrupt the process set by the U.S. Supreme Court, under which patent settlements are evaluated. In response to the bill’s success on the state level, PhRMA expressed that the “current national framework allows patent settlement agreements to bring generics to market prior to patent expiration. Any of these legislative efforts could result in delaying generic entry by forcing generic companies to take patent challenges all the way to a court decision.” (InsideHealthPolicy).

Similar talks in Washington around pay-for-delay legislation have recently stalled.