Spending Bill Debate Stalls Over Immigration Reform

House Minority Leader Nancy Pelosi (D-Calif.) and Senate Minority Leader Chuck Schumer (D-N.Y.) cancelled a meeting at the White House last week to negotiate a bipartisan agreement on government funding. The decision followed a tweet from President Trump stating that he did not believe a deal could be reached to avoid a government shutdown. Democrats are demanding that the spending bill include protections for young undocumented immigrants known as “Dreamers.” They face deportation next year due to the President’s decision to end the Obama-era Deferred Action for Childhood Arrivals (DACA) program. Speaker of the House Paul Ryan (R-Wis.) would prefer to consider spending legislation and immigration reform separately. The current funding bill expires on December 8. Congress is expected to pass another short term continuing resolution (CR) to allow for additional time to negotiate an appropriations deal that would last through the end of the fiscal year (FY) – September 30, 2018.

Kellyanne Conway to Lead WH Opioid Crisis Response

President Trump has asked White House adviser Kellyanne Conway to coordinate and lead the Administration’s efforts to combat the opioid overdose epidemic. The announcement followed a statement from Sen. Lamar Alexander (R-Tenn.) during the confirmation hearing of Alex Azar, U.S. Department of Health and Human Services (HHS) Secretary nominee, that the federal government does not need an opioids czar; rather, the next HHS secretary should lead the charge of the federal government’s response to the opioid crisis. The Administration has countered that headlines touting Conway as the opioid czar are incorrect – their announcement instead indicates a continuation of her role handling the White House’s opioids portfolio.

NAS Report Recommends Federal Government Rx Negotiations

A new report from the National Academies of Sciences, Engineering and Medicine (NAS) recommends that the federal government negotiate drug prices and allow for more flexible drug formularies. The report examines the role of generics and biosimilars, intellectual property issues, financial transparency, drug advertising, and insurance benefit design in the prescription marketplace. The National Academies argue that increasing prescription drug and medical costs, which equal 18 percent of the nation’s gross domestic product (GDP), are unsustainable to society as a whole, and make recommendations aimed at improving the affordability of prescription drugs while continuing innovation in drug development. The report includes 27 action items, in addition to the following eight overarching recommendations:

  • Accelerate the market entry and use of safe and effective generics as well as biosimilars;
  • Consolidate and apply governmental purchasing power, strengthen formulary design, and improve drug valuation methods;
  • Assure greater transparency of financial flows and profit margins in the biopharmaceutical supply chain;
  • Promote the adoption of industry codes of conduct and discourage direct-to-consumer advertising of prescription drugs as well as direct financial incentives for patients;
  • Modify insurance benefits designs to mitigate prescription drug cost burdens for patients;
  • Eliminate misapplication of funds and inefficiencies in federal discount programs that are intended to aid vulnerable populations;
  • Ensure that financial incentives for the prevention and treatment of rare diseases are not extended to widely sold drugs; and
  • Increase the available information and implement reimbursement incentives to more closely align prescribing practices of clinicians with treatment value.

The Senate Health, Education, Labor, and Pensions (HELP) Committee plans to hold a hearing on December 12 to hear from NAS regarding the report.

Upcoming Congressional Hearings and Meetings

Senate Appropriations Subcommittee on Labor, Health and Human Services, Education, and Related Agencies hearing “Addressing the Opioid Crisis in America: Prevention, Treatment & Recovery;” 10:00 a.m., 124 Dirksen Bldg.; December 5

Senate Health, Education, Labor, and Pensions Committee hearing “Implementation of the 21st Century Cures Act: Progress and the Path Forward for Medical Innovation;” 10:00 a.m., 430 Dirksen Bldg.; December 7

House Committee on Veterans’ Affairs hearing “New Names, Same Problems: The VA Medical Surgical Prime Vendor Program;” 10:00 a.m., 334 Cannon Bldg.; December 7

House Oversight and Government Reform Subcommittee on Information Technology hearing “Oversight of IT and Cybersecurity at the Department of Veterans Affairs;” 2:00 p.m., 2154 Rayburn Bldg.; December 7

Senate Health, Education, Labor, and Pensions Committee hearing “Implementation of the 21st Century Cures Act: Responding to Mental Health Needs;” 10:00 a.m., 430 Dirksen Bldg.; December 13

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