Hart Health Strategies provides a comprehensive policy briefing on a weekly basis. This in-depth health policy briefing is sent out at the beginning of each week. The health policy briefing recaps the previous week and previews the week ahead. It alerts clients to upcoming congressional hearings, newly introduced bills, regulatory announcements, and implementation activity related to the Patient Protection and Affordable Care Act (PPACA) and other health laws.


HHS to Require Pharmaceutical List Prices in DTC Advertising

The Trump administration issued a proposed rule last week that would require pharmaceutical manufacturers to disclose the wholesale acquisition cost (WAC), or list price, of their products in direct-to-consumer (DTC) television advertising. The idea had previously been included in the President’s drug pricing blueprint. Under the proposal, companies would be required to state the list price of a 30-day supply or the usual course of treatment for any medication covered through Medicare or Medicaid that costs at least $35 a month. The information would be required to be posted in clear, legible text on screen at the end of the advertisement. Companies that do not comply with the policy would be subject to potential litigation. Lawmakers from both sides of the aisle have expressed support for the proposal, which is expected to face legal challenges from industry. Chairman of the Senate Judiciary Committee Chuck Grassley (R-Iowa) and Democratic whip Dick Durbin (D-Ill.) have stated that they would offer legislation, if necessary, to help authorize the proposal. A similar price transparency provision authored by Sens. Grassley and Durbin was included in a Senate-passed government funding bill but was removed by House Republicans in their version of the legislation. Supporters of the proposal believe that increased transparency will empower patients and slow the rising cost of prescription drugs. Pharmaceutical companies, however, argue that the inclusion of list prices in advertisements could confuse consumers and even discourage patients from seeking treatment because the list price is often higher than what patients end up paying with insurance. Many experts believe that the proposal is unlikely to have a significant impact on the price of drugs. The proposed rule will be open for public comment for 60 days. According to U.S. Department of Health and Human Services (HHS) Secretary Alex Azar, the proposal will take effect “in the months ahead.”

Spotlight on Preexisting Conditions Ahead of November Midterms

President Trump touted his support for protections for people with pre-existing conditions in a series of tweets last week, stating “All Republicans support people with pre-existing conditions, and if they don’t, they will after I speak to them. I am in total support.” Patient protections are a pivotal issue in most campaigns this election year. The administration is currently backing a lawsuit filed by the state of Texas contending that because the individual mandate penalty was repealed by Congress, the rest of the Affordable Care Act (ACA), including consumer protections, must be thrown out. Vulnerable Democrats running in red-states are using the lawsuit against their Republican rivals, while Republican candidates argue that the ACA is not the only means necessary to maintain protections for pre-existing conditions. Senate Majority Leader Mitch McConnell voiced support for the lawsuit in an interview last week. McConnell also suggested that Republicans may try to repeal the ACA again next year, depending on the outcome of the November midterm elections. McConnell spoke about the GOP’s dissatisfaction with the way the law is working and also argued the need to rein in spending on Medicare and other entitlement programs. Many predict that Democrats will win the House of Representatives, which would thwart any major repeal or entitlement reform by the GOP next year.

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