POLICY BRIEFINGS


Energy and Commerce Health Subcommittee Advance 12 Health Care Bills


The House Energy and Commerce Health Subcommittee advanced a package of bills to strengthen the ACA and its protections for individuals with pre-existing conditions and to reduce the cost of health care and prescription drugs. Many of the bills were passed by voice vote but are largely backed by Democrats, lessening the chance of their passage in the GOP-controlled Senate. Republican panel members expressed opposition to many of the bills, stating that they would reduce access to affordable health insurance options and reduce state flexibility. The bills will now be considered by the full committee and are likely to be voted on by the full House as a part of the Democratic response to what lawmakers characterize as the administration’s efforts to undermine the ACA. Energy and Commerce Chairman Frank Pallone (D-N.J.) hopes the bills will be considered on the House floor before the end of April.


House Democrats Unveil “Sweeping” Health Bill


On Tuesday, House Democratic leaders unveiled legislation aimed at making health care coverage more affordable and protecting individuals with pre-existing conditions. The Protecting Pre-Existing Conditions & Making Health Care More Affordable Act of 2019 was introduced today by Energy and Commerce Chairman Frank Pallone, Jr. (D-N.J.), Ways and Means Chairman Richard Neal (D-Mass.), and Education and Labor Chairman Bobby Scott (D-Va.) -- the three chairmen whose committees have jurisdiction over health care. The bill would expand the eligibility for premium tax credits beyond 400 percent of the federal poverty line and increase the size of tax credits for all income brackets. The bill also reverses recent administrative decisions to increase the access to association health plans and short-term, limited duration policies and curtail state waiver processes related to pre-existing conditions and essential benefits. The bill would require plans to cover benefits in each of the essential health benefit categories and would prohibit substitution across categories. Prescription drug coverage would be required to include access to a wide variety of drug classes and include an exceptions process for medically necessary drugs not included in a plan’s formulary. It would also require HHS to offer a standard benefit plan to better enable customers to compare their options. The bill would create a $10 billion reinsurance program and provide $200 million in grants for states to set up their own insurance exchanges if they do not already have one. The grants could be awarded through the end of 2022 and would last for two years. The bill also includes $200 million annually from FY 2020-2022 for state grants to pursue the expansion of health coverage, and $100 million annually for state grants to provide health insurance assistance to consumers. It would provide $100 million annually for the ACA’s navigators program, and an additional $100 million annually for HHS to carry out outreach and educational activities related to enrollment in ACA-compliant plans on the federal exchange. HHS would be required to report to Congress on how it spends user fees collected from participating insurers. The timing of the introduction coincided with the ninth anniversary of the ACA being signed into law, and the legislation addresses what Democrats characterize as the Trump administration’s sabotage of the law. Given the bill’s focus on shoring up the ACA, they do not include provisions related to Medicare for All. The legislation is expected to be included in a package of measures to strengthen the 2010 health care law that the House plans to vote on this year. It is unlikely to attract much support from Republican lawmakers or the administration, and the bill’s prospects in the Senate are unclear.


Drug Pricing Provision Added to Senate Budget Resolution


The Senate Budget Committee included a provision in its fiscal year (FY) 2020 budget resolution calling for legislation to make drugs more affordable and to hold the pharmaceutical industry accountable for high drug prices. The provision was offered by Sen. Chris Van Hollen (D-Md.) and was adopted by a vote of 14-6, with Republican Sens. Mike Braun (Ind.), Rick Scott (Fla.), John Kennedy (La.), Kevin Cramer (R-N.D.) and Chairman Mike Enzi (Wyo.) voting in support of the measure. The budget resolution was advanced on a party-line 11-9 vote.


Finance Opens Investigation in Potential Pharmaceutical Kickback Schemes


The Senate Finance Committee has opened a bipartisan inquiry into pharmaceutical companies that use charities for their own financial gain. Chairman Chuck Grassley (R-Iowa) and Ranking Member Ron Wyden (D-Ore.) have written to the HHS Office of the Inspector General (OIG) requesting details regarding “potential illegal kickback schemes” in which companies donate money to patient assistance programs and then steer patients toward their company’s product. It is legal for drug companies to donate to charities that help patients cover their out-of-pocket costs, but the charities must be independent of the drug companies.


Lawmakers Push for Inclusion of Migraine Research in Appropriations Language


A group of bipartisan lawmakers has written to the leadership of House Appropriations Labor-HHS-Education Subcommittee requesting that the panel include language in their FY 2020 appropriations bill addressing the National Institutes of Health’s (NIH) policy deficiencies, specifically in the area of headache disorders. The lawmakers argue that the NIH has largely neglected research on migraines, which impact one in seven Americans.



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