E&C Advances Bipartisan Package of Generic Drug Legislation

The House Energy and Commerce Committee advanced a package of 12 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. Democratic and Republican panel members reached an agreement to approve a set of six bills aimed at increasing generic drug competition, and the bills were advanced with bipartisan support. Among the bills that were passed was a revised version of the CREATES Act (H.R. 965) to address Republican concerns about potential frivolous lawsuits between generic and brand manufacturers. Democrats also agreed to changes to the Protecting Consumer Access to Generic Drugs Act of 2019 (H.R. 1499) to address Republican opposition to retroactively making pay-for-delay agreements illegal. The remaining legislation was largely approved along party lines, with Republicans objecting to the bills’ lack of pay-fors and reduction of affordable health insurance options. A vote in the full House has not yet been scheduled, and it is unlikely the ACA-focused measures could be approved in the GOP-controlled Senate. Bipartisan support for the drug pricing measures makes it more likely that the Senate will act, especially given Senate Finance Committee Chairman Chuck Grassley’s (R-Iowa) support for the CREATES Act and pay-for-delay legislation.

Finance Committee Contacts PBMs Ahead of Tuesday Hearing

Senate Finance Committee Chairman Chuck Grassley (R-Iowa) and Ranking Member Ron Wyden (D-Ore.) have written to three pharmacy benefit managers (PBMs) regarding their role in the rising price of insulin. The lawmakers wrote to Express Scripts, CVS Health Corp., and OptumRx requesting information related to the PBMs’ relationships with insulin manufacturers and public insurance programs and private insurance plans, and how PBMs determine the availability of drugs and the size of rebates. Grassley and Wyden question whether PBMs are actually working to reduce the cost of insulin. The Senate panel is scheduled to hear testimony from PBMs on April 9. The House Energy and Commerce Oversight Subcommittee has a similar hearing scheduled for April 10.

HELP Hopes to Advance Health Care Cost Legislation this Summer

The Senate Health, Education, Labor, and Pensions (HELP) Committee plans to vote on legislation to lower health care costs early this summer, according to Chairman Lamar Alexander (R-Tenn.). He stated that the panel has received more than 400 specific recommendations on improving health outcomes and patient care experiences at a lower cost. The recommendations were sent to the HELP Committee in response to a letter that Alexander sent at the conclusion of the 115th Congress to the American Enterprise Institute, the Brookings Institution, governors, state insurance commissioners, economists, doctors, hospitals, patients, and innovators. Alexander will compile the proposals, which could include efforts to increase transparency, lower drug costs, eliminate surprise billing, expand primary care, improve electronic health records (EHRs), and address consolidation in the health care industry, into a single package to be voted on by HELP. He said that he is working with Ranking Member Patty Murray (D-Wash.), alongside Senate Finance Committee Chairman Chuck Grassley (R-Iowa) and Ranking Member Ron Wyden (D-Ore.), on developing bipartisan legislation that has the potential to be sent to the President’s desk for his signature. He called on his Senate colleagues to send specific proposals for lowering health care costs to the leadership of each committee.

House Dems Continue Internal Drug Pricing Discussions

Several progressive House lawmakers are in talks with Speaker Nancy Pelosi’s (D-Calif.) office regarding legislation to lower drug prices. Reps. Lloyd Doggett (D-Texas) and Pramila Jayapal (D-Wash.) hope to advance legislation that would impose severe punishments on pharmaceutical manufacturers that refuse to negotiate prices with the federal government. The bill would allow Medicare to negotiate drug prices and strip a company of its exclusivity if it refuses to reach an agreement. The lawmakers have expressed concerns that leadership will either strike a deal with the White House on drug pricing or propose its own legislation that does not go as far as their own legislation. Staff for Pelosi stress that any drug pricing bill will move through regular order, but that the Speaker is also considering a bill that would use an arbitrator to set a price for a drug in the case that Medicare and the drug company cannot reach a pricing agreement; this proposal would only apply to a subset of high-cost treatments.

FY2020 Appropriations Update

Some lawmakers have already indicated that a stopgap spending measure may be necessary to keep the government open after the end of the fiscal year (FY) on September 30. Appropriators had hoped to reach an agreement to raise funding caps under the Budget Control Act (BCA), but in the increasing likelihood that this does not occur, the House and the Senate will mark up bills with different top-line spending figures. According to Ranking Member of the House Appropriations Labor-Health and Human Services-Education Subcommittee Tom Cole (R-Okla.), appropriations negotiators now appear content with relying on a last-minute government funding deal.

Lawmakers Request Suicide Prevention Funding

Suicide Prevention Task Force co-chairs John Katko (R-N.Y.) and Don Beyer (D-Va.) sent a letter to appropriations leadership requesting funding for the purpose of suicide prevention. They request $51.2 million for the National Suicide Prevention Hotline and $10 million for the Centers for Disease Control and Prevention (CDC) to study suicide.

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