POLICY BRIEFINGS

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.


THIS WEEK'S BRIEFING - MAY 6, 2019

House Labor-HHS-Education Appropriations Advances to Full Committee


The House Appropriations Labor-Health and Human Services (HHS)-Education Subcommittee advanced its fiscal year (FY) 2020 spending bill by voice vote last week, with no amendments offered. Members expect a full committee markup this week, making it the first of 12 annual appropriations bills to be considered by the full Committee as Democrats work to pass spending legislation that includes a total of $631 billion in nondefense funding, an increase from $597 billion in FY 2019. The Labor-HHS-Education bill would increase discretionary funding by $11.7 billion for a total of $189.98 billion, $47.8 billion over the President’s budget request. The bill includes an increase of $8.5 billion for the U.S. Department of Health and Human Services (HHS). The National Institutes of Health (NIH) would receive a total of $41.1 billion, an increase of $2 billion above currently enacted levels and enough to provide sufficient funding to increase the appropriation for each institute and Center by nearly five percent. The Centers for Disease Control and Prevention (CDC) would receive $8.3 billion, a $921 million increase above current levels. The measure also proposes $50 million in funding for the CDC and the NIH to study firearm injury and mortality prevention, but it is unclear whether such a provision could be approved in the GOP-controlled Senate. The Substance Abuse and Mental Health Services Administration (SAMHSA) would be funded at $5.9 billion, a $115 million increase. The Health Resources and Services Administration (HRSA) would receive a $475 million increase for a total of $7.6 billion, and the Agency for Healthcare Research and Quality (AHRQ) would receive a $20 million increase for a total of $358 million. The bill directs $4 billion for administrative expenses at the Centers for Medicare and Medicaid Services (CMS), an increase of $315 million, and instructs CMS to use $100 million in carryover funds from Affordable Care Act (ACA) user fees to support the Navigators program and open enrollment outreach and advertising. The Public Health and Social Services Emergency Fund (PHSSEF) would receive $2.7 billion, an increase of $77 million. House Republican appropriators Kay Granger (R-Texas) and Tom Cole (R-Okla.) argue that the top-line spending figures in the Labor-HHS-Education measure are too high and will be rejected by the President and the Republican-controlled Senate. If appropriators succeed in marking up spending legislation in May, the 12 total appropriations bills are likely to be considered in packages on the floor in the month of June, according to House Majority Leader Steny Hoyer (D-Md.). The Senate has not yet scheduled markups while waiting for a deal to be struck on spending caps, but Appropriations Chairman Richard Shelby (R-Ala.) has also said that funding bills will be bundled together for consideration to expedite their passage in the Senate.


House Judiciary Advances Drug Pricing Legislation


The House Judiciary Committee advanced several bills related to prescription drug costs last week. The bills were approved by voice vote on a largely bipartisan basis with little debate. The CREATES Act (H.R. 965) would ensure that generic manufacturers have access to the brand samples necessary to develop generic products. The bill, which the Congressional Budget Office (CBO) estimates would save $3.9 billion, has already been advanced by the House Energy and Commerce Committee and is expected to be considered by the full House this month. H.R. 2375, the Preserve Access to Affordable Generics and Biosimilars Act, would create a presumption of anti-competitiveness for so-called “pay-for-delay” agreements. This legislation differs from the pay-for-delay bill previously advanced by the House Energy and Commerce Committee (H.R. 1499), under which such settlements would be prohibited. The Judiciary Committee also passed legislation (H.R. 2376) that would give the Federal Trade Commission (FTC) authority to study proprietary data from pharmacy benefit managers (PBMs), and a bill (H.R. 2374) that would restrict brand manufacturers from using the Food and Drug Administration’s (FDA) citizen petition process to slow generic drug approvals.



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