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.


Ways and Means Advances Drug Pricing, Vaping Legislation

The House Ways and Means Committee advanced Speaker Nancy Pelosi’s (D-Calif.) legislation to reduce drug prices (H.R. 3) following a lengthy markup last week. The Lower Drug Costs Now Act was approved by the committee along a party-line vote. The bill would allow the Secretary of the U.S. Department of Health and Human Services (HHS) to negotiate the prices of certain of the most expensive medications that currently face little or no competition, capping costs relative to the prices paid in six other nations. During the 12-hour markup, lawmakers voted down nearly every amendment offered by both Democrats and Republicans, only agreeing to a change that would rename the legislation after the late Rep. Elijah Cummings (D-Md.). H.R. 3 must now be reconciled with the two slightly different versions of the bill that have already been reported out of the other two committees of jurisdiction. According to House Rules Chairman Jim McGovern (D-Mass.), Democrats plan to bring the legislation to the floor for a vote in mid-November. Because of a week-long recess beginning November 4, the earliest the measure could be considered would be the week of November 11. Leadership had previously planned to vote on the measure before the end of this month, but members are still awaiting a full score from the Congressional Budget Office (CBO).

During its markup of H.R. 3, the committee also considered three bills that would direct savings from government drug pricing negotiations to create dental (H.R. 4650), vision (H.R. 4665), and hearing (H.R. 4618) coverage in Medicare and legislation to create opportunities for low-income individuals to enter health professions (H.R. 3398). The measures may be attached to the final drug pricing bill when it comes to the House floor for a vote.

During a separate markup last week, the House Ways and Means Committee advanced bipartisan legislation (H.R. 4742) to bring the taxation of the nicotine contained in vaping products in line with the rate at which nicotine in traditional cigarettes is taxed. The legislation, which was approved in a 24-15 vote, would place an excise tax on tobacco alternatives equivalent to the $1.01 federal levy per pack of cigarettes. A similar bill has been introduced by Democrats in the Senate, and Finance Committee Chairman Chuck Grassley (R-Iowa) has also expressed interest in considering legislation to address the problem of underage vaping. The Joint Committee on Taxation (JCT) estimates that the bill would produce $10 billion in revenue over the next decade. This money would be used to offset the other bills passed by the panel during the markup, which would require health savings accounts (HSAs) qualified insurance plans to cover the cost of inhalers before the deductible is met (H.R. 4716), allow the purchase of certain over-the-counter (OTC) and menstrual-care products as qualified medical expenses through tax-advantaged accounts (HSAs, Flexible Spending Accounts, and Health Reimbursement Arrangements) without a prescription (H.R. 1922), and permit people with direct primary care arrangements to remain eligible individuals for purposes of HSAs (H.R. 3708).

Cassidy, Hassan Convene Surprise Billing Roundtable

A group of 10 bipartisan senators led by Bill Cassidy (R-La.) and Maggie Hassan (D-N.H.) convened a roundtable with health care stakeholders on the issue of surprise insurance gaps. More than a dozen provider, insurer, and business groups were in attendance. Negotiations on a solution to protect patients from surprise medical bills have stalled amid disagreements on how to resolve payment disputes between physicians and payers. The lawmakers who attended the meeting were all supporters of Sen. Cassidy’s surprise billing legislation and are pushing for the addition of an independent dispute resolution (IDR) process to the bill advanced by the Senate Health, Education, Labor, and Pensions (HELP) Committee. The panel’s current legislation would set a benchmark payment rate based on local charges for out-of-network services. The lawmakers reportedly requested input from attendees on potential compromises they could support, but the roundtable did not result in any new breakthroughs.

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