House to Vote on H.R. 3 This Week

The House of Representatives plans to vote on Democratic leadership’s drug pricing measure, the Lower Drug Costs Now Act (H.R. 3), this week. The bill would allow Medicare to negotiate the prices of some drugs. Majority Leader Mitch McConnell (R-Ky.) has vowed to block a vote on the bill in the Senate.

According to a new estimate from the White House Council of Economic Advisers, H.R. 3 would cost $1 trillion over the next decade and result in the availability of 100 fewer drugs. This is in contrast to the Congressional Budget Office’s (CBO) preliminary analysis of the price negotiation portion of the bill, which estimates $345 billion in savings to the Medicare program. CBO is expected to release an estimate of savings from the entire bill before the vote this week.

Chairman of the House Ways and Means Subcommittee on Health Lloyd Doggett (D-Texas) hopes to offer an amendment to H.R. 3 that would increase the number of drugs subject to government pricing negotiations. His measure would apply Medicare negotiation to any treatment with a launch price higher than the median household income. Doggett has threatened to vote against the package if progressive attempts to revise the bill are rejected. Congressional Progressive Caucus (CPC) Co-Chair Mark Pocan (D-Wis.) has also warned that some Democrats may vote against the bill unless revisions are made. Progressive lawmakers will meet with leadership early this week to discuss increasing the minimum number of drugs that can be negotiated under the legislation, extending the lower negotiated prices to uninsured individuals, and fully repealing the ban on Medicare drug price negotiations. The CPC is conducting a whip count of its members to determine how many would be willing to vote no on the rule for the legislation, a procedural motion that could stop the bill from coming up for a vote, which could incentivize leadership to make changes to the underlying bill or to allow floor votes on progressive amendments. Democratic leadership are reportedly considering weakening an amendment to the bill inserted by progressive congresswoman Pramila Jayapal. The change would direct the government to conduct a study on the feasibility of extending limits on drug price increases to private health plans, rather than requiring regulations be issued to implement such a policy. The amendment may be stripped from the bill due to the additional time necessary for CBO to analyze the cost of the provision.

The House Rules Committee will consider H.R. 3 on Tuesday, setting up a floor vote on the legislation no later than Thursday.

Finance Drug Packaged Stalled by Senate Leadership

Senate Finance Committee Chairman Chuck Grassley (R-Iowa) and Ranking Member Ron Wyden (D-Ore.) released an updated version of their bipartisan health care package last week. The second draft of the Prescription Drug Pricing Reduction Act would lower Medicare enrollee’s out-of-pocket expenses in the initial phase of a prescription drug plan from 25 percent to 20 percent and would allow beneficiaries the option to more evenly divide what they pay each month for their medications, capping out-of-pocket costs at $3,100 per year. The latest version of the bill also includes several health care extenders, which would be paid for with the drug pricing provisions of the legislation. The Committee did not provide any new savings estimates. While the package has the support of President Trump, who praised the new version of the bill and urged its passage this year, it remains stalled by Majority Leader Mitch McConnell’s (R-Ky.) reluctance to bring it up for a vote on the Senate floor. McConnell has reportedly expressed thoughts in private conversations that the bill is bad policy and is hesitant to hold votes that could divide Republicans. Nine GOP Finance panel members voted against the measure in Committee, specifically objecting to a provision that would require manufacturers to pay rebates to the Medicare program if their prices rise faster than inflation – a policy the lawmakers argue is akin to a government price control. Such GOP objections make it unlikely that the bill will be attached to must-past, end-of-the-year legislation. McConnell has instead focused the chamber’s time on confirming the President’s judicial nominations; according the Senate Finance Committee Chairman Chuck Grassley (R-Iowa), a vote on the drug pricing bill “would be dependent upon the White House asking him to do it at this point.”

House Will Remain In Session Through Dec. 20

The House of Representatives has changed its schedule to remain in session the week of December 16, with last votes expected on December 20, the day the current stopgap spending measure expires. Lawmakers are working to draft the 12 appropriations bills in the midst of disagreements over border wall funding and abortion-related provisions in order to avoid a government shutdown at the end of the month. The House had previously planned to recess for the year on December 13. The President supports efforts to pass the 12 appropriations bills, according to remarks from White House legislative affairs director Eric Ueland, but he continues to push for the inclusion of border wall funding. Ueland has also highlighted trade and prescription drug pricing reforms as priorities for the administration before the end of the year.

E&C Chairman Releases Draft Bill to Modernize Cosmetics Regulations

House Energy and Commerce Committee Chairman Frank Pallone (D-N.J.) released a draft proposal to modernize the Food and Drug Administration’s (FDA) ability to regulate cosmetics ahead of a hearing in his panel’s Health Subcommittee on the same subject. The Cosmetic Safety Enhancement Act of 2019 would give the agency the authority to recall cosmetics and require cosmetics companies to report adverse events. Federal cosmetics regulations have not been updated in 80 years and concerns were raised during the hearing regarding the patchwork of state laws that have arisen to regulate cosmetic products. Chairman Pallone’s legislation would not preempt state laws regarding civil or criminal action against cosmetic manufacturers, but the Chairman stated that he was still open to making revisions to the bill.

Lawmakers Continue Push for E-Cig Guidance

A group of lawmakers have written to the President urging him to finalize a previously announced compliance policy designed to ban all flavored e-cigarettes from the market. The letter stressed that any guidance on flavored e-cigarettes should include mint and menthol and apply to all retailers. The letter was signed by Reps. Raja Krishnamoorthi (D-Ill.) and Peter King (R-N.Y.) and Sens. Dick Durbin (D-Ill.), Richard Blumenthal (D-Conn.), and Chris Van Hollen (D-Md.).

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