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.


Coronavirus Update

The Centers for Disease Control and Prevention (CDC) has confirmed three positive cases and six presumptive positive cases, along with one death, of individuals with COVID-19 not related to travel. All of these cases suggest community spread, but health officials are continuing their investigations in Arizona, California, Illinois, Oregon, Rhode Island, Washington State, and Wisconsin.

Lawmakers are reportedly close to reaching a bipartisan agreement on emergency funding to combat the virus. Democrats are insisting that any emergency supplemental spending is entirely comprised of new funding and not transferred from other accounts. They wish to put guardrails in place so that the funding cannot be used for any purpose other than coronavirus and infectious diseases response. Democrats are also pushing to include interest-free loans for small businesses affected by the outbreak, and reimbursements to state and local governments for costs incurred from assisting with the federal response to the outbreak. The White House initially suggested a total of $2.5 billion to combat the spread of the virus, with $1.25 billion in new funding and the remainder taken from existing health programs. This request was strongly criticized by members of both parties for being too low. Lawmakers are instead discussing a supplemental bill in the range of $6 billion to $8 billion. Eric Ueland, Director of Legislative Affairs for the administration, said that he expects Congress to release a bipartisan, bicameral funding measure as early as this week. The measure is expected to skip committee consideration. The House calendar for this week includes “possible consideration of Emergency Supplemental Funding Related to the Coronavirus.”

It also remains unclear whether Congress will include measures to address potential drug shortages stemming from the COVID-19 outbreak in the supplemental funding bill. House Energy and Commerce Subcommittee on Health Chairwoman Anna Eshoo (D-Calif.) has convened a working group on vulnerabilities in the prescription drug supply chain but indicated that legislation may be delayed to allow for stakeholder input. Rep. Bill Pascrell (D-N.J.) and Sen. Robert Menendez (D-N.J.) have sent a letter to Commissioner of Food and Drugs Stephen Hahn requesting more information on the agency’s plan to protect the medical supply chain from the COVID-19 outbreak, arguing that the risk to the supply chain is “potentially calamitous” because of global dependence on Chinese manufacturing. On Friday, the FDA confirmed the first shortage due to the COVID-19 outbreak but did not name the specific drug in question.

WH Pushes Senate Republicans to Address Drug Pricing, Health Care Costs

During a Senate GOP retreat last week, administration officials pressed lawmakers to pass legislation to lower drug prices and health care costs more broadly before the November 2020 elections. The President’s campaign manager Brad Parscale and White House adviser Jared Kushner spoke favorably about the Prescription Drug Pricing Reduction Act (S. 2543), the bipartisan bill advanced by the Senate Finance Committee. Chairman Chuck Grassley (R-Iowa) has argued that it is the only bill with a chance of being passed by Congress.

House Passes Bill to Restrict Tobacco Flavoring

The House of Representatives passed legislation last week to ban flavored tobacco and vaping products by a vote of 213-195. The Reversing the Youth Tobacco Epidemic Act (H.R. 2339) would impose a tax on e-cigarettes in line with the current levy on traditional cigarettes. It would also require tobacco advertisements to carry graphic warnings. The measure is unlikely to be considered in the Senate, where Republicans have raised concerns that banning flavored tobacco could lead to an increase in black market vaping products. The bill was also opposed by some members of the Congressional Black Caucus, which argued that including menthol in the flavor ban while exempting high-end cigars would unfairly target communities of color.

In related news, House Energy and Commerce Committee Chairman Frank Pallone (D-N.J.) has written to FDA Commissioner Stephen Hahn expressing concerns that the agency may be reconsidering proposed regulations that would set a maximum nicotine level in cigarettes. Pallone calls on the FDA to move forward with the proposal.

Finance Leaders Threaten Express Scripts Subpoena

Senate Finance Committee Chairman Chuck Grassley (R-Iowa) and Ranking Member Ron Wyden (D-Ore.) wrote to Express Scripts and Cigna Services following their failure to comply with a committee investigation into the rising costs of insulin. The lawmakers state that the pharmacy benefit manager (PBM) failed to answer questions posed to it in April 2019 and have not given a reason for not producing the requested documents. Grassley and Wyden continue to seek information about how Express Scripts chooses which insulin medications to cover and details about the rebates it has negotiated with manufacturers. Failure to comply with the latest letter by March 10 will likely result in a subpoena.

March 2, 2020: | Page 1 Page 2



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