Health Update (January 28)
|The government shutdown has entered its 35th day, and there still appears to be no end in sight. Yesterday, the Senate considered procedural motions to end debate on two competing bills which would reopen the government agencies that remain shut down. The first bill included the $5.7 billion requested by the White House for border wall funding. It also included a three-year extension of protections for hundreds of thousands of “Dreamers” (people who were brought to the United States as young children) and other immigrants who hold Temporary Protected Status. The second bill would fund all closed agencies with the exception of the Department of Homeland Security (DHS). DHS would have been funded by a three-week continuing resolution to allow congressional leaders to continue negotiations over what to do at the southern border. The second bill contained no additional money for a border wall.
Neither bill met the required 60 vote threshold, but it is worth noting that the second proposal received more votes than the White House-supported bill. Six Republican Senators (Cory Gardner of Colorado, Susan Collins of Maine, Lisa Murkowski of Alaska, Mitt Romney of Utah, Lamar Alexander of Tennessee, and Johnny Isakson of Georgia) voted in favor of both bills. The Republicans have cancelled their annual retreat scheduled for next week in order to continue working on a solution to the partial shutdown. It appears that some Republicans are beginning to break with the hard line approach taken by Senate Majority Leader Mitch McConnell (R-KY), who has said that any proposals which contain no money for border barriers are nonstarters. In a statement following the Senate votes, Senator Rob Portman (R-OH) said he was supportive of a “third way” which would “reopen the government in the short term with the commitment to a border-security plan that can be enacted in the next few weeks.”
Senate Finance Committee Chairman Chuck Grassley (R-IA) and Ranking Member Ron Wyden (D-OR) reintroduced the Right Rebate Act this week. The bill would close a loophole in Medicaid, which has allowed drug manufacturers to misclassify drugs and overcharge consumers by billions of dollars. The bill would give increased authority to the Department of Health and Human Services to guarantee proper classification of drugs. This bill has previously cleared the House of Representatives by an overwhelming bipartisan majority. For a summary of the bill, click here. The full text of the bill can be found by clicking here.
This week, patients and medical experts met at the White House to discuss the epidemic of surprise billing. Surprise billing (often referred to as balance billing) occurs when patients receive unexpected bills for out-of-network care. In many cases, patients are unaware that they have received out-of-network care, even when their primary doctor may be in network. One common instance of balance billing occurs when a patient undergoes an operation performed by an in-network doctor, but is treated by an out-of-network anesthesiologist. One extreme example of a surprise bill sent to a retired doctor in Ohio was a $17,850 bill for a routine urine test. President Donald Trump and several administration officials attended the meeting, and President Trump instructed staff to investigate ways to prevent surprise bills altogether. He said, “The pricing is hurting patients. We’re going to stop all of it.” While no explicit policy proposals were discussed, White House officials have indicated that price transparency remains a high priority for the Trump administration.
 Russell Berman and Elaine Godfrey. “Republicans Bend, but Don’t Break, on the Shutdown.” The Atlantic, 24 Jan 2019. https://www.theatlantic.com/politics/archive/2019/01/senate-didnt-take-its-chance-end-shutdown/581185/
 “Grassley, Wyden Release Bill to Crack Down on Big Pharma Games.” Senate Committee on Finance, 24 Jan 2019. https://www.finance.senate.gov/chairmans-news/grassley-wyden-release-bill-to-crack-down-on-big-pharma-games
 Emmarie Huetteman. “Trump Zeroes In On Surprise Medical Bills In White House Chat With Patients, Experts.” Kaiser Health News, 23 Jan 2019. https://khn.org/news/trump-zeroes-in-on-surprise-medical-bills-in-white-house-chat-with-patients-experts/