Health Update (April 8)
|Committee and Floor Proceedings
This week, the House passed a resolution condemning the recent move by the Trump administration which supported the Texas lawsuit that would invalidate the entirety of the Affordable Care Act (ACA). The resolution passed along party lines with near unanimous Democratic support. While it is unlikely that this resolution will see the light of day in the Senate, expect health care to continue to play a large role in messaging throughout the weeks and months leading up to the 2020 elections. President Trump recently walked back claims that Republicans would take any votes on repealing and replacing the ACA until after the 2020 elections. Congress will, however, continue to work on health care in the interim. Democrats on Capitol Hill in both chambers continue to grill their Republican colleagues and administration officials who they say are working to sabotage the landmark health law.
On a related note, the full Energy and Commerce Committee passed 6 ACA bills that would reverse several actions taken by the administration to change the way the law is enforced. These bills were heard in subcommittee last week. For a recap, the ACA bills are H.R. 1385, H.R. 1386, H.R. 987, H.R. 1010, H.R. 986, and H.R. 1425. Together, the bills would offer states federal funds for state-based marketplaces, reinstate funding for the ACA navigator program, restore outreach and marketing funding for open enrollment, invalidate the Short-Term, Limited Duration rule, rescind the Section 1332 waiver guidance, and provide $10 billion annually to states for reinsurance programs. The ACA bills were passed along party lines, but the full committee also advanced 6 drug pricing bills with overwhelming bipartisan support. Committee Chairman Frank Pallone said the committee “took a big step in following through on Democrats’ commitment to the American people to lower health care and prescription drug costs.” The bills now advance to the House floor.
On Tuesday, the Senate passed H.R. 1839, the Medicaid Services Investment and Accountability Act of 2019. The bill extends protections for Medicaid recipients of home and community-based services, establishes a State Medicaid option for coordinated care to children with complex medical conditions, and prevents the misclassification of drugs for the purposes of the Medicaid drug rebate program. The bill now goes to President Trump’s desk for his signature.
Department of Health and Human Services News
This week, the Department of Health and Human Services (HHS) Secretary Alex Azar appeared before the Senate Appropriations HHS Subcommittee to discuss the FY2020 budget. Members from both parties echoed concerns about cuts to Medicaid and NIH funding. A topic of frequent discussion was the administration’s recent actions concerning the Texas lawsuit which struck down the Affordable Care Act. Sec. Azar said that the administration was committed to finding a replacement for the health care law in an attempt to ease concerns among Democrats on the subcommittee. Senators encouraged the funding for fighting the opioid epidemic, but some stressed that cuts to Medicaid would harm populations who are already facing addiction. Sec. Azar also recommitted the health agency’s commitment to strong regulations for the e-cigarette industry, saying that he wants to support smoking cessation tools without introducing nicotine products to new users (This comment is timely, given that today was FDA Commissioner Gottlieb’s last week at the agency). Finally, Sec. Azar highlighted the proposed rule that would require passing drug rebates to Part D beneficiaries directly at the pharmacy, urging senators’ support for the rule.
This morning, CMS Administrator Seema Verma issued guidance for the Pard D bids based on the proposed rule that Sec. Azar highlighted during his testimony. The letter indicated that CMS will conduct a demonstration that would test the transition for beneficiaries and plans in the event of a change for safe harbor rules. To view the letter from Administrator Verma, click here.
This week, the Senate Homeland Security and Governmental Affairs Subcommittee on Investigations sent a letter to the Postmaster General and Commissioner of Customs and Border Protection requesting briefings from both agencies regarding the implementation of processes that aim to stop the flow of fentanyl through international mail. The Chairman and Ranking Member of the Subcommittee, Senators Rob Portman (R-OH) and Tom Carper (D-DE), wrote about “troubling” findings from two detailed reports from the US Postal Service and Department of Homeland Security Offices of Inspector General, which both detailed a failure to effectively secure incoming international mail. The full letter can be found here.
 Ella Nilsen. “House Democrats just passed a resolution condemning Trump’s attacks on Obamacare.” Vox, 3 Apr 2019. https://www.vox.com/policy-and-politics/2019/4/3/18292175/house-democrats-trump-resolution-obamacare
 “E&C Chairman Pallone on Passage of 12 Bills to Lower Health Care and Prescription Drug Costs for Consumers.” Energy and Commerce Committee, 4 Apr 2019. https://energycommerce.house.gov/newsroom/press-releases/ec-chairman-pallone-on-passage-of-12-bills-to-lower-health-care-and
 “Medicaid Services Investment and Accountability Act of 2019” 116th United States Congress, 2 Apr 2019. https://www.congress.gov/bill/116th-congress/house-bill/1839/text
 Seema Verma. “Guidance Regarding Part D Bids.” Centers for Medicare & Medicaid Services, 5 Apr 2019. https://www.cms.gov/Research-Statistics-Data-and-Systems/Computer-Data-and-Systems/HPMS/Downloads/HPMS-Memos/Weekly/SysHPMS-Memo-2019-Apr-5th.pdf
 Senators Rob Portman and Tom Carper. “Letter to Postmaster General and Commissioner of Customs and Border Protection.” United States Senate, 4 Apr 2019. https://www.portman.senate.gov/public/index.cfm?a=files.serve&File_id=7956109A-D53C-418A-AB35-4075C333A1C7