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.


CMS Releases Updated Health Care Spending Estimates

The Centers for Medicare and Medicaid Services (CMS) Office of the Actuary has published updated projections of national health expenditures for 2018-2027. National health expenditure growth is expected to average 5.5 percent annually, similar to last year’s projected average, reaching nearly $6 trillion by 2027. The health share of gross domestic product (GDP) is projected to rise from 17.9 percent in 2017 to 19.4 percent by 2027. This rise is driven in part by increases in prices for medical goods and services, which are projected to grow 2.5 percent from 2018-2027, compared to 1.1 percent from 2014-2017.

Senate Finance Launches Insulin Investigation

The Senate Finance Committee has announced a bipartisan investigation into insulin pricing practices. Chairman Chuck Grassley (R-Iowa) and Ranking Member Ron Wyden (D-Ore.) sent letters to three insulin manufacturers - Eli Lilly, Novo Nordisk, and Sanofi - requesting information on recent price increases and the processes used to determine list prices and net prices. The lawmakers express concerns that “the substantial increases in the price of insulin over the past several years will continue their upward drive and pose increasingly severe hardships not only on patients that require access to the drug in order to stay alive but also on the taxpayer.” They ask for data detailing the costs, revenues and margins from insulin sales. They also ask the manufacturers how the administration’s proposal to eliminate drug rebates would impact the pricing of insulin products. The lawmakers seek responses by March 8.

Democrats Urge Rejection of 1115 Waivers

House Energy and Commerce Committee Chairman Frank Pallone (D-N.J.) and Senate Finance Committee Ranking Member Ron Wyden (D-Ore.) have written to U.S. Department of Health and Human Services (HHS) Secretary Azar regarding the administration’s use of Section 1115 waivers in the Medicaid program. The Democrats express concerns that the waivers “threaten to impede access to critical care for millions of Americans,” and point to the situation in Arkansas where more than 18,000 people have lost coverage following the approval of work requirements in the Medicaid program. Arkansas was the first state to implement work requirements for Medicaid enrollees; eight states have had waivers approved to implement the requirements. The lawmakers urge HHS to reject “any and all Section 1115 demonstration requests that jeopardize the health and financial security” of low-income Americans.

Dems Comment on 2020 Notice of Benefit and Payment Parameters

A group of Democrats have written to CMS Administrator Seema Verma outlining their concerns with the Administration’s proposed changes to the 2020 health insurance marketplace. The lawmakers object to the proposed change in premium adjustment calculation, proposed changes in re-enrollment, proposed rules relating to coverage of women’s services, and proposed prescription drug policies. They call on Verma to not finalize these policies and “instead work with Congress and stakeholders across the health care system to reduce costs, secure patient protections, and improve access to coverage.” The letter was signed by House Energy and Commerce Committee Chairman Frank Pallone (D-N.J.), House Education and Labor Chairman Bobby Scott (D-Va.), Senate Health, Education, Labor, and Pensions (HELP) Committee Ranking Member Patty Murray (D-Wash.), and Senate Finance Committee Ranking Member Ron Wyden (D-Ore.).

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