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.


HELP Advances Lower Health Care Costs Act

The Senate Health, Education, Labor, and Pensions (HELP) Committee voted to advance the Lower Health Care Costs Act (S. 1895) last week. The bipartisan bill is a package of 54 different proposals from 36 Democrats and 29 Republicans to end surprise insurance gaps, reduce the prices of prescription drugs, and improve transparency in health care. The latest legislation added a provision from Senate Majority Leader Mitch McConnell (R-Ky.) and Sen. Tim Kaine (D-Va.) that would raise the legal age to buy tobacco products from 18 to 21. It also includes the CREATES Act (S. 974), aimed at spurring the creation of low-cost drugs and increasing generic competition.

The bill was voted out of committee by a 20-3 vote, with Sens. Rand Paul (R-Ky.), Bernie Sanders (I-Vt.), and Elizabeth Warren (D-Mass.) voting against the measure. Sanders objected to the bill because it proposes a flat, five-year extension of funding for Federally Qualified Health Centers (FQHCs) and the National Health Service Corps (NHSC), which he argues would amount to a nearly 20 percent cut for both programs. Warren voted in opposition to the bill’s lack of provisions to strengthen the Affordable Care Act (ACA).

The committee added an amendment from Sen. Bill Cassidy (R-La.) that would require hospitals to tell patients when their plan has no in-network providers for a certain service. Chairman Lamar Alexander (R-Tenn.) assured Cassidy that he would continue to work with him to make similar changes to strengthen the final bill. Lawmakers also agreed to an amendment based on the FAIR Drug Pricing Act (S. 1391) that would require pharmaceutical manufacturers to notify the government if they increase

the price of a drug by more than 10 percent in one year or 25 percent over three years, and to justify the price increase. Chairman Alexander, who opposed the amendment, has stated that he will be requesting some changes to the provision before it reaches the floor. Sen. Tammy Baldwin (D-Wis.), the lead sponsor of S. 1391, said that the Chairman is only interested in adding clarifying language.

During the markup, some members of the panel expressed opposition to the bill’s approach to settling payment disputes between insurers and providers in the case of a surprise medical bill. The legislation would set a benchmark payment rate at the median, in-network rate for each insurer of the particular geographical area. Chairman Alexander and Ranking Member Patty Murray (D-Wash.) each appeared open to further revising the bill before it reaches the floor.

Chairman Alexander expects the Lower Health Care Costs Act to be coupled with drug pricing measures from the Senate Finance and Judiciary committees for consideration on the Senate floor in late July prior to August recess, but has said that he does not want to postpone a full Senate vote if the other panels’ legislation is not ready. Details of the Senate Finance bill have not yet been announced. Chairman Chuck Grassley (R-Iowa) hopes to release a bill in July, but negotiations with Ranking Member Ron Wyden (D-Ore.) are still ongoing. The two still have several areas of disagreement to work through and are reportedly discussing provisions to make manufacturers pay back money to Medicare Part D if prices rise faster than inflation or if a new drug is launched with a high price, as well as a measure to help states finance and establish quality metrics for expensive gene therapies.

The HELP Committee also advanced S. 1199, the Poison Center Network Enhancement Act of 2019, and S. 1173, the Emergency Medical Services for Children Program Reauthorization Act of 2019 to the full Senate.

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