POLICY BRIEFINGS

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.


THIS WEEK'S BRIEFING - SEPTEMBER 16, 2019

Another Physician Heads to Washington


Republican Greg Murphy, MD defeated Democratic opponent Allen Thomas in the race for North Carolina’s 3rd Congressional District by more than 20 points last week. The special election was held to fill the seat vacated following the death of Rep. Walter Jones Jr. (R-N.C.) earlier this year. Dr. Murphy is a board certified urologist who ran a private practice prior to joining the North Carolina state legislature in 2015. During his campaign, he stated support for “healthcare reforms that put the decision making process of doctor choice and treatment options in the hands of the citizens and will look for new and innovative ways to implement such changes.”


Draft Version of Pelosi Drug Pricing Plan Leaked


A draft of House Speaker Nancy Pelosi’s (D-Calif.) plan to lower drug prices was leaked last week. The bill, which has been in the works for months, would direct the U.S. Department of Health and Human Services (HHS) Secretary to negotiate the prices of the 250 drugs that are most expensive to Medicare each year and that lack the competition of at least two other generic drugs, biologics, or biosimilars. Pharmaceutical manufacturers that do not negotiate or are unable to reach an agreement with the government would face a 75 percent penalty of the gross sales of the drug from the previous year – a reversal of an earlier proposal to involve an arbiter if negotiations fail. Speaker Pelosi’s plan would also cap drug prices at 1.2 times the average international price of Australia, Canada, France, Germany, Japan, and the U.K., similar to a concept proposed by the Administration related to Part B. The lower drug prices would apply to both Medicare and private insurers. Savings resulting from the lower-priced drugs would be directed to the National Institutes of Health (NIH) for the development of new drugs and treatments. The legislation also proposes to instate a $2,000 cap on Medicare beneficiary out-of-pocket spending starting in 2022. Senior leadership staff has clarified that the leaked draft is no longer current and could still change before it is formally introduced, and House committees begin holding hearings on the measure later this year.

House Democratic Caucus Chairman Hakeem Jeffries (N.Y.) expressed confidence that the bill could pass this year and stated that the Speaker is currently discussing the plan with House Ways and Means Committee Chairman Richard Neal (D-Mass.) and House Energy and Commerce Committee Chairman Frank Pallone (D-N.J.). According to a recent statement by Chairman Neal, the House plans to prioritize smaller, bipartisan drug pricing bills like the STAR Act (H.R. 2113), which would require manufacturers to publicly justify certain price increases. Although the Pelosi proposal is unlikely to be supported by many Senate Republicans, proponents of the bill are hopeful that it will gain the White House’s endorsement due to its similarity to some of the President’s rhetoric and campaign promises.

Meanwhile, Senate Finance Committee Chairman Chuck Grassley (R-Iowa) is using the bill to garner support for his panel’s own drug pricing proposal, characterizing it as a more moderate alternative. That bill was advanced out of committee despite significant Republican opposition to a provision that would require manufacturers to issue rebates to the Medicare program if prices rise faster than inflation, which some GOP members characterized as government price-fixing. The White House has reiterated its support for the Senate Finance Committee’s plan, stating that the administration has been in discussions with Speaker Pelosi on the subject of drug pricing but has not been provided with a specific proposal or legislative text.



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