HEALTH CARE BRIEFING: Panel Takes Up Drug Pricing Debate

A House health panel pushed consideration of a major drug pricing bill into today as Democrats continue debate a key part of their domestic policy agenda.

The House Energy and Commerce Committee approved several climate- and telecom-related bills yesterday. Consideration of several key health care provisions, including one to empower the government to negotiate with drugmakers for better prices, will now occur as early as today.

One Democrat on the panel has introduced an amendment replacing the committee’s drug pricing legislation, which mirrors one (H.R. 3) that’s stood as the party’s signature prescription drug pricing legislation for years. Rep. Scott Peters’ (D-Calif.) amendment is a narrowed-down version of H.R. 3.

Rep. Kurt Schrader (D-Ore.), another member of the Energy and Commerce Committee, said he and Peters have been rallying support for their own bill that would permit the government to negotiate for lower prices for just Medicare Part B, which pays for drugs administered by doctors and at hospitals, and puts a cap on what seniors pay for medicines each year relative to their income. “Let’s vote on a bill that can actually pass,” Schrader said.

H.R. 3 permits government negotiation for all parts of Medicare and puts a cap on what Medicare beneficiaries pay for medicines but doesn’t base that cap on income.

Schrader also signaled he’s opposed to his party’s proposal to expand Medicare to include new benefits, namely dental coverage. He said he’s worried about the program’s fiscal solvency and the American Dental Association’s opposition to growing Medicare, Alex Ruoff reports.

• A group of health-care organizations including Better Medicare Alliance sent a letter to congressional leaders urging them to protect Medicare Advantage beneficiaries when adding new benefits to fee-for-service Medicare programs. “The addition of dental, vision, and hearing benefits as part of the medical benefit is an important policy change that will benefit millions of seniors and individuals living with disabilities,” the coalition’s letter says. Read it here.
• Meanwhile, House progressives are “still pushing very hard” on lowering the Medicare eligibility age to at least 62, Congressional Progressive Caucus Chair Pramila Jayapal (D-Wash.) told reporters on a press call last night, Emily Wilkins reports. The effort would fold another 13 million people into Medicare, she said. “We need to make sure we get that. That is a big push for us now in the House.”

Ways and Means Also Weighing Drug Prices: In addition to the Energy and Commerce markup, the Ways and Means Committee will also weigh similar legislation to H.R. 3, which would allow the government to demand much lower prices for up to 250 drugs currently on the market. The Ways and Means panel is also proposing making permanent a two-year expansion of the Affordable Care Act’s insurance subsidies started earlier this year, Ruoff reports.

• Meanwhile, a divide has emerged in the business community over support for legislation to lower drug costs, pitting major business groups against each other. Groups like ERIC and the Purchaser Business Group on Health, which represents Wal-Mart, Chevron, and McKesson, have been urging lawmakers to fold in employer plans in legislation on federal negotiation authority for drug prices. They want employers to be able to buy drugs at the same rates as the government.
• “Congress has an opportunity to make a real difference in the lives of all Americans with this drug price reform,” said PBGH’s CEO Elizabeth Mitchell in a letter to lawmakers yesterday. “But to be meaningful for the nation, their reforms must include the 60% of the population who are covered by private insurance.”
• The U.S. Chamber of Commerce and other major business groups are pushing back, saying ERIC and PGBH don’t represent them and that they’re adamantly opposed to Democrats’ drug pricing plan. Katie Mahoney, the chamber’s vice president of health policy, told reporters yesterday that it’s being held up as a “carrot” for employers to back the reconciliation package, but large businesses oppose any kind of government negotiation with drugmakers.
• Joel White, president of the Council for Affordable Health Coverage and a lobbyist for the Pharmaceutical Research and Manufacturers of America, said business groups that support drug pricing legislation don’t represent the interests of the business community. “You wouldn’t go to the drywall hangers to ask if the building is going to fall down. You’d go to the CEO,” he said, Alex Ruoff reports.

Ways and Means Measure Includes Tobacco Tax: The House Ways and Means Committee yesterday in its legislation also proposed doubling the current rate of excise taxes on cigarettes, small cigars and roll-your-own tobacco. The legislation also effectively imposes taxes on e-cigarettes by adding levies on other types of nicotine not used in tobacco products. A document circulated among lawmakers says the tobacco and nicotine provisions would generate $96 billion in revenue, Bloomberg News reports.

Group Sees Support for Health Items in Biden Agenda: A group allied with Democrats is circulating a poll among 1,200 people showing that health-care language in the budget reconciliation effort is the most popular part of it. “Support for the investments in critical priorities in the act is strong (74-26%), but is significantly stronger (80-20%) when the description includes that the plan reduces health care costs and the price of prescription drugs,” the group Protect Our Care said in a statement. Find the poll here.

BGOV’s Fall 2021 Hill Watch

Lawmakers returning to Washington for a busy fall work period face immediate decisions on how to head off a government shutdown and potential federal default, while Democrats push to advance — without Republican support — their ambitious plans to boost spending on social programs by as much as $3.5 trillion, Nancy Ognanovich and Emily Wilkins report.

The stretch into December could be lawmakers’ last realistic chance at policymaking before the 2022 election year begins in earnest. Several deadlines will dominate the weeks ahead, including: the deadline tomorrow for 13 House and 12 Senate committees to write their portion of the reconciliation bill; the House’s agreed timeline to begin consideration by Sept. 27 of the $1 trillion Senate-passed bipartisan infrastructure bill (H.R. 3684); and the Oct. 1 deadline for both chambers to pass a continuing resolution to fund the government that could suspend or raise the statutory debt limit.

Read More: Congress Confronts Multiple Budget Battles: BGOV Fall Hill Watch

Find all the health-specific legislation to watch in the full Fall 2021 Hill Watch here.

Also on Lawmakers’ Radars

Sweeping Biomedical Research Bill Nears: The biomedical research legislation “Cures 2.0″ will come out later this month as architects of the bill hope to pass it this year. Reps. Fred Upton (R-Mich.) and Diana DeGette (D-Colo.) said yesterday their bill will include a wide swath of health programs to build on their 2016 law known as “21st Century Cures.” The pair introduced a draft bill in June. Among the measure’s provisions include language on:

• Making permanent provisions that made telehealth easier during the pandemic;
• Ways for the Medicare agency to make faster and more predictable decisions on cutting-edge therapies;
• Efforts to improve clinical trial diversity; and
• Improvements in pandemic preparedness.

“One thing that we realized when we got into the pandemic was how important 21st Century Cures was, because many of those provisions actually helped us to develop the vaccine as quickly as we did,” DeGette said yesterday at Research!America’s national health research forum. “One thing we learned throughout the process was that we just have to be better prepared in the future.”

The bill also will authorize the Advanced Research Projects Agency for Health (ARPA-H), which is modeled after DARPA, an agency within the Department of Defense that paved the way for technologies such as the internet and GPS. ARPA-H aims to offer similar breakthroughs in biomedical research by offering a nimble, flexible funding schedule to bring big ideas to fruition in half the time. Read more from Jeannie Baumann.

Biden’s Drug Czar Pick to Testify: Sen. Shelley Moore Capito (R-W.Va.) announced yesterday that Rahul Gupta, Biden’s pick to be director of the Office of National Drug Control Policy, will appear before the Senate Judiciary Committee today. Gupta is a primary care physician who currently serves as the chief medical and health officer at the March of Dimes. He previously was the health commissioner of West Virginia under two governors, Valerie Bauman and Alex Ruoff report.

The Coronavirus Pandemic

Most Don’t Need Vaccine Booster, Scientists Say: Covid-19 vaccines work so well that most people don’t yet need a booster, an all-star panel of scientists from around the world said in a study that’s likely to fuel debate on whether to use them. Governments would be better served to focus on immunizing unvaccinated people and to wait for more data on which boosters would be most effective and at what doses, the authors, including two prominent FDA experts, said in The Lancet. Read more from Naomi Kresge.

• Meanwhile, variants that can eventually evade Covid-19 vaccines are increasingly likely with vast parts of the world unprotected, and rich countries should hold back on booster doses until others catch up, according to a special envoy to the World Health Organization. Novel variants “that can beat the protection offered by vaccines are bound to emerge all over the world in the coming months and years,” David Nabarro, the WHO envoy, told Bloomberg TV. Read more from James Paton.

U.S. Trails Its Peers in First Covid Shots After Japan’s Surge: The U.S. is now last among the world’s most powerful democracies when it comes to Covid vaccinations, squandering an early lead and plentiful supplies, as it was surpassed by Japan’s steady progress in rolling out shots. Japan, which started its mass vaccination program in April, has given a first dose to 63.6% of its population, according to government figures released Tuesday. The U.S. has administered at least one dose to 63.1% of its residents, the lowest among the Group of Seven nations. Read more from Lisa Du.

FDA Official Sees Promise in Covid-19 Trial Diversity: Record-breaking minority recruitment for Covid-19 vaccine trials could set an example for other drug manufacturers to diversify their own clinical trials, according to the top U.S. vaccine regulator. Of those participating in studies for the vaccines by Pfizer-BioNTech, Moderna, and Johnson & Johnson, around 10% identified as Black, 25% identified as Hispanic or Latino, and a quarter were over 65, drawing praise from FDA’s Peter Marks. Jeannie Baumann has more.

More Headlines:

• New York City Schools Reopen to a Mixture of Fear and Relief
• Get Off ‘Rear Ends’ on J&J Booster, Colorado’s Polis Tells FDA
• U.K. Will Allow Covid-19 Vaccines for Children Ages 12 and Up
• CDC Lowers Brazil Covid Travel Advisory by One Notch
• Western Michigan Athletes Win Injunction Against Vaccine Mandate

What Else to Know Today

Abortion Providers Warn of ‘Chaos’ if SCOTUS Rejects Roe: Abortion-rights advocates told the U.S. Supreme Court that “chaos” will reign if the justices reverse constitutional protections, saying that women will be left without a way to legally end pregnancies in much of the country. In a court filing yesterday, reproductive-rights groups said a decision upholding Mississippi’s ban after 15 weeks of pregnancy would have a devastating impact even if justices do not explicitly overturn Roe v. Wade. Greg Stohr has more.

• Related: Texas Anti-Abortion Group Agrees Not to Enforce Law

NY to Allow Medication Abortion Via Telemedicine: Women in New York state will be able to access medication abortion services via telemedicine, Gov. Kathy Hochul (D) announced yesterday. Hochul, standing with female lawmakers including U.S. Sen. Kirsten Gillibrand (D-N.Y.), U.S. Rep. Carolyn Maloney (D-N.Y.), and state Senate Majority Leader Andrea Stewart-Cousins, announced plans to continue to push for women’s reproductive rights and to be a haven for women. Read more from Keshia Clukey.

Big Task, Small Budget Awaits Health Agency’s New Climate Office: A newly-launched federal office faces a variety of challenges if it is to succeed in its goal of connecting the dots on health in interagency climate work, health and climate experts said. With an eight-person crew and limited budget, the Health and Human Services Department’s new Office of Climate Change and Health Equity—which opened its doors on Sept. 6— will need to keep focus within a range of competing agency interests, including its own health agency of over 80,000 employees. Read more from Stephen Lee and Jennifer Hijazi.

Deaths of Despair Worsen Among Non-College Graduates: In the U.S., a four-year degree is increasingly a “talisman” against deaths related to suicide and economic hardship, according to a new research paper that provides a stark verdict on the current economy. While the suicide rate almost doubled among White non-Hispanics without a bachelor’s degree in the 1992-2019 span, to 31 per 100,000 people, there was almost no increase among those with a degree, economists found. Katia Dmitrieva has more.

Biden Team Proposes to Nix Medicare Rule for Life-Saving Devices: The Biden administration is proposing to repeal a Trump-era rule that gives medical device companies faster Medicare payments for life-saving products. The rule, which was finalized in January, allows Medicare to start paying for some devices right after they get a green light from the FDA—cutting back the typical nine- to 12-month turnaround time companies wait to get paid. Read more from Alexis Kramer.

More Headlines:

• CVS Wins Support From States in SCOTUS Disability Bias Suit
• Aetna Faces Suit Over LGBTQ Discrimination in Fertility Coverage
• Provention Working With FDA to Request 4Q Type A Meeting
• $1 Billion VA Telehealth Request for Proposal Released

With assistance from Emily Wilkins and Valerie Bauman

To contact the reporters on this story: Brandon Lee in Washington at blee@bgov.com; Alex Ruoff in Washington at aruoff@bgov.com

To contact the editors responsible for this story: Zachary Sherwood at zsherwood@bgov.com; Giuseppe Macri at gmacri@bgov.com; Michaela Ross at mross@bgov.com