HEALTH CARE BRIEFING: House Panels to Consider Drug Price Plans

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Two House committees this week will hold markups of legislation empowering the government to negotiate with drugmakers and peg prices for medications in the U.S. relative to their cost in other countries, Alex Ruoff reports.

The House Ways and Means and Energy and Commerce committees will each debate legislation similar to a sweeping drug pricing bill (H.R. 3) that passed the House in 2019. That bill would allow the government to demand much-lower prices for up to 250 medicines currently on the market.

The government negotiation provision would generate more than $450 billion in savings to the government and is coupled in this package with a penalty for drugmakers that increase the price of their drugs and a repeal of a Trump-era drug rebate policy that could cut government spending further.

The Ways and Means Committee also proposed making permanent a two-year expansion of the Affordable Care Act’s insurance subsidies started earlier this year.

Related: Biden’s Child Tax Credit Plan Backed by House Democrats

The House Energy and Commerce Committee’s reconciliation measure also proposes to extend the ACA’s tax credits for the first time to the millions of people who make too much money to qualify for Medicaid in states that haven’t expanded their public health insurance programs, until a federally run Medicaid program can be created in 2025.

The committee’s proposal would direct the Department of Health and Human Services to hire third-party entities to operate these federal Medicaid plans in non-expansion states. The plans would closely mirror the benefit package and beneficiary protections of the Medicaid expansion under the ACA.

There would also be a new maintenance of effort requirement to encourage states that have already expanded Medicaid not to fall back on this new federal program. Democrats are also proposing to pump money into reinsurance programs to lower ACA marketplace premiums by 7% overall.

Moderates Prepare Own Plans: Moderate Democratic Reps. Scott Peters (D-Calif.) and Kurt Schrader (D-Ore.) introduced their own drug pricing bill Friday, Alex Ruoff reports. The measure would place a means-tested cap on out-of-pocket costs for drugs for Medicare beneficiaries. The would penalizes manufacturers that raise the price of a drug beyond the inflation rate for drugs in Medicare Part B and D, recouping price increases above inflation going back to 2016. It would also allow Medicare to negotiate drug prices in Part B for products that no longer have exclusivity and for which there is no competition on the market.

Ways and Means Approves Health Elements: The House Ways and Means Committee on Friday approved by a 24-19 vote it’s reconciliation measure to grant vision, hearing and dental benefits to Medicare beneficiaries, Alex Ruoff reports. Vision coverage is slated to begin in 2022 under the proposal, hearing aides would be covered starting in 2023, and dental coverage would be phased in from 2028-2032. Rep. Stephanie Murphy (D-Fla.) joined Republicans in voting against the legislation.

The panel also approved a slate of elder-care measures on Friday. The committee approved elder justice legislation by a 24-18 vote and a nursing home bill by a 24-17 vote. Rep. Murphy was the only Democrat to vote no, joining all Republicans. The quality of nursing home care has come under question since last year, when Covid-19 hit seniors in long-term care facilities the hardest. The virus killed more than 186,000 residents and staff of nursing homes, according to an AARP database.

The committee’s proposal would open up $400 million in grants per year for three years to bolster pay for nursing home workers and help long-term care facilities retain staff through student loan repayment or child-care programs. It would also empower the government to reduce payments to nursing homes that lie to authorities about their number of workers to hide understaffed facilities. The package would create ombudsman programs to flag elder abuse and neglect. Alex Ruoff has more.

Democrats on the House Ways and Means Committee are looking to new taxes for cryptocurrency and tobacco to help pay for Biden’s $3.5 trillion economic plan, which a committee document estimates would be fully paid for under its plan, people familiar with the matter said. The proposal would raise an estimated $16 billion by limiting deductions for executive compensation and $96 billion by higher taxes on tobacco and nicotine products, including e-cigarettes. Read more from Kaustuv Basu and Billy House.

The Coronavirus Pandemic

Biden to Announce New Vaccine Aid: Biden will announce his next steps to boost the global vaccine supply before this year’s United Nations General Assembly begins on Sept. 21, U.S. Surgeon General Vivek Murthy said.

Biden is weighing a multilateral meeting ahead of the UN leaders’ sessions aimed at vaccine supply, and has said he will announce new vaccine measures this month. Murthy told CNN yesterday that the announcement will precede the UN sessions. Read more from Josh Wingrove.

Biden Hits GOP Governors Over Covid-19 in Schools: Biden lambasted Republican governors for fighting mask mandates and other Covid-19 precautions in schools, accusing them of endangering children. “I am so disappointed that particularly some Republican governors have been so cavalier with the health of these kids,” Biden said at a Washington, D.C., middle school Friday. “So cavalier with the health of their communities. We’re playing for real here. This isn’t a game.”

Biden and his wife, Jill Biden, visited Brookland Middle School to outline his support for measures school administrators have taken to prevent the spread of coronavirus, including requiring masks on campuses. Republican governors including Ron DeSantis of Florida and Greg Abbott of Texas have tried to prohibit schools in their states from requiring masks, calling it a personal decision for parents. Read more from Sophia Cai and Mario Parker.

A Florida appeals court said Friday that DeSantis’s ban on school mask mandates can be enforced for now, even after a lower court judge ruled in favor of parents who had challenged the governor. It’s the latest twist in an on-again, off-again saga with the ban. Leon County Circuit Court Judge John C. Cooper ruled in favor of parents who challenged the ban; the state appealed, triggering an automatic stay; and on Wednesday, the circuit court judge vacated the automatic stay. Now, the pendulum has swung once again. Read more from Bloomberg News.

FDA Says Vaccine for Kids Will be Reviewed Rapidly: Covid-19 vaccines for younger children will be vetted as quickly as possible once drugmakers seek authorization for them, U.S. regulators said, vowing a swift review amid concern about the infection risks faced by kids. Currently, Americans 12 and older are eligible to receive a vaccine. But the recent surge in infections fueled by the delta variant and the start of a new school year have increased calls for younger children to be immunized. The Food and Drug Administration is “prepared to complete its review as quickly as possible, likely in a matter of weeks rather than months,” Janet Woodcock, acting commissioner of the FDA, and Peter Marks, the director of the agency’s Center for Biologics Research and Evaluation, said in a statement on Friday. Read more from Fiona Rutherford.

Pfizer’s Covid-19 vaccine could be approved for children from 5 to 11 years old by the end of October, Reuters reported, citing two sources familiar with top health officials. Timeline is based on expectation that Pfizer will have enough clinical trial data to seek an emergency use authorization from the FDA toward the end of September. The FDA could make decision within three weeks of the EUA submission, Reuters said.

Vaccine Messaging Revamp Called Critical: A Biden administration push for states to pay low-income residents to get the Covid-19 shot is clashing with research findings that certain financial incentives are largely ineffective—leaving government officials on the line for new ways to bolster vaccination numbers. States across the nation have offered up gift cards, lottery tickets, and other perks to nudge the vaccine hesitant to get the jab. The Medicare agency is encouraging states to do more, greenlighting funds to create incentives for recipients of the Medicaid and Children’s Health Insurance Programs. But research from academics at the University of Pennsylvania and the University of Chicago shows that states with and without incentives have similar vaccination trends. Read more from Ian Lopez.

What Contractors Should Know About Vaccine Order: The White House’s latest order requiring federal contractors to mandate Covid-19 vaccines for their employees has raised numerous legal questions about its scope and practical implementation—and businesses are pressing for answers. Biden‘s executive order, announced last week, will affect a wide range of companies that do business with the federal government in industries from information technology and banking to legal services, construction, and manufacturing. Collectively, federal contractors employ about one-quarter of the U.S. workforce, according to the U.S. Labor Department. Paige Smith and Erin Mulvaney explain the order.

Biden’s vaccine requirement for most health-care employees could allow home health agency workers who don’t want the jab to seek employment at other agencies that may not be subject to the mandate. If unresolved, the situation could exacerbate a home health staffing shortage and further destabilize the industry’s labor force through increased employee turnover, said Bill Dombi, president of the National Association for Home Care & Hospice. In California, several hundred thousand workers could be affected, Dombi said. Read more from Tony Pugh.

Senators Want Nursing Home Vaccine Data: Senate Finance Chairman Ron Wyden (D-Ore.) and Senate Aging Chairman Bob Casey (D-Pa.) in a Friday letter asked the Biden administration to provide more usable and accessible information on the rate of Covid-19 vaccinations among residents and workers in nursing homes.

Health Providers Eligible for $25 Billion in Relief Funds: Doctors, hospitals, and other health-care providers are eligible for a new release of $25.5 billion in pandemic assistance, the Health and Human Services Department announced Friday. Of the funds, $17 billion will go to providers who can show they have lost revenue and expenditures between July 1, 2020 and March 31, 2021. Another $8.5 billion, included in the March $1.9 trillion pandemic-related stimulus package known as the American Rescue Plan Act, will go to doctors and other health workers who serve rural Medicare and Medicaid patients.

“This funding critically helps health care providers who have endured demanding workloads and significant financial strains amidst the pandemic,” HHS Secretary Xavier Becerra said in a statement. “The funding will be distributed with an eye towards equity, to ensure providers who serve our most vulnerable communities will receive the support they need.” Read more from Shira Stein.

More Headlines:

What Else to Know

Texas Officials Shielded From Suit Over Abortion Ban: The Fifth Circuit lacks the ability to block Texas officials from enforcing a ban on abortion at or after six weeks gestation because the officials have sovereign immunity under the 11th Amendment, it said Friday. Whole Woman’s Health, Planned Parenthood Federation of America, and others aren’t likely to win their lawsuit against the officials to invalidate a law they say violates a woman’s constitutional right to end a pregnancy before viability because the officials can’t be sued in federal court, the U.S. Court of Appeals for the Fifth Circuit said in an order explaining its decision not to block enforcement of the law pending appeal. Read more from Mary Anne Pazanowski.

FDA Calls on Patent Office to Fend Off Drug Costs: The FDA is asking the U.S. Patent and Trademark Office for a hand in curbing drug costs as part of Biden’s plan to promote competition within the pharmaceutical industry. Patents have come center stage in a fight being waged in Congress, the administration, and industry over U.S. drug costs. Policy experts say major drug companies have erected patents around products in ways that make it more difficult for generics to enter the marketplace. Read more from Ian Lopez.

California Genetic Information Privacy Act Heads to Governor: California may soon have a law requiring direct-to-consumer genetic testing companies to provide information about the collection, use, and disclosure of people’s genetic data. Senate Bill 41, the Genetic Information Privacy Act, passed the California Senate on concurrence 38-0 on Thursday and will now be sent to Gov. Gavin Newsom’s (D) desk. The bill passed the state Assembly unanimously on Wednesday. Read more from Jake Holland.

Related: California Legislature Closes Session With Health Care Reforms

More Headlines:

With assistance from Alex Ruoff

To contact the reporter on this story: Zachary Sherwood in Washington at zsherwood@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

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