HEALTH CARE BRIEFING: Trump Aims to Match Foreign Drug Prices

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A top priority of President Donald Trump, lowering prescription drug prices, could see executive action as early as today, including a policy to tie Medicare payments to foreign countries’ drug prices, according to five sources familiar with the move.

The White House schedule has a 3 p.m. drug pricing signing slated for today.

The slate of policies will also include a plan for Americans to buy lower-cost prescription medication imported from Canada. Canadian drug importation and the international pricing index have both been on the White House agenda for over a year. The index will match Medicare payments for drugs administered in a doctor’s office more closely with the lower prices other countries pay.

The order is also expected to include a policy to reduce the cost of insulin and Epi-Pens at hospitals through an existing drug discount program, the sources said. That 340B program is funded in part by drugmakers.

The administration plans to officially publish the international pricing index proposed rule, which has been under review at the Office of Management and Budget since June 2019. The White House and the Department of Health and Human Services have toyed with releasing that rule several times over the last year but then put it on hold. Read more from Shira Stein, Alex Ruoff and Saleha Mohsin.

GOP Weighs $235 Billion for Health, Labor

Senate Republicans are debating giving federal health and labor departments $235 billion as part of their proposal for the next coronavirus-relief package, which would include $51 billion for Covid-19 testing and vaccine development, according to a draft obtained by Bloomberg Government.

The proposal is more generous in some respects—such as giving $15.5 billion to the National Institutes of Health—than what Democrats have proposed and what the White House has suggested.

The draft, which Republican aides caution is still subject to negotiations, would also add $25 billion in emergency funds to the provider relief fund, bringing to total amount of money sent to hospitals and doctors this year to $200 billion.

Republicans also want to prevent an increase in the Medicare Part B Premium for 2021 and plan to freeze it at 2020’s price, according to the draft document.

Doctors who took advanced Medicare payments would also get until January to repay the loans, many of which are due in August, under the proposal.

Lingering differences among Senate Republicans have stalled the rollout of the pandemic relief package, though Treasury Secretary Steven Mnuchin said yesterday they had a “fundamental agreement” on a $1 trillion plan. “We’re still looking at the timing” for producing legislation, Mnuchin said following a meeting with Senate Majority Leader Mitch McConnell (R-Ky.) at the Capitol yesterday. “We have a fundamental agreement, we’re just looking at language.”

McConnell later said the $1 trillion GOP plan won’t be ready until Monday, after lawmakers had initially expected a series of bills to be released yesterday.

As the Senate closed out business, McConnell said that committee chairman and other Republicans would begin introducing components of their stimulus plan on Monday.

House Ways and Means Chairman Richard Neal (D-Mass.) expressed concern the GOP proposal would include the TRUST Act (S. 2733,H.R. 4907), which McConnell indicated it would. “The TRUST Act will result in far-reaching cuts to Social Security and Medicare – that is the intention of the bill,” Neal said in a statement. “The legislation sets up closed-door commissions to fast-track the destruction of these programs.” Read more from Laura Litvan, Erik Wasson and Saleha Mohsin.

More Pharmacy Covid Testing Backed by White House, Republicans: Pharmacists pushing to get paid by Medicare for Covid-19 testing have gained key congressional allies but say they face opposition from the country’s top doctors lobby. Congressional leaders and the White House support altering Medicare rules to allow reimbursements for pharmacists who administer Covid-19 tests and a potential future vaccine, Rep. Buddy Carter (R-Ga.), the lead sponsor of the change, said. Read more from Alex Ruoff.

Pharma Industry Would Get Boost Under GOP Bills: House Ways and Means Committee Republicans unveiled a string of bills to help the pharmaceutical industry amid the coronavirus pandemic. The provisions have the support of House Republican leadership, an aide said.

A bill (H.R. 4549) by Rep. Ron Estes (Kan.) would repeal a research and development requirement set to take effect in 2022, which has raised concerns from manufacturing companies. Companies will have to amortize R&D expenses over five years, or 15 years for expenses incurred outside the U.S., instead of deducting them immediately each year. Rep. Jodey Arrington’s (Texas) measure would make full expensing—known as 100% bonus depreciation—permanent. As part of the 2017 law, full expensing is scheduled to phase out after 2022. Read more from Kaustuv Basu.

Also Happening on the Hill

Appropriations: The House is scheduled to vote on its first package of fiscal 2021 appropriations bills (H.R. 7608), including the Agriculture-FDA, Interior-Environment, Military Construction-Veterans Affairs, and State-Foreign Operations bills.

Lawmakers voted yesterday 223-194 to add a package of amendments that would:

Bar the U.S. from withdrawing from NATO or from the World Health Organization;
Emphasize the need for a binational coronavirus testing strategy with Mexico;
Bar the State Department from promoting the sale or export of e-cigarettes; and
Block officials from using the Defense Production Act to keep meat and poultry processing facilities operational during the coronavirus emergency.

Members also agreed via voice vote to add another collection of amendments that would:

Increase nutrition aid to Puerto Rico by $528.6 million;
Expand oversight of state-run veterans’ homes that may be affected by the coronavirus pandemic; and
Encourage the Department of Veterans Affairs to study the effect of the coronavirus on veterans who have been exposed to burn pits and other airborne hazards.

BGOV Closer Look at Appropriations Amendments: Adam M. Taylor, Naoreen Chowdhury and Michael Smallberg take a closer look at amendments to the bill.

Minibus No. 2: Progressive lawmakers aim to strip next week’s seven-bill spending package (H.R. 7617) of the longstanding Hyde Amendment, which holds that federal funds cannot pay for abortions, except to save the life of the woman, or in the case of incest or rape. Rep. Ayanna Pressley (D-Mass.) offered the amendment. The House Rules Committee is set to meet Monday to determine which measures will get votes on the floor.

House Appropriations Labor-HHS-Education Subcommittee Chairwoman Rosa DeLauro (D-Conn.) included the Hyde Amendment even though she opposes it because the bill wouldn’t stand a chance of becoming law without it, she said. She has said she hopes not to include the measure in future legislation if a Democrat is president. Last year, former Vice President Joe Biden (D) said he opposes the Hyde Amendment after previously supporting it.

The seven-bill package includes funding for Defense, Commerce-Justice-Science, Energy and Water, Financial Services, Homeland Security, Labor-HHS-Education, and Transportation-HUD.

Testing, Treatment & Prevention

Virus Slows in Some States: Testing shortcomings are making it more difficult to get a clear picture of the U.S. coronavirus pandemic, as case counts in some hot spots wane but health officials warn that new infections may be significantly undercounted. The U.S. outbreak remains on a troubling trajectory. The country is on course to reach a total of four million infections, and deaths continue to hit records in some states. But new cases in Florida and Arizona are showing signs of slowing down after a surge that has jarred residents, businesses and policy makers and led Trump to resume daily briefings on the pandemic.

Still, a definitive picture of Covid-19’s spread in the U.S. remains elusive. Health and Human Services Assistant Secretary Brett Giroir, the country’s testing czar, told Fox News yesterday that while the nation is officially logging about 67,000 new cases a day, the reality is more likely about 200,000.

That’s twice the level of 100,000 that Anthony Fauci, the country’s top infectious disease expert, warned senators the country could reach early this month. Read more form Emma Court and Olivia Raimonde.

DOJ Won’t Challenge Moves to Speed Up Making Covid-19 Therapies: The Justice Department said it won’t challenge proposed efforts to share information that could expedite production of antibody treatments to treat Covid-19, according to agency statement. Efforts to share information have been proposed by Eli Lilly, AbCellera Biologics, Amgen, AstraZeneca, Genentech, and GlaxoSmithKline, Elizabeth Elkin reports.

More Headlines:

What Else to Know

Humana Expands Screening at Home: Health insurer Humana is sending at-home screening tests for cancer and other conditions to more than a million of its members who may have postponed medical care because of Covid-19. The kits will allow members to collect samples of blood, urine or stool without having to go to a clinic. The program is focused on managing diabetes and screening for colorectal cancer. The materials will be sent to members who Humana’s data indicates are due for screenings. “The goal is to reduce all barriers possible for access to essential preventive care,” said William Shrank, Humana’s chief medical officer. Read more from John Tozzi.

More Headlines:

To contact the reporters on this story: Alex Ruoff in Washington at aruoff@bgov.com; Jaclyn Diaz in Washington at jdiaz@bloomberglaw.com; Zachary Sherwood in Washington at zsherwood@bgov.com

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

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