Daily on Healthcare: House Republicans feel left out of drug-pricing ideas

Good morning from Daily on Healthcare! Kimberly Leonard here. I’m the senior healthcare policy writer at the Washington Examiner and starting today I’m the new lead author for our newsletter, which goes out every week day around 11 a.m. You can send me tips at [email protected] or get my attention on Twitter at @LeonardKL. I’m joined by healthcare reporter Cassidy Morrison, who can be reached at [email protected] or @CassMorrison94. Did someone forward this email to you? If so, you can get it delivered to your own inbox by signing up here.

House Republicans feel left out of drug-pricing ideas: House Democrats aren’t giving Republicans enough opportunity to weigh in on drug-pricing proposals, Rep. Greg Walden, R-Ore., the ranking member of the Energy and Commerce Committee, and Rep. Mike Burgess, R-Texas, the ranking member of the Health Subcommittee, said in opening remarks at a hearing Wednesday morning to examine ideas to make medicines more affordable.

Three of the seven bills under consideration are bipartisan, with Republicans saying they had only a week — instead of the traditional two — to look at the ideas, and therefore couldn’t co-sponsor the other measures. The bills make incremental changes to the drug system, largely by allowing more generics to enter the market.

Drug pricing is one area where members of both parties hope to make strides, but as the hearing kicked off, Republicans expressed frustration and urged Democrats to bring in officials from the Food and Drug Administration and from the trade association representing generics to testify.

“Regrettably, while Republicans share the goal of the today’s hearing — lowering the cost of prescription drugs — the process has been anything but inclusive,” Walden said.

Democrats are hoping the bills examined Wednesday can be bipartisan before they move on to hearings that will include ideas that are more strictly Democratic, such as letting the government directly negotiate drug prices in Medicare. Rep. Frank Pallone, D-N.J., who chairs the committee, and Rep. Anna Eshoo, D-Calif., who chairs the subcommittee, said members would have adequate time to continue weighing in on the legislation. Tune in.

Azar finishes first of three hearings: Health and Human Services Secretary Alex Azar faced questions Tuesday in the Health subcommittee about short-term health insurance, proposed cuts to global AIDS funding, the administration’s prescription drug plans, and the family separation policy.

Here’s what stood out: Democrats asked Azar about the Trump administration’s decision not to defend Obamacare in court. While he declined to discuss the case, citing pending litigation and “highly privileged, sensitive discussions,” he did tell Pallone that he would provide documentation about contingency plans if the courts should ultimately rule Obamacare unconstitutional. Pallone has sent HHS several letters asking for such documentation, as well as any studies about how many people might lose coverage and what the costs of health insurance will become.

Rep. G.K. Butterfied, D-N.C., ripped Azar over the administration’s proposal to turn Medicaid into a block grant, which would reduce the amount states get for the program in exchange for greater flexibility. The idea, he warned, would “be in for a real serious firestorm not just from the Congress but from the American people.” Azar noted that the administration wouldn’t be able to move forward on such a proposal nationwide without Congress, but said states may decide themselves to apply to receive Medicaid this way. “If we got that kind of proposal we’d have to assess that with our legal council and with [the Office of Management and Budget],” Azar said.

Azar is up to talk about the budget again, this time before the House Appropriations Committee, at 2 p.m. today. Tune in.

It’s PBMs’ turn to face the Finance Committee: The Senate Finance Committee has invited executives from five pharmacy benefit managers to testify publicly about high drug prices on Wednesday, April 3. This will be the third hearing on drug pricing this year by the committee, and will give PBMs an opportunity to defend themselves from drug company executives who largely have blamed them for patient complaints about high drug prices at the pharmacy.

“Middlemen in the healthcare industry owe patients and taxpayers an explanation of their role… We’ve heard from pharmaceutical companies and it’s only fair that the committee has the opportunity to ask questions of other players in the healthcare supply chain,” Sen. Chuck Grassley, chairman of the committee, and Sen. Ron Wyden, the ranking member, said in statement.

Cigna Corporation, CVS Caremark and CVS Health Corporation, Humana Inc., OptumRx, and Prime Therapeutics LLC have been invited to testify.

Ernst, Lee roll out conservative paid parental leave idea: New parents would have the option to use their Social Security benefits early in exchange for delaying retirement under a bill introduced Tuesday by Republican Sens. Joni Ernst of Iowa and Mike Lee of Utah. Their bill, the Child Rearing and Development Leave Empowerment, or CRADLE, Act has emerged as one of several conservative options on paid parental leave as President Trump has given the issue his blessing and as GOP senators have been encouraged by first daughter and senior White House adviser Ivanka Trump.

What’s in the bill: The CRADLE Act would let parents take one, two, or three months off from work to care for a newborn or adoptive child. In exchange, people could delay retirement benefits for two, four, or six months, respectively. Parents would fill out a form anywhere between six and one months before a birth or adoption to notify the Social Security Administration, and then the government’s first month of payments to parents would start two weeks after they applied for their child’s Social Security number.

Payfors still have to be worked out: The senators presented their policy as the start of a discussion rather than a finished product. Ernst said she welcomed ideas from Senate colleagues and from the White House. “We think this is the right way to move forward, but it’s a discussion draft,” she said. One area they hope their colleagues can weigh in on is cost, Lee said. The proposal is expected to cost between $8 billion and $9 billion a year, and the senators want to find a way to offset the amount.

Democrats have dismissed the idea of using Social Security to fund paid family leave: They contend families should not have to choose between their retirement and paid family leave, saying the benefit should apply not only to people who have children but to families who have sick relatives or become sick themselves. They have instead rallied around the Family and Medical Insurance Leave Act from Sen. Kirsten Gillibrand, D-N.Y. That bill would funds up to 12 weeks of paid family leave through a payroll tax.

Ivanka Trump weighs in: “I thank Sens. Ernst and Lee for their commitment to advancing paid family leave policy and look forward to reviewing their proposal,” she said.

Democrats seek to let government pay for abortions: Democrats on Tuesday re-introduced the Equal Access to Abortion Coverage in Health Insurance Act with 106 House co-sponsors, and will be pushing House Speaker Nancy Pelosi, D-Calif., to bring the bill to the floor for a vote. The bill was also introduced for the first time in the Senate by Democratic Sens. Tammy Duckworth of Illinois, Patty Murray of Washington, Mazie Hirono of Hawaii, and Kamala Harris of California. The bill would undo the Hyde Amendment that says federal funds cannot pay for abortions except in the cases of rape, incest, or when a woman’s pregnancy threatens her life. Supporters of repealing Hyde say that it discriminates against poor women who are unable to pay for abortions.

They also introduced a bill to prevent maternal mortality: Rep. Robin Kelly, D-Ill., will be introducing the Mothers and Offspring Mortality and Morbidity Awareness, or MOMMA Act, to Congress in the coming days to combat high rates of maternal mortality. The bill would let women stay on Medicaid for up to a year after they give birth and encourage healthcare facilities to develop better protocols when women need emergency obstetric care.

Hospitals warn Medicare public option would be an $800 billion hit to industry: Hospitals warned Tuesday that their industry would suffer an $800 billion cut if Democrats succeed in massively expanding Medicare. The American Hospital Association and the Federation of American Hospitals published a report concluding that allowing the public to buy in to Medicare plans would not only contribute to massive budget cuts to hospitals nationwide but would also jeopardize patients’ access to care.

The FAH study specifically examines the Medicare-X Choice Act, which would allow people to buy a public plan that would cost less than private insurance. This idea is less sweeping than a fully government-financed system, but the latest report shows hospitals will be prepared to battle both incremental and sweeping expansions of Medicare.

Federal appeals court upholds Ohio law restricting funds to Planned Parenthood: A federal appeals court on Tuesday upheld an Ohio law that restricts government funding of Planned Parenthood and other abortion providers. In an 11-6 ruling, the full 6th U.S. Circuit Court of Appeals reversed a ruling from the lower court and ruled against two Planned Parenthood affiliates that challenged the law. The Cincinnati-based court found the measure does not violate the Constitution and ruled the affiliates “do not have a due process right to perform abortions.” The law, passed by the state legislature and signed by Republican Gov. John Kasich in 2016, prohibits the Ohio Department of Health from providing funds distributed through six government-sponsored programs to organizations that perform non-therapeutic abortions.

Ned Sharpless to take over at FDA following Scott Gottlieb departure: Dr. Ned Sharpless, an official who runs the government’s cancer research arm, was tapped Tuesday by Azar to temporarily run the Food and Drug Administration once the current commissioner, Scott Gottlieb, resigns his position. Sharpless since 2017 has been director of the National Cancer Institute, the branch within the National Institutes of Health that provides medical research grants for cancer research. “We are grateful for Commissioner Gottlieb’s service at FDA and, under Dr. Sharpless’ leadership, we look forward to the agency continuing its important work,” Azar said in a statement. “Dr. Sharpless’ deep scientific background and expertise will make him a strong leader for FDA. There will be no let-up in the agency’s focus, from ongoing efforts on drug approvals and combating the opioid crisis to modernizing food safety and addressing the rapid rise in youth use of e-cigarettes.”

AARP launches campaign that supports letting the government set drug prices: AARP on Tuesday launched a “Stop Rx Greed” TV, radio, and online campaign that will push policies such as letting the federal or state governments negotiate drugs for people on Medicare, giving state attorneys general power to crack down on price increases, capping patients’ out-of-pocket costs, and clamping down on brand-name drug companies that delay generics from getting to market.

“It’s time for pharmaceutical companies to stop deflecting blame and acknowledge that the root cause is the price they set for their products,” executive vice president Nancy LeaMond said in a statement.

Italy has banned unvaccinated children from returning to public school: Parents who send their unvaccinated child to school are subject to a 500 euro fine, or roughly $565, for putting the health of their peers in jeopardy.

The Rundown

FierceHealthcare VA Secretary Robert Wilkie announces precision medicine testing initiative with Sanford Health

Forbes Two Blue Cross plans to create national health insurer

Modern Healthcare Trump’s Medicaid budget plan could leave states and enrollees hanging

The New York Times Trump’s proposed budget undermines His H.I.V. plan, experts say

The Wall Street Journal UnitedHealth to require drug Rebates go to consumers

The Washington Post Baltimore begins construction on center for those with substance-use disorders

Calendar

WEDNESDAY | March 13

House and Senate in session.

March 13-16. American Bar Association 20th Annual Emerging Issues in Healthcare Law Conference. Agenda.

March 13-14. America’s Health Insurance Plans health policy conference. Agenda.

10 a.m. 2123 Rayburn. House Energy and Commerce Committee hearing on “Lowering the Cost of Prescription Drugs: Reducing Barriers to Market Competition.” Tune in.

2 p.m. 2358-C Rayburn. Health and Human Services Secretary Alex Azar to testify about the agency’s budget before the House Appropriations Committee. Details.

5 p.m. U.S. Capitol. Planned Parenthood to hold rally against Trump administration’s rule on Title X, the family planning grants.

THURSDAY | March 14

March 14-15. Meeting of the Presidential Advisory Council on HIV/AIDS. Details.

10 a.m. Arkansas Medicaid work requirement oral arguments in the U.S. District Court for the District of Columbia. Kentucky oral arguments follow at 11 a.m.

10:15 a.m. 215 Dirksen. Health and Human Services Secretary Alex Azar to testify about the agency’s budget before the Senate Finance Committee. Details.

TUESDAY | March 19

2:30 p.m. 1775 Massachusetts Ave. NW. Brookings interview with departing Food and Drug Administration Commissioner Scott Gottlieb. Details.