HealthCare Roundtable e-News – June 29, 2021


Save the Date

2021 Congressional Forum
Monday, July 26, 2021

The Roundtable will host a virtual Congressional Forum on Monday, July 26th. The two-hour forum will convene at 11:00 AM (EDT) and will include a keynote address, a panel presentation, and a discussion of Roundtable priorities.

Attendees will be encouraged to schedule Zoom appointments with staff for members of their Congressional delegation. Contact information for key health care staff members will be provided to each registered participant.

A preliminary agenda and a registration link will be provided next week’s E-News. For now, save the date for this important opportunity to learn about and to advance the Roundtable’s federal priorities!

A Quick Survey… Tell Us What You Think!

If you haven’t already responded to the quick survey we circulated last week, here’s one more chance. Please help us finalize our plans for the Roundtable’s 2021 Annual Conference by taking a few moments to respond this this survey.

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With your help, we’ll be announcing our November Conference plans within the next few weeks!


Senate Finance Committee Chair Outlines New Drug Pricing Proposal

Last week, Senate Finance Committee Chairman Ron Wyden (D-Ore.) announced his proposal to lower drug prices by giving commercial insurers the same drug prices that Medicare negotiates and blocking a Trump-era policy banning rebates, which has been delayed by the Biden administration. The policy comes as Democrats are facing mounting pressure to use funds that result from drug price reform to pay for other priorities in the Biden administration’s infrastructure package.

In the proposal, Wyden suggests building on the drug pricing reform legislation that he had worked on with former committee chair Sen. Chuck Grassley (R-Iowa), which had Democrat support but came up short with members of the GOP. Wyden’s proposal also includes provisions similar to the House’s drug pricing bill enabling Medicare to negotiate with pharmaceutical companies and apply lower prices across other public and private insurance programs.

On the table is also the continued blocking of a Trump-era ban on rebates in Medicare. According to CMS, blocking the Trump-era policy that banned rebates would also add to the savings. The agency projects that the rule, which requires plans to share Medicare Part D rebates with beneficiaries at the pharmacy counter, would increase government spending by $196 billion over a decade. (InsideHealthPolicy)

Some Democrats on the committee are skeptical of the proposal and expressed concerns that the plan doesn’t explain the mechanism for drug pricing negotiations, which relates to another ongoing debate about how the U.S. might use the prices other countries pay for drugs as a baseline. An aide to Wyden suggested the proposal is meant to “jump start a conversation,” and get feedback from other legislators on what they like, what they don’t like.

Durbin, Grassley Co-Sponsoring Bill Requiring Disclosure of Drug Prices in Ads

Sens. Dick Durbin (D-Ill.) and Chuck Grassley (R-Iowa) are currently working on legislation to require that drug companies disclose the price of drugs in consumer advertisements. The announcement comes after a report from the Government Accountability Office was released outlining the impact of ads on Medicare spending and the amount drug companies are spending on advertised products.

Durbin and Grassley asked the GOA to study the influence of drug ads on Medicare spending between 2016 and 2018. According to the report, brand drug makers spend about $6 billion annually on ads, and nearly 60% of Medicare drug spending in Parts B and D is on advertised products. The report also identified Humira as the top-selling drug globally, at the time, and was also the highest-advertised drug overall with $1.4 billion in consumer ad spending over the three years. (InsideHealthPolicy)

A federal judge had previously axed Trump’s 2019 rule requiring price disclosure for drugs in advertisements. U.S. District Judge Amit Mehta said HHS didn’t have the authority to require drug makers to publish list prices, referencing the fact that Congress didn’t give HHS the power to issue the rule and stating “no matter how vexing the problem of spiraling drug costs may be, HHS cannot do more than what Congress has authorized.”

Draft Budget Committee 2022 Fiscal Documents Include Medicare Expansion, Drug Price Negotiation and ACA Premium Tax Credits

Drafts of the proposed fiscal 2022 budget resolution began circulating around Capitol Hill last week, including several anticipated health policies relating to the ACA and Medicare expansion. Among those referenced in the budget are the extension of Medicare coverage to hearing, vision and dental and a proposal to make ACA premium tax credits permanent.

The Budget committee’s draft resolution outlines overall costs for the proposed policies, which includes permanently increasing ACA premium tax credits at a cost of $163 billion over 10 years, adding Medicare dental, hearing and vision coverage at a cost of $299 billion over 10 years, and the lowering the Medicare eligibility age to 60 at a cost of $200 billion, all of which the documents say would be paid for over time by drug price negotiation and other policies to lower drug prices.

Upon the documents’ circulation, Senate Majority Leader Chuck Schumer (D-NY) tweeted his support for adding Medicare hearing, vision and dental benefits. Schumer said on Sunday during a news conference that the campaign to expand Medicare will be an “uphill legislative effort,” adding that lawmakers will have to “galvanize support from the public.”

CMS Grants State-Based Marketplaces $20M to Boost Exchanges, Programs and Technology

Last week, CMS awarded $20 million in grants to states to help boost state-based health marketplaces. States will be able to use the grants to fund eligibility and enrollment systems and modernize programs and technology needed to comply with federal requirements.

Newly instated CMS Administrator Chiquita Brooks-LaSure called state-based marketplaces and exchanges “the gateway to quality, affordable health care for millions of consumers,” and hoped that the grants would make it easier for consumers to sign up for coverage. According to the agency, states with their own eligibility platforms have enrolled more than 3.8 million consumers so far in the 2021 pan year. (InsideHealthPolicy)

The grants will be awarded to already-approved, state-based marketplaces that meet the funding application requirements, including those that use the HealthCare.gov for eligibility and enrollment. All eligible marketplaces can submit their applications by July 20, 2021, with CMS looking to issue grant awards by early September of this year.

Congress had included the funding in the American Rescue Plan to help implement the increased premium tax credits in the law. While the enhanced subsidies are scheduled to expire after the 2022 coverage year, the Biden administration has said it would like them to be made permanent. (InsideHealthPolicy)