HealthCare Roundtable e-News – August 18, 2021


Senate Passes Budget Resolution, Tees Up Health Care Debates for $3.5T Reconciliation Bill

Last week, the Senate passed the proposed budget resolution by a 50-49 party-line vote, taking the first step to passing the massive $3.5 trillion reconciliation bill that is expected later this year. The resolution includes provisions for extending the higher Affordable Care Act tax credits from the American Rescue Plan, adding Medicare dental, vision and hearing benefits, a fix to the Medicaid coverage gap, and the lowering of the Medicare age, among other policies.

Leaders of groups, including Families USA and Protect Our Care, have praised lawmakers’ efforts to define the blueprint for the reconciliation bill, with Frederick Isasi, executive director of Families USA, stating that Congress needs “to keep going big and bold for families to get the best health and health care they deserve, no matter their income or where they live. That means increasing affordability and closing coverage gaps so that no one has to choose between paying the rent and going to the doctor.” (InsideHealthPolicy)

However, the size of the reconciliation package hasn’t received support from the all Senate Democrats: Sens. Joe Manchin (W.Va.) and Kyrsten Semina (Ariz.) backed the resolution to proceed with budget talks but have criticized the large price tag on the overall package. Other moderate Democrats in the House and Senate have been vocal in their opposition to letting Medicare negotiate drug prices (see more on this below).

“Given the current state of the economic recovery, it is simply irresponsible to continue spending at levels more suited to respond to a Great Depression or Great Recession – not an economy that is on the verge of overheating,” Manchin said in a statement.

House Speaker Nancy Pelosi (D-Calif.), in balancing competing interests in Congress, has said that she will not address either the infrastructure bill or reconciliation package until the Senate has passed both of them.

Biden Urges Democrat Lawmakers to Include Drug Price Negotiation in Reconciliation Package

President Joe Biden is urging Democrats to let CMS negotiate drug prices and include drug copay caps, among other tactics to lower drug prices, in the upcoming reconciliation bill. Biden reaffirmed that U.S. prescription drug costs were higher than any other nation in the world by two to three times, and wants lawmakers to follow his administration’s lead and enact laws to help lower drug prices. The news came shortly after the Senate passed the approved budget resolution for the $3.5 trillion reconciliation package.

A significant portion of Democrats support letting Medicare negotiate drug prices, but full party support would be needed to pass legislation. Senate Finance Chair Ron Wyden (D-Ore.) has pressed for drug price negotiation in his proposed drug pricing bill, but risks losing the vote on the reconciliation package if moderate Democrats can’t be swayed. The drug industry has lobbied against the bill, arguing that allowing Medicare to negotiate prices would harm innovation by cutting into pharma’s funding for research and development; however, research from West Health Policy Center and Bentley University suggests drug makers could experience little to no negative impact from drug price negotiation and other related legislation. (InsideHealthPolicy)

The president views the drug-pricing reforms as an essential part of his Build Back Better agenda. According to Biden, out-of-pocket costs could fall by at least $9,000 a year and Medicare beneficiaries could save on average about $200 if the legislative reforms were enacted. (InsideHealthPolicy)

Lawmakers Press CMS for 2021 Medicare Trustees Report Ahead of Reconciliation Bill Discussions

CMS administrator Chiquita Brooks-LaSure announced last week that she anticipates the release of the overdue Medicare trustees report later this month. Findings from the report, which was originally slated for an April release but had since been delayed, has been frequently requested by Republican lawmakers in recent months and could likely play into the party’s pushback against Democrats’ plan to expand Medicare benefits through the reconciliation bill, according to lobbyists.

Health experts have questioned Brooks-LaSure how much CMS has been paying to Medicare’s finances after the 2020 Medicare trustees’ report didn’t consider effects from the pandemic, and now with the delay of the 2021 report. Brooks-LaSure commented that ensuring the solvency of Medicare is a high priority of the agency, saying that the administration is “always focused on making sure that our policies are balanced with all of these priorities we talked about, also keeping an eye on the taxpayer dollar.” (InsideHealthPolicy)

In a letter to Treasury Secretary Janet Yellen sent earlier this month, Senate Finance Committee ranking Republican Mike Crapo (Idaho) pushed for more transparency around the delivery of the 2021 trustees’ report, claiming that information on the trust fund is needed prior to lawmakers moving on any reconciliation package.

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