The Headlines
- Congress continues to work towards funding the government for FY 2020.
- Another House committee approved legislation aimed to reduce drug costs.
- The House Ways and Means Committee approved other health and tax bills.
- Bipartisan legislation is introduced to assist rural accountable care organization (ACO) providers.
- Legislation is introduced in the Senate to address mass violence.
- A framework to replace the Affordable Care Act is proposed in the House.
The Details
1. Federal funding update
Congress has until November 21 to agree on all 12 FY 2020 appropriations bills before the current continuing resolution expires. As of October 1, the House passed 10 of 12 annual spending measures, and the Senate Appropriations Committee advanced 10 bills. Among other things, the pending impeachment inquiry and funding for the president’s border wall continue to be sticking points for negotiations.
2. Drug pricing hearings
On October 22, the Ways and Means Committee held a hearing to consider several drug pricing bills and approved H.R. 3 to allow the federal government to negotiate the cost of at least 35 drugs per year with the maximum price no more than 1.2 times that paid in other wealthy countries. Last week, both the Energy and Commerce Committee and Education and Labor Committee approved the bill. The House may consider the bill next month.
3. Markup of health and tax legislation
On October 23, the Ways and Means Committee approved legislation along party lines to establish the first federal tax on e-cigarettes. The bill (H.R. 4742) would tax nicotine-based vapes at the same rate as traditional combustible cigarettes — equal to about $1 per pack. Supporters believe it would help curb the use of e-cigarettes. It is unlikely the Senate Finance Committee will consider similar legislation before the end of the year.
The estimated $10 billion in revenue the tax would raise over a decade would cover the cost of other bills considered by the Ways and Means Committee, including expanded access to medical inhalers for chronic lung diseases (H.R. 4716) and allowing medical savings accounts to be used to purchase over-the-counter drugs and menstrual care products (H.R. 1922).
4. Bipartisan legislation in support of rural ACO providers
Senators Catherine Cortez Masto (D-NV) and Pat Roberts (R-KS) introduced a bill to fix the so-called "rural glitch" in the reimbursement formula for ACOs and potentially increase reimbursement rates for ACO providers under the Medicare Shared Savings Program. The bill is supported by 15 health care organizations, including the American Hospital Association and the American Medical Association.
5. Mass violence legislation introduced in the Senate
On October 23, Senator John Cornyn (R-TX) introduced legislation that aims to make schools less vulnerable to violence through promoting best practices and internet safety policies that would help schools better identify and assess students whose behavior indicates a threat of violence. It would also create a nationwide task force to investigate and prosecute those who are illegally selling firearms, and those attempting to buy firearms who provide false statements as part of a background check. It is unclear whether the bill will be heard in committee or considered by the full Senate. The House passed related legislation earlier this year.
6. Repeal and replace framework
On October 22, the House Republican Study Committee introduced a plan to repeal the Affordable Care Act’s expansion of Medicaid and several other regulations that govern the individual health insurance market. Instead, the bill would provide federal block grants to states to establish their own health insurance markets, including coverage pools to help low-income patients. States would be empowered to determine which health benefits to cover and how to price health care coverage based on one’s age.