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Capitol Correspondence - 08.08.23

Congress Moves Forward on Health Policy Bills

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In a significant push towards advancing health policy legislation, Congress has a mix of bipartisan and must-pass measures emerging from House and Senate committees, but some disparities in size and scope threaten to hinder their progress. Policymakers are faced with the challenge of reconciling these differences before critical federal programs expire on September 30.

Among the programs set to expire are: support for graduate medical education, pandemic and emergency preparedness measures, and funding for community health centers. With only limited legislative days left in the year, time is limited to reach bipartisan agreements and reauthorize these vital initiatives.

Various house panels, namely the Energy and Commerce, Ways and Means, and Education and the Workforce Committees, have been active in moving health care bills forward.

The Energy and Commerce Committee’s legislation stands out as the most wide-ranging, encompassing various reauthorizations and transparency measures. It seeks to promote price transparency for the industry and the 340B discount drug program, as well as delaying cuts to safety net hospitals and adopting site-neutral payment policies for Medicare patients.

The Education and the Workforce Committee has also shown bipartisan cooperation, approving four bills. However, the Ways and Means Committee has faced obstacles as they advanced a partisan legislative package, drawing objections from Democrats due to the removal of a provision related to private equity players in the health care system.

To consolidate these efforts into a singular health package, House leadership has called for the committees to work together during the August recess. The challenge lies in finding common ground on preferred policies, which could spark a turf war among committee leaders.

The Senate Finance and Health, Education, Labor and Pensions (HELP) Committees have taken a different approach, focusing on policies targeting pharmacy benefit managers (PBMs) and their practices. Legislation restricting certain PBM fees has advanced, and further bills aimed at lowering insulin costs for patients are expected to follow.

Senator Bernie Sanders (I-VT), Chair of the Senate HELP Committee, has been working on a plan to authorize funding for community health centers and improve access to primary care. However, challenges have arisen in finding bipartisan support and determining appropriate authorization levels.

One of the critical areas being addressed is pandemic preparedness. The Senate HELP Committee’s version of the plan to reauthorize the Pandemic and All-Hazards Preparedness Act is comprehensive, including provisions on long Covid, FDA programs for emerging pathogens, and strategies to address drug shortages. The House counterpart, however, faces differences over drug shortage policies, creating tension between the parties.

Speaking of drug shortages, House Republicans have sought more extensive legislation on this matter and initiated a request for information to tackle the issue effectively. The House Energy and Commerce Chair has proposed a discussion draft that aims to study the problem and speed up pre-approval inspections for new sterile manufacturing facilities.