THIS WEEK IN REVIEW: Monday, Feb. 25th – Friday, Mar. 1st

March 2, 2019 by B. Cameron Webb, MD, JD

THIS WEEK IN REVIEW: Monday, February 25th – Friday, March 1st

Viewpoints here, marching into another month (get it…March?) <cue eye roll>. We’ll just go ahead in get to the health policy news, yes?…

The Trump Administration’s changes to the Title X family planning program late last week evoked swift responses from around the country. Washington State Attorney General Bob Ferguson announced his plan Monday to sue the Administration, with California and New York’s Attorneys Generals following suit. The Department of Health and Human Services (HHS) posted their final rule that would make any clinic that refers or provides abortions ineligible to receive Title X funding. The new changes would mean clinics such as Planned Parenthood must perform abortions in a separate facility if they wish to receive federal funds for other services they provide such as contraception, cancer screenings, and STD prevention. The rule also makes other clinics such as crisis pregnancy centers and religiously affiliated groups eligible to receive federal funding under Title X. These organizations were previously ineligible due to Title X requirements mandating health clinics to inform patients of every reproductive option available; many of these groups choose not to disclose the option of abortion. While the Trump Administration has found support for the new rule with their conservative base, critics contend that the new rule violates Roe v. Wade, and some health organizations regard the new rule as outright unethical. States and stakeholders across the country are readying their armaments, so expect to hear more on this in the weeks to come!

On to one of our most consistent topics of the last year: reducing the price of prescription drugs. Earlier this week, the Senate Finance Committee called leaders from seven prominent pharmaceutical companies to Capitol Hill to defend their drug pricing policies. This hearing is in line with Committee Chairman Chuck Grassley’s (R-IA) recent bipartisan efforts to facilitate generic drug development and combat the sky-rocketing cost of insulin. Senator Ron Wyden (D-OR) argued that curbing list prices is “the easiest way for American consumers to pay less at the pharmacy counter as individuals with high deductibles and co-payments are the most vulnerable to escalating costs. Pharma disagreed—placing the blame instead on the country’s complex supply chain that favors insurance companies and middlemen rather than consumers. In spite of the deadlock on list prices, many in attendance expressed their support of President Trump’s proposal to end secret rebates. If the proposal included private plans (rather than just Medicare), pharmaceutical industry leaders indicated a willingness to consider lowering list prices. Even still, despite the Committee’s bipartisan efforts to curb escalating drug costs, Republicans largely remain opposed to Democrat efforts to allow Medicare to negotiate drug costs as a strategy.

In other Medicare news, Democratic members of the House—led by Rep. Pramila Jayapal (D-WA)—finally introduced the Medicare for All Act of 2019 this week. Under this legislation, the government would transform Medicare into a universal single-payer system that covers most medical care under hospitals, doctors, preventive care, prescription medications, and dental and vision services for all U.S. citizens. Senior citizens would be incorporated into this new bill, expanding their coverage and ensuring their current medical care is uninterrupted. Those receiving coverage from the Veterans Health Administration and the Indian Health Service would be able to enroll in the new Medicare-for-all plan or continue with their current insurance.

You might be wondering how this bill differs from those proposed before… Well, the new bill covers abortions, long-term care, and would allow for direct negotiation between the government and pharmaceutical manufacturers on drug prices. While many opponents to Medicare-for-all fear that the bill would eliminate private health insurance and raise taxes, private plans would still be available to pay for any services not included in the government plan. As there is no cost estimate for the bill as of yet, and some provisions remain open to interpretation, we promise to keep you in the loop as things develop!

On the topic of insurance, a bill was introduced by a group of moderate House Democrats regarding the Affordable Care Act (ACA). Their goal is to collaborate with Republicans to stabilize the ACA’s markets by forming a national reinsurance program to lower premiums, increase premium assistance, and reinstate insurer subsidies. Additionally, regarding the Medicaid program, the States Achieve Medicaid Expansion (SAME) Act of 2019 was recently introduced as well. This would allow states who expanded Medicaid post-2014 (or eventually do) to receive federal matching funds much like the states who received the same funds pre-2014. This will would also provide incentives to the remaining 14 states who have not yet expanded their Medicaid programs.

It’s been a busy week on the hill as two gun control bills have flown through the House of Representatives this week; these are the first major gun control bills to pass since the release of Nintendo 64 (we knew that would orient you). The first to pass was a bill requiring universal background checks. The Bipartisan Background Checks Act, backed by Reps. Mike Thompson (D-CA) and Pete King (R-NY), would include sales at gun shows and online rather than just federally licensed firearms dealers. The second bill aims to close what is often referred to as the “Charleston loophole.” Currently, background checks for gun sales are completed by the FBI and can take up to 3 days; however if a delay is longer, the sale can continue. The Enhanced Background Checks Act of 2019 changes that threshold to ten days.

Opponents of the bill expressed concern regarding the wait time and suggested an amendment that would allow exemptions for domestic abuse survivors. Regardless of House support, both bills are unlikely to pass in the Senate. While health officials argue that gun violence is a public health problem, it’s clear that not everyone can agree on how to solve it.

Whew…what a whirlwind from the Hill this week! While we hope you are able to catch up on sleep this weekend, don’t count on it making up for any all-nighters you pulled during the week. “Recovery sleep” on the weekend may help temporarily, but any benefits are gone as soon as you go back to staying up until 2 AM reading the deluge of new legislation from the Hill…or binging Netflix.

March on, friends! March on.

 


This Week’s Viewpoints Writing Team:
Avery Bullock, Cristalle Madray, Jo McClain, Tes Sabin


 

Filed Under: Viewpoints - Week in Review, Viewpoints: Health Policy Blog