THIS WEEK IN REVIEW: Monday, Jan. 13th – Friday, Jan. 17th

January 17, 2020 by B. Cameron Webb, MD, JD

THIS WEEK IN REVIEW: Monday, January 13th – Friday, January 17th

Happy New Year, everyone—hard to believe Viewpoints is coming to you with our first blog of a new decade! From where we sit, we have a feeling this won’t be the *boring* 20s when it comes to health policy…

With the new year comes renewed goals, and the House of Representatives has a few of their own on the horizon. In a recent interview, House Majority Leader Steny Hoyer (D-MD) outlined a few of the goals that lay before the House in the coming months. With regard to health care, one of their main objectives is to tackle the continuing issue of surprise billing. As of now, there are two competing plans– a bill presented earlier that “settle(s) disputes by pegging payments to providers to a federal benchmark payment based on median in-network rates”; and a one-page plan which calls for more outside mediation between parties after negotiations between providers and insurers. 

Some House leaders have indicated that a compromise bill could be created from both proposals, but it is likely that whichever proposal gains the most support would need to be agreed upon before May 22nd, when the most recent spending bill expires. Alongside surprise billing, Leader Hoyer indicated that other major health care goals for the new year include prescription drug pricing and further protections for preexisting conditions under the Affordable Care Act, alongside potentially addressing maternal mortality and youth vaping. As we continue to search for direction in our healthcare systems, perhaps 2020 will be a year of innovation.

Along with their attempt to tackle surprise bills, the House held a hearing this past Wednesday on cannabis research and the gaps between state and federal policy. Committee chairwoman Anna Eshoo (D-CA) invited officials from the Drug Enforcement Agency (DEA) and the Food & Drug Administration (FDA) to address potential efforts by the government to block research, as well as proposed legislation pertaining to cannabis. Rep. Eshoo said that she hoped the hearing would “provide answers,” especially as there is a lack of consensus regarding the de-scheduling of marijuana as a Schedule 1 drug. Federal restrictions have limited research on cannabis to essentially one facility at the University of Mississippi, but the Trump administration had signaled potentially increasing the number of sites that could legally grow the plant. We will see what steps the administration does (or does not) take in the coming months.

While we’re not sure whether President Trump will puff-or-pass on changes to cannabis laws, we are seeing him take a swing at changes with other drugs. On Monday, the administration tried to convince a federal appeals court to overturn their ruling that would require pharmaceutical companies to list prices for drugs covered by Medicare and Medicaid on TV ads. While the Trump administration argues that this can increase transparency over prices, the judges pointed out that the list price is often not what people end up paying and can lead to confusion. Drug pricing has been a recent priority for the President and we can hope to see more action in the coming months as various bills about importing, capping price increases, and Medicare negotiations work their way through the system. 

But as we hit the gas on some topics, we may be hitting the breaks for a while on the pending lawsuits regarding the Affordable Care Act (ACA). While supporters of the ACA are eager for the Supreme Court to make a decision, the President’s lawyers are arguing that while the case is undoubtedly important, it doesn’t present a real emergency that would warrant an emergency review. As of right now, it seems like we might not be seeing much on this front until after the 2020 election.

On Thursday, sixteen municipalities including Washington D.C., New York City, and fourteen states filed a lawsuit against a new federal rule that would affect food stamp eligibility for potentially 700,000 Americans. The new rule would impede states from making exemptions to employment requirements based on economic disparities. U.S. Secretary of Agriculture Sonny Perdue has voiced the rule’s underlying philosophy: since the country currently has a strong economy, “we need everyone who can work, to work.” In their rebuttal, states argue that only they and local governments can best understand the underlying economic factors of their communities and appropriately allocate resources.

Tennessee is working towards a block grant system to fund their Medicaid program. The state would receive a $7.9 billion lump sum from the federal government and be responsible for costs above the grant but could keep half of all unspent funds. Some are concerned this incentivizes the state to slash Medicaid spending. In a letter from Tuesday, Sens. Ron Wyden (D-Ore.) and Frank Pallone Jr. (D-N.J.) urged the Department of Health and Human Services’ Office of Inspector General to “exercise vigorous oversight” if the block grant is approved by the Trump Administration.

Nebraska is designing its own Medicaid expansion that will cover able-bodied individuals under 138% of the Federal Poverty Line, while also instating work requirements. Those that meet work requirements will have “prime” healthcare, traditional Nebraskan Medicaid. Otherwise, individuals will have “basic” healthcare, covering basic health services and prescription drugs, but dropping coverage for dental, vision and over-the-counter drugs. This plan goes into effect this year and has piqued the interest of Red States as it circumvents legal rulings against work requirements. The federal public comment period closes today, but it is fraught with frustration. When Nebraskans voted for Medicaid expansion in 2018, adding work requirements was not part of the language.

On Monday, state legislators in New Jersey came one vote short of passing a controversial bill that would have eliminated religious exemptions for vaccinations. In spite of the hundreds of protesters that gathered outside the statehouse in Trenton, Senate President Stephen Sweeny, along with the bill’s sponsors, vowed to reintroduce the bill next week, citing concern over recent measles outbreaks in New Jersey and New York. Governor Phil Murphy (D) also expressed his support of the bill, stating “If that were to come our way — I don’t talk about prospective bills in specifics — but I think we’ve given a pretty strong indication that that’s something that we would support.” 

In other states news, Oklahoma announced a new lawsuit against three major drug distributors on Monday for their alleged role in the state’s opioid crisis. Following the state’s court victory against opioid manufacturer Johnson and Johnson last year, Attorney General Mike Hunter (R) is now seeking compensatory damages from companies McKesson Corp, AmerisourceBergen Corp, Cardinal Health. It remains uncertain as to whether the case will end in an out-of-court settlement or go to trial.

We hope you enjoy your weekend and eat some salad (romaine is safe again!)- we’ll see you next week!

 


This Week’s Viewpoints Writing Team:
Avery Bullock, Carina Clawson, Jo McClain, Steven Moore and Nana Owusu