Overnight Health Care — Presented by That’s Medicaid — Progressives hope to avoid drug-pricing showdown with Pelosi | ‘Medicare for All’ backers get high-profile hearing | Dems take victory lap after eliminating drug protections in trade deal

Welcome to Tuesday’s Overnight Health Care. 

Progressives are pushing for more changes to House Speaker Nancy Pelosi’s drug pricing bill– which the White House said it will veto anyway. The new trade deal has a measure that is bad news for drug companies, House Democrats held a hearing on Medicare for All (and eight other health care proposals), and the Supreme Court heard arguments in an ObamaCare case. 

Let’s start with an update on drug pricing…

 

Progressives hopeful for deal with Pelosi to avert showdown on drug prices

Progressive leaders in the House said Tuesday they are hoping to avoid a standoff with Democratic leaders following a meeting with Speaker Nancy Pelosi (D-Calif.) on her sweeping bill to lower drug prices.

Reps. Mark Pocan (D-Wis.) and Pramila Jayapal (D-Wash.), the co-chairs of the Congressional Progressive Caucus (CPC), have floated the idea of rebelling against Pelosi and blocking a vote on her legislation if changes are not made to the measure.

But after a meeting with the Speaker, which followed months of tension over the bill, the progressive lawmakers struck a positive tone, even though they said the details of any agreement are still being worked out.

Jayapal said leaving the meeting with Pelosi that the fixes on the table are her amendment to extend limits on drug price spikes into the employer-sponsored insurance market, as well as increasing the minimum number of drugs subject to negotiation under the bill.

The House Rules Committee is meeting Tuesday evening to make a final decision on changes that will be allowed.

Why it matters: Earlier, Pocan and Jayapal seemed on the verge of a showdown with Pelosi over the bill, a top priority for House Democrats that will get a floor vote on Thursday.

They have been contemplating a rebellion against leadership, in an effort to vote down the rule for the bill, effectively blocking the measure from going forward.

If a deal can be reached, it would potentially avoid an embarrassing situation for House Democratic leadership, which wants to show it can impeach the president and pass policy at the same time. 

Read more on the talks here.

 

Pelosi drug pricing plan would save $456 billion over ten years: analysis

Pelosi’s drug pricing bill would save the government $456 billion over ten years, according to an analysis released Tuesday.

The bill, which will get a vote on the House floor this week, would require that federal health officials negotiate the prices of at least 35 brand-name drugs per year.

Medicare price negotiation, which is prohibited under current law, has been touted by Democrats as a solution to rising drug costs. 

The Congressional Budget Office (CBO), Congress’ nonpartisan scorekeeper, cautioned in its report that the estimates are “uncertain.” 

But the estimate is a win for House Democrats, who argue they won back the House majority in 2018 in part because they promised to work on lowering drug prices and health care costs.

Read more here.

 

But ultimately, the bill has a bleak future…

 

White House promises veto of House drug pricing bill

The White House on Tuesday said President Trump would veto Pelosi’s drug pricing bill if he was presented with it.

According to a statement from the Office of Management and Budget, the legislation “contains several provisions that would harm seniors and all who need lifesaving medicines.”

The statement had some positive notes about the bill, including applauding a provision to limit the annual price increases of certain drugs in Medicare to the rate of inflation. The OMB statement said the administration “strongly prefers” the bipartisan Senate Finance Committee bill, which “offers a sound approach to delivering relief to seniors from high prescription drug costs.”  

But as we’ve reported earlier, that legislation has its own set of problems.

 

Medicare for All supporters notch win with Energy & Commerce hearing 

“Medicare for All” supporters scored a victory Tuesday with a long-awaited hearing in one of the House’s most powerful committees, putting more focus on the health care proposal that has divided the field of 2020 Democratic presidential candidates.

The Energy and Commerce Committee discussed the single-payer health plan backed by White House hopefuls Sens. Elizabeth Warren (D-Mass.) and Bernie Sanders (I-Vt.) after a sustained campaign led by Rep. Pramila Jayapal (D-Wash.), a co-chairwoman of the Congressional Progressive Caucus, and other members of the party’s liberal wing.

Chairman Frank Pallone Jr. (D-N.J.), whose committee has primary jurisdiction over health care issues, included eight other bills that aim to achieve universal coverage as part of Tuesday’s hearing, stealing some of Medicare for All’s spotlight.

Jayapal nonetheless touted the “historic” hearing as a success, even as polls show support for the proposal is waning.

“Our movement is alive and well,” she told The Hill on Tuesday. “We’re just continuing to bring more and more people on board, and we’ll have more hearings, but these are substantive discussions, which is what really excites me.”

Why it matters: Medicare for All previously received hearings in the Ways and Means, Education and Labor, and Budget committees. Jayapal thinks the hearings will gin up support for Medicare for All, which is slipping in the polls. She said she expects to have two more hearings in the House next year. 

Read more here. 

 

Justices grapple with multibillion-dollar ObamaCare case

A divided Supreme Court on Tuesday grappled with a multibillion-dollar lawsuit over ObamaCare payments that health insurance companies say they were promised by the federal government.

At issue are financial incentives in ObamaCare that Congress used to encourage insurers to participate in the early years of the Affordable Care Act’s (ACA) health care marketplaces. Congress, though, later sharply curtailed those payments through the appropriations process, sparking a legal challenge from health insurers.

The justices appeared torn over whether to force the federal government to reimburse companies the $12 billion they lost in the marketplaces, or if the insurers had fair warning the repayment program could be reduced by Congress exercising its power of the purse.

Justice Brett Kavanaugh, a Trump appointee, put his finger on the dilemma at the heart of the case, laying out the wide-reaching implications for future partnerships between the federal government and the private sector, as well as potential burdens on the legislative process. 

“If we were to rule for you, everyone will be on notice going forward, private parties and Congress itself, that ‘shall pay’ doesn’t obligate actual payments,” he said. “If we rule against you, Congress also will be on notice going forward that it needs to include ‘subject to appropriations’ kind of language in any mandatory statute.”

Read more on the case here.

 

Democrats declare victory for eliminating drug protections in trade deal

House Democrats are taking a victory lap after getting rid of controversial protections for biologic drugs in the new North American trade agreement.

House Democrats and the White House on Tuesday announced a deal on a trade pact to update the North American Free Trade Agreement (NAFTA), securing a major legislative goal for both Democrats and President Trump.

The final version of the deal does not include a provision that would have locked in 10 years of patent protection for biologic drugs, which are made from living organisms rather than synthetic chemicals.

“We now have a new and improved renegotiated NAFTA that prevents Big Pharma from raising the price of prescription drugs across the United States, Mexico and Canada,” Rep. Jan Schakowsky (D-Ill.) said during a press conference.

Democrats argued that removing the protection language preserves Congress’s ability to change current law without being bound by the constraints of the trade deal. In the U.S., biologics are protected from generic competition for 12 years.

“The Trump administration tried to tuck in big corporate gifts to Big Pharma. This trade bill would have tied Congress’s hands and prevented us from enacting legislation … But that provision is now out of the trade deal. It is gone,” Schakowsky added.

Read more here.

 

What we’re reading

White House summons feuding health officials for counseling session (The New York Times)

Whole Foods is selling dangerous anti-vaccine propaganda in its checkout aisles (Insider)

In campaign to stop teen vaping, states turn to tried-and-true remedy: taxes (Kaiser Health News)

 

State by state

Ohio bill aims to increase in-network care for mental health, addiction treatment (cleveland.com)

Feds free up Medicaid funding for psychiatric patients (vtdigger.org)

‘Food Pharmacies’ in clinics: when the diagnosis is chronic hunger (Nashville Public Radio)

 

From The Hill’s opinion page

Deadly measles and Ebola outbreaks show why vaccinations are so essential