Bipartisan Talks on ACA Fix Resume
Following the collapse of Republican’s latest attempt to repeal and replace the Affordable Care Act (ACA), the Senate Health, Education, Labor, and Pensions (HELP) Committee leadership resumed bipartisan negotiations focused on stabilizing the individual health insurance market and lowering health insurance premiums. Committee Chairman Lamar Alexander (R-Tenn.) and Ranking Member Patty Murray (D-Wash.) have both stated that they are close to reaching an agreement that will focus on market changes over the next two years. The deal would likely legislate funding for cost- sharing reduction (CSR) payments and allow for the sale of low-cost health care plans. Insurers have already made decisions about participation and rates for the 2018 plan year, but successful legislation could still have an impact in 2019.
The House Problem Solvers Caucus — a group of 43 bipartisan lawmakers led by Reps. Josh Gottheimer (D-N.J.) and Tom Reed (R-N.Y.) — have written to congressional leadership supporting work on a bipartisan health reform plan. They request mandatory funding for CSR payments, the creation of a stability fund for states to help reduce premiums and limit losses in providing insurance coverage, repeal of the medical device tax, and steps to reduce the impact of the employer mandate on small employers. While the talks are strongly supported by Democratic leadership, it is unclear whether a deal would have enough Republican support to pass the full Senate or the House of Representatives.
GOP Scraps Plans to Repeal and Replace This Year
Senate Republicans decided not to hold a vote on the Graham-Cassidy-Heller-Johnson proposal to repeal and replace the Affordable Care Act (ACA) after it became apparent that they lacked the 50 votes needed to successfully pass the legislation. The plan would have eliminated insurance mandates and converted Obamacare funding into block grants for states to set up and regulate their own health insurance markets.
Sen. Susan Collins (R-Maine) provided the decisive third ‘no’ vote from the Republican caucus, following earlier announcements from Sens. Rand Paul (R-Ky.) and John McCain (R-Ariz.). Even under the fast-track budget process known as reconciliation, Republicans could not afford to lose more than two votes and still pass the bill with Vice President Pence serving as the 51st vote.
HHS to Cut ACA Advertising Budget
U.S. Department of Health and Human Services (HHS) announced decision to reduce the budget for promotion of the Affordable Care Act (ACA) last week. HHS will lower spending on Obamacare advertising and outreach from $100 million last year to $10 million going forward. The Administration also plans to cut payments for health insurance navigators, who assist people in choosing a health insurance option, by 39 percent. In order to increase accountability, funding for navigators will be proportional to how successful a navigator was in meeting their enrollment target the previous year. HHS officials are planning on setting a goal for exchange enrollment for the coming year, but the target has not yet been announced
FDA Announces New Stem Cell Policy
The Food and Drug Administration (FDA) will advance a new policy framework for stem cell therapies in the coming months. The FDA hopes to establish which regenerative medicine products are sufficiently complex to be considered within the agency’s regulatory authority, and to define a process for evaluating stem cell therapies for safety and effectiveness. The decision follows the FDA’s announcement that the company US Stem Cell Clinic marketed stem cell products without FDA approval. The Agency found that the firm’s deviations from current good manufacturing practice requirements may have affected the sterility of their products and put patients at risk. The FDA requests a response from the company within 15 days. The House Energy and Commerce Committee also announced that it plans to conduct a review of companies selling unproven stem cell treatments.
Single Payer Medicare-for-All Legislation Introduced
Sen. Bernie Sanders (I-Vt.) has formally introduced his long awaited “Medicare-for-All” legislation that would transition the nation into a single-payer health care system. The plan currently has the support of 15 Democratic senators, many of whom are expected to run in the next presidential election. The list includes Sens. Cory Booker (D-N.J.), Richard Blumenthal (D-Conn.), Kirsten Gillibrand (D-N.Y.), Kamala Harris (D-Calif.), Mazie Hirono (D-Hawaii), Jeff Merkley (D-Ore.), Brian Schatz (D-Hawaii), Tom Udall (D-N.M.), Elizabeth Warren (D-Mass.), Al Franken (D-Minn.), and Tammy Baldwin (D-Wis.). The bill would end the private insurance industry and be implemented over a period of four-years. Children younger than age 18 would be immediately and automatically eligible for coverage. The plan would be paid for through a tax increase on both individuals and employers. Senator John Barrasso (R-Wyo.) wrote the Congressional Budget Office (CBO) requesting a full cost estimate of the bill saying, “it is imperative that the public understand the cost.”
Opioid Recommendations Pushed to November
The White House Opioid Commission, chaired by New Jersey Governor Chris Christie (R), has requested an additional four weeks to complete its report. In the interest of “sound recommendations” the extra time will allow the Commission to complete the research and policy developments that are still in progress. The report was originally due on October 1. The final version is now expected to be released on November 1.
The commission has also announced a new partnership between pharmaceutical manufacturers and the federal government. The public private collaboration with the National Institutes of Health (NIH) will work to speed the development of non-opioid, non-addictive pain medication and new medication assisted treatment (MAT) options. In related news, the Food and Drug Administration (FDA) announced that it will require information be added to buprenorphine and methadone drug labels indicating that the medications should not be withheld from patients taking benzodiazepines or other drugs that depress the central nervous system.
Secretary Tom Price Resigns
Dr. Tom Price, MD has resigned from his Cabinet position as Secretary of the Department of Health and Human Services (HHS). The announcement reports that Price used military flights and private jets for travel totaling more than $1 million since May. In his resignation letter, Price expresses regret for creating a distraction from the important objectives of HHS and pledges to continue to support the Administration’s priorities in the future. Prior to being confirmed as Secretary, Price had served in the House of Representatives and authored legislation to repeal the Affordable Care Act (ACA).
Don J. Wright will serve as Acting HHS Secretary. Wright has worked as the Deputy Assistant Secretary for Health and Director of the Office of Disease Prevention and Health Promotion since 2012. He joined HHS in 2007 during the Bush Administration and previously served as the Deputy Assistant for Health Care Quality. During his time at HHS, he has worked on efforts to reduce adverse drug events and to monitor the nation’s leading health indicators. He previously worked on health and safety issues at the Department of Labor as Director of the Office of Occupational Medicine. He is board certified in both family medicine and preventive medicine and holds a master’s degree in public health.
The short-list to replace Price includes several current members of the Administration, including Acting HHS Secretary Don Wright, Administrator for the Centers for Medicare and Medicaid Services (CMS) Seema Verma, Secretary of Veterans Affairs David Shulkin, Commissioner of Food and Drugs Scott Gottlieb, and Housing and Urban Development Secretary Ben Carson.