United States: Capitol Hill Healthcare Update - April 1, 2019

Below is this week's "Capitol Hill Healthcare Update," which is posted on Mondays when Congress is in session.


President Donald Trump last week said Republicans would introduce legislation to replace the Affordable Care Act (ACA) after he called on federal courts to strike down the law, but GOP lawmakers on Capitol Hill don't want to renew a policy fight many believe cost them control of the House in 2018.

Congressional Republicans were dumbfounded when the Trump doubled down on his administration's decision to ask a federal court in New Orleans to overturn the ACA by saying Congress could swiftly pass a new healthcare law. "The Republican Party will become 'The Party of Healthcare!' Trump tweeted last week.

Republicans famously couldn't pass ACA replacement legislation in 2017, when the party controlled both chambers in Congress. In fact, despite campaigning against the ACA for nearly a decade, the GOP has never been able to reach consensus on replacement legislation.

Individual GOP lawmakers – such as Sens. Bill Cassidy, R-La., and John Barrasso, R-Wyo. – are working on component pieces of healthcare legislation. But the party is light years away from agreement on the law's most thorny issues, such as how to keep insurance premiums low but still cover pre-existing conditions.

Senate Majority Leader Mitch McConnell, R-Ky., said he "looks forward to what the president is proposing and what he can work out with [House Speaker Nancy Pelosi, D-Calif.]." McConnell doesn't want the Senate to lead on what likely would be a political fool's errand.

Senate Finance Committee Chairman Chuck Grassley, R-Iowa., echoed McConnell's statement, saying any healthcare legislation advancing in the divided Congress would need to be "very, very bipartisan." When asked by reporters whether he's working on ACA replacement legislation, Grassley flatly said, "no."

Meanwhile, sensing Republicans' political peril, House Democrats scheduled a vote Tuesday on a resolution reaffirming support for popular items in the ACA, such as coverage for pre-existing conditions, while criticizing Trump's decision to try to overturn the health law in the courts.


The House Education and Labor Subcommittee on Health will hold a hearing Tuesday on surprise medical bills, which can occur when patients receive invoices for hospital services or physician treatments outside their insurance networks.

The hearing will mark the first House action on the issue, which has gained increasing attention in recent months. The White House in February hosted a roundtable with patients who received surprise medical bills.

Sens. Bill Cassidy, R-La., Michael Bennet, D-Colo., and Maggie Hassan, D-N.H., are working on bipartisan legislation to address the issue. Senate HELP Committee Chairman Lamar Alexander said he and the panel's top Democrat, Sen. Patty Murray, D-Wash., would introduce legislation later this year putting limits on surprise billing.

Scheduled subcommittee witnesses include Christen Linke Young, a health fellow at the Brookings Institution; Ilyse Schuman, a senior vice president of health policy at American Benefits Council; Frederick Isasi, executive director of Families USA; and Jack Hoadley, a public policy professor at Georgetown University.


NIH Director Dr. Francis Collins will highlight a House Appropriations subcommittee hearing Tuesday on his agency's fiscal 2020 budget request.

President Donald Trump last month proposed reducing NIH's budget by 12 percent, or about $5 billion.

Funding for the government's basic medical research agency has been a favorite for lawmakers, and Congress is unlikely to acquiesce to the White House's request to cut NIH's funding this year.

In fact, Rep. Rosa DeLauro, D-Conn., the chairwoman of the Appropriations Committee's health panel, told reporters: "It would be a cold day in hell before I helped pass a budget like this."

In addition to Collins, scheduled witnesses include Dr. Diana Bianchi, director of the National Institute of Child Health and Human Development; Dr. Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases; Dr. Gary Gibbons, director of the National Heart Lung and Blood Institute; Dr. Doug Lowy, deputy director of the National Cancer Institute; and Dr. Nora Volkow, director of the National Institute on Drug Abuse.


The House last week approved legislation that would permit HHS to fine pharmaceutical manufacturers that knowingly overcharge Medicaid by misclassifying their prescription drugs as generics.

An HHS inspector general report in 2017 found 3 percent of drugs in the Medicaid program may have been misclassified, with Medicaid being overcharged $1.3 billion in 2016 for just 10 of those drugs.

Drugmamkers face a maximum $100,000 penalty today for each item of false information provided to HHS. The bill would force companies to repay the government the difference for not properly classifying their drugs as generics.

The House-approved measure enjoys bipartisan support in the Senate, where Finance Committee Chairman Chuck Grassley, R-Iowa, and the panel's top Democrat, Sen. Ron Wyden, D-Ore., back the bill.


Freshman Sen. Rick Scott, R-Fla., last week introduced legislation that would prohibit pharmaceutical manufacturers from setting retail prices higher than those of prescription drugs sold in other industrialized countries.

Scott, Florida's former two-term governor, would block drug companies from charging U.S. consumers more than the cost of drugs sold in Canada, France, the United Kingdom, Japan or Germany. The legislation takes a cue from President Donald Trump's controversial proposal to fix U.S. prices for physician-administered drugs to an index of prices paid in foreign countries where governments set prices.

Scott's bill would also require pharmacies to inform patients if paying cash for prescription drugs would be cheaper than using their insurance.


The House Energy and Commerce Subcommittee on Health last week approved legislation addressing prescription drug prices and provisions to shore up Affordable Care Act markets.

The drug-pricing bills focused on limiting the practice of delaying generic products from coming to market, including pay-for-delay arrangements and so-called exclusivity parking.

The subcommittee also approved legislation by Rep. David Cicilline, D-R.I., that would allow generic manufacturers to gain access to drugs protected by the FDA's risk evaluation and mitigation strategy safety program. The legislation is a priority for full committee Chairman Frank Pallone, D-N.J., and its Senate version is being pushed by Finance Committee Chairman Chuck Grassley, R-Iowa.


Keeping up Congress' scrutiny on rising insulin costs, a House subcommittee on Tuesday will hear from patient advocates and researchers about ways to reverse recent price spikes.

The Energy and Commerce Subcommittee on Oversight and Investigations will examine supply chain issues for insulin and a lack of competition.

Subcommittee Chairwoman Diana DeGette, D-Colo., has frequently questioned manufacturers over insulin prices. DeGette is also co-leader of the Congressional Diabetes Caucus.

Scheduled witnesses include Gail DeVore, a patient advocate from Colorado with type 1 diabetes; Dr. William Cefalu, chief scientific officer at the American Diabetes Association; Dr. Alvin Powers, director of the division of diabetes, endocrinology and metabolism at Vanderbilt University Medical Center; Dr. Kasia Lipska, a clinical investigator at Yale University Medical Center; Christel Marchand Aprigliano, CEO of Diabetes Patient Advocacy Coalition; and Aaron Kowalski, chief mission officer of the Juvenile Diabetes Research Foundation.

Last month, Sens. Dick Durbin, D-Ill., Kevin Cramer, R-N.D., Bill Cassidy, R-La., and Tina Smith, D-Minn., called on the FDA to change a recent agency guidance that the lawmakers said would block new generic insulin products.

The Senate Finance Committee and the Senate Aging Committee are also examining insulin prices.

Rep. Peter Welch, D-Vt., introduced legislation in February that would allow patients, pharmacists and wholesalers to import insulin from Canada and other countries.


Bipartisan legislation introduced in the House last week would require CMS to implement a study on antipsychotic prescribing practices in non-nursing home settings for individuals with Alzheimer's.

Introduced by Reps. Annie Kuster, D-N.H., Christopher Smith, R-N.J., and Maxine Waters, D-Calif., the bill would extend the current CMS practice of data collection on prescribing practices in nursing homes to other settings. The lawmakers said the bill would provide Alzheimer's patients, caregivers, doctors and lawmakers with information needed to reduce inappropriate use of medications and improve overall care.

Antipsychotic medications are typically used to treat individuals with illnesses such as schizophrenia and bipolar disorder, and they are sometimes prescribed to dementia patients to control behavior. More than 170,000 Medicare beneficiaries living outside of nursing homes were prescribed antipsychotic drugs in 2012, the lawmakers said.

Smith and Waters are the co-leaders of the Congressional Alzheimer's Caucus.

Meanwhile, the Senate Aging Committee will hold a hearing Tuesday on new directions in biomedical research and caregiving for Alzheimer's disease.


The House last week approved on a voice vote bipartisan legislation that would allow states to provide coordinated care for children with medically complex conditions through pediatric health homes.

Introduced by Rep. Raul Ruiz, D-Calif., the legislation includes several Medicaid provisions previously introduced but not enacted, including the provision creating a state option to coordinate care for kids with medically complex conditions. The overall bill is co-sponsored by Reps. Kurt Schrader, D-Ore., Markwayne Mullin, R-Okla., and Fred Upton, R-Mich.

The legislation also aims to protect Medicaid recipients of home- and community-based services against spousal impoverishment by renewing through September a federal provision that disregards a spouse's income when determining Medicaid eligibility.


Bipartisan legislation introduced in the Senate last week aims to increase the number of doctors in rural and other medically underserved areas.

Introduced by Sens. Amy Klobuchar, D-Minn., Susan Collins, R-Maine, and Jacky Rosen, D-Nev., the legislation also would allow international doctors to remain in the United States after completing their residency under the condition they practice in underserved areas, such as rural communities.

Currently doctors from other countries working in America on J-1 visas are required to return to their home country for two years after their residency expires before they can apply for another visa or green card.

The senators' bill won endorsements from the American Medical Association, the American Hospital Association and the Association of American Medical Colleges.

The content of this article is intended to provide a general guide to the subject matter. Specialist advice should be sought about your specific circumstances.

To print this article, all you need is to be registered on Mondaq.com.

Click to Login as an existing user or Register so you can print this article.

Similar Articles
Relevancy Powered by MondaqAI
In association with
Related Topics
Similar Articles
Relevancy Powered by MondaqAI
Related Articles
Related Video
Up-coming Events Search
Font Size:
Mondaq on Twitter
Mondaq Free Registration
Gain access to Mondaq global archive of over 375,000 articles covering 200 countries with a personalised News Alert and automatic login on this device.
Mondaq News Alert (some suggested topics and region)
Select Topics
Registration (please scroll down to set your data preferences)

Mondaq Ltd requires you to register and provide information that personally identifies you, including your content preferences, for three primary purposes (full details of Mondaq’s use of your personal data can be found in our Privacy and Cookies Notice):

  • To allow you to personalize the Mondaq websites you are visiting to show content ("Content") relevant to your interests.
  • To enable features such as password reminder, news alerts, email a colleague, and linking from Mondaq (and its affiliate sites) to your website.
  • To produce demographic feedback for our content providers ("Contributors") who contribute Content for free for your use.

Mondaq hopes that our registered users will support us in maintaining our free to view business model by consenting to our use of your personal data as described below.

Mondaq has a "free to view" business model. Our services are paid for by Contributors in exchange for Mondaq providing them with access to information about who accesses their content. Once personal data is transferred to our Contributors they become a data controller of this personal data. They use it to measure the response that their articles are receiving, as a form of market research. They may also use it to provide Mondaq users with information about their products and services.

Details of each Contributor to which your personal data will be transferred is clearly stated within the Content that you access. For full details of how this Contributor will use your personal data, you should review the Contributor’s own Privacy Notice.

Please indicate your preference below:

Yes, I am happy to support Mondaq in maintaining its free to view business model by agreeing to allow Mondaq to share my personal data with Contributors whose Content I access
No, I do not want Mondaq to share my personal data with Contributors

Also please let us know whether you are happy to receive communications promoting products and services offered by Mondaq:

Yes, I am happy to received promotional communications from Mondaq
No, please do not send me promotional communications from Mondaq
Terms & Conditions

Mondaq.com (the Website) is owned and managed by Mondaq Ltd (Mondaq). Mondaq grants you a non-exclusive, revocable licence to access the Website and associated services, such as the Mondaq News Alerts (Services), subject to and in consideration of your compliance with the following terms and conditions of use (Terms). Your use of the Website and/or Services constitutes your agreement to the Terms. Mondaq may terminate your use of the Website and Services if you are in breach of these Terms or if Mondaq decides to terminate the licence granted hereunder for any reason whatsoever.

Use of www.mondaq.com

To Use Mondaq.com you must be: eighteen (18) years old or over; legally capable of entering into binding contracts; and not in any way prohibited by the applicable law to enter into these Terms in the jurisdiction which you are currently located.

You may use the Website as an unregistered user, however, you are required to register as a user if you wish to read the full text of the Content or to receive the Services.

You may not modify, publish, transmit, transfer or sell, reproduce, create derivative works from, distribute, perform, link, display, or in any way exploit any of the Content, in whole or in part, except as expressly permitted in these Terms or with the prior written consent of Mondaq. You may not use electronic or other means to extract details or information from the Content. Nor shall you extract information about users or Contributors in order to offer them any services or products.

In your use of the Website and/or Services you shall: comply with all applicable laws, regulations, directives and legislations which apply to your Use of the Website and/or Services in whatever country you are physically located including without limitation any and all consumer law, export control laws and regulations; provide to us true, correct and accurate information and promptly inform us in the event that any information that you have provided to us changes or becomes inaccurate; notify Mondaq immediately of any circumstances where you have reason to believe that any Intellectual Property Rights or any other rights of any third party may have been infringed; co-operate with reasonable security or other checks or requests for information made by Mondaq from time to time; and at all times be fully liable for the breach of any of these Terms by a third party using your login details to access the Website and/or Services

however, you shall not: do anything likely to impair, interfere with or damage or cause harm or distress to any persons, or the network; do anything that will infringe any Intellectual Property Rights or other rights of Mondaq or any third party; or use the Website, Services and/or Content otherwise than in accordance with these Terms; use any trade marks or service marks of Mondaq or the Contributors, or do anything which may be seen to take unfair advantage of the reputation and goodwill of Mondaq or the Contributors, or the Website, Services and/or Content.

Mondaq reserves the right, in its sole discretion, to take any action that it deems necessary and appropriate in the event it considers that there is a breach or threatened breach of the Terms.

Mondaq’s Rights and Obligations

Unless otherwise expressly set out to the contrary, nothing in these Terms shall serve to transfer from Mondaq to you, any Intellectual Property Rights owned by and/or licensed to Mondaq and all rights, title and interest in and to such Intellectual Property Rights will remain exclusively with Mondaq and/or its licensors.

Mondaq shall use its reasonable endeavours to make the Website and Services available to you at all times, but we cannot guarantee an uninterrupted and fault free service.

Mondaq reserves the right to make changes to the services and/or the Website or part thereof, from time to time, and we may add, remove, modify and/or vary any elements of features and functionalities of the Website or the services.

Mondaq also reserves the right from time to time to monitor your Use of the Website and/or services.


The Content is general information only. It is not intended to constitute legal advice or seek to be the complete and comprehensive statement of the law, nor is it intended to address your specific requirements or provide advice on which reliance should be placed. Mondaq and/or its Contributors and other suppliers make no representations about the suitability of the information contained in the Content for any purpose. All Content provided "as is" without warranty of any kind. Mondaq and/or its Contributors and other suppliers hereby exclude and disclaim all representations, warranties or guarantees with regard to the Content, including all implied warranties and conditions of merchantability, fitness for a particular purpose, title and non-infringement. To the maximum extent permitted by law, Mondaq expressly excludes all representations, warranties, obligations, and liabilities arising out of or in connection with all Content. In no event shall Mondaq and/or its respective suppliers be liable for any special, indirect or consequential damages or any damages whatsoever resulting from loss of use, data or profits, whether in an action of contract, negligence or other tortious action, arising out of or in connection with the use of the Content or performance of Mondaq’s Services.


Mondaq may alter or amend these Terms by amending them on the Website. By continuing to Use the Services and/or the Website after such amendment, you will be deemed to have accepted any amendment to these Terms.

These Terms shall be governed by and construed in accordance with the laws of England and Wales and you irrevocably submit to the exclusive jurisdiction of the courts of England and Wales to settle any dispute which may arise out of or in connection with these Terms. If you live outside the United Kingdom, English law shall apply only to the extent that English law shall not deprive you of any legal protection accorded in accordance with the law of the place where you are habitually resident ("Local Law"). In the event English law deprives you of any legal protection which is accorded to you under Local Law, then these terms shall be governed by Local Law and any dispute or claim arising out of or in connection with these Terms shall be subject to the non-exclusive jurisdiction of the courts where you are habitually resident.

You may print and keep a copy of these Terms, which form the entire agreement between you and Mondaq and supersede any other communications or advertising in respect of the Service and/or the Website.

No delay in exercising or non-exercise by you and/or Mondaq of any of its rights under or in connection with these Terms shall operate as a waiver or release of each of your or Mondaq’s right. Rather, any such waiver or release must be specifically granted in writing signed by the party granting it.

If any part of these Terms is held unenforceable, that part shall be enforced to the maximum extent permissible so as to give effect to the intent of the parties, and the Terms shall continue in full force and effect.

Mondaq shall not incur any liability to you on account of any loss or damage resulting from any delay or failure to perform all or any part of these Terms if such delay or failure is caused, in whole or in part, by events, occurrences, or causes beyond the control of Mondaq. Such events, occurrences or causes will include, without limitation, acts of God, strikes, lockouts, server and network failure, riots, acts of war, earthquakes, fire and explosions.

By clicking Register you state you have read and agree to our Terms and Conditions