ACA Repeal Talks Continue

House Majority Leader Kevin McCarthy (R-Calif.) has said that Congress will work to repeal and replace the Affordable Care Act (ACA) in the least disruptive manner possible. While some members of the Freedom Caucus support a faster timeline in repealing the health care law, it is estimated that 22 million people would be left without coverage if repeal is passed without a replacement plan. Republicans are exploring the use of reconciliation to repeal and replace the law. Reconciliation requires only 51 votes, rather than the usual 60, to pass the Senate. Budget Committee Chairman Tom Price (R-Ga.) has indicated that the same tactic that would be used to repeal the ACA could also be used to overhaul the
Medicare program in 2017. Medicare reform has been a longstanding goal of Speaker of House Paul Ryan (R-Wis.). A revised fiscal year (FY) 2017 budget resolution passed early next year could make way for ACA repeal, while a new FY 2018 budget resolution could include reconciliation instructions to accomplish these other objectives. Ways and Means Committee Chairman Kevin Brady (R-Texas) has said that he and his staff are already drafting legislation to address changes to the Medicare program next Congress.

Shimkus Runs on Platform to Rein in Agency Authority

Rep. John Shimkus (R-Ill.) has promised to address the power of federal agencies should he become the next chairman of the House Energy and Commerce Committee. In a letter sent to his colleagues, Shimkus said that he will build a case against the Chevron Deference – legal doctrine granting power to federal agencies to interpret statute. Shimkus has served on the Energy and Commerce Committee for 20 years, and is currently chairman of the Subcommittee on Environment and the Economy. He is running against Rep. Greg Walden (R-Ore.), Communications and Technology Subcommittee Chairman, for the top spot on the full Committee for the 115th Congress. Rep. Joe Barton has also said that he is seeking the position. Because he has previously served as Committee Chairman, Barton would need a waiver from
GOP leadership in order to lead the panel again.

Federal Drug Spending Database Updated

Spending on prescription drugs in the Medicare program was driven by a treatment for hepatitis and a form of insulin in 2015, according to an update of the federal database that tracks which drugs the government spends the most money on overall and per person, and which drugs experience the largest price increases. Medicare spent a total of $137.4 billion on drugs last year, a 13 percent increase over 2015, while Medicaid expenditures totaled $57.3 billion. Harvoni and the insulin injection Lantus cost a total of $11 billion to the Medicare program last year. Eleven drugs included in the database doubled in price. It should be noted that these numbers do not include the impact of rebates, which on average cover 17.5 percent of the price of medicines in the Part D drug benefit. In 2014, rebates amounted to $16 billion for the Medicare program. This year’s data indicates steady price hikes over time, a trend that is also being seen in some generic medications.

Report on Addiction Released

U.S. Surgeon General Vivek Murthy has released the country’s first comprehensive report on addiction. “Facing Addiction in America: The Surgeon General’s Report on Alcohol, Drugs and Health” covers the issue of substance abuse broadly – looking at alcohol and drugs, legal and illegal. The report includes key findings and statistics on alcohol and drug misuse, as well as opportunities for increased access to effective prevention and treatment services. Murthy has made the issue of opioid abuse and addiction one of his top priorities.

House Passes Four Public Health Bills

Last week, the House of Representatives passed four public health bills under suspension of the rules. H.R. 1192 would create a National Clinical Care Commission to make recommendations to improve care for patients with diabetes, metabolic and autoimmune diseases. H.R. 1209 would identify areas of the country with a shortage of maternity health care providers and assign them health professionals from the National Health Service Corps. H.R. 2713 would reauthorize and expand nursing education and workforce development programs through 2021. H.R. 4365 would authorize emergency medical services personnel to administer controlled substances pursuant to standing or verbal orders under certain conditions. It is unknown whether the Senate will act on the legislation before adjourning for the year.

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