McCaskill Report Links Opioid Manufacturers and Advocacy Spending

Sen. Claire McCaskill (D-Mo.) has released a new report detailing $9 million in payments between 2012 and 2017 from five opioid manufacturers to 14 outside groups that work on issues related to chronic pain and opioids. She argues that the third-party patient and physician organizations, such as the Academy of Integrative Pain Management, the U.S. Pain Foundation, and the American Academy of Pain Medicine, were often advocates for increased opioid use, and were found to have lobbied against prescriber limits and the Centers for Disease Control and Prevention’s (CDC) 2016 opioid guidelines. She also notes the lack of transparency around the donations from the opioid manufacturers. Nonprofit patient and physician groups are not currently required to disclose their donors publicly.

In related news, leadership on the Senate Health, Education, Labor, and Pensions (HELP) Committee Lamar Alexander (R-Tenn.) and Patty Murray (D-Wash.) met with a group of insurance company CEOs last week on the subject of combatting the opioid crisis. The group discussed what they are doing to fight opioid abuse, and offered suggestions for additional congressional action. On the House side, Rep. Elijah Cummings (D-Md.), Ranking Member on the House Oversight and Government Reform Committee, has written to Committee Chairman Trey Gowdy (R-S.C.) requesting a White House briefing on the status of the Administration’s efforts to implement the recommendations of the President’s Commission on Combating Drug Addiction and the Opioid Crisis.

House GOP Considers Employer Mandate Repeal

Republicans in the House are currently discussing repeal of the Affordable Care Act’s (ACA) employer mandate, according to House Ways and Means Committee Chairman Kevin Brady (R-Texas). The mandate requires businesses with 50 or more employees to offer health coverage for their workers or face a financial penalty. Chairman Brady has spoken about the idea with both his colleagues as well as U.S. Department of Health and Human Services (HHS) Secretary Alex Azar. Brady supports retroactive repeal of the mandate to prevent employers from being penalized by the provision, which first took effect in 2015. Speaker of the House Paul Ryan (R-Wis.) has made parallel remarks in recent weeks about the need to take an incremental approach to health care reform during the remainder of the 115th Congress.

Good Samaritan Advanced to the House for Consideration

The House Energy and Commerce Committee advanced H.R. 1876, the Good Samaritan Health Professionals Act, to the full House of Representatives by voice vote. This bill, authored by Rep. Marsha Blackburn (R-Tenn.), would shield health care professionals from liability from harm caused by any act or omission if: (1) the professional is serving as a volunteer in response to a disaster in a declared disaster area and (2) the act or omission occurs during the period of the disaster, in the professional’s capacity as a volunteer, and in a good faith belief that the individual being treated is in need of health care services.

CMS Actuary Releases Annual Report

The Centers for Medicare and Medicaid Services (CMS) Office of the Actuary estimates that national health spending will grow an average of 5.5 percent a year between 2017 and 2026, one percentage point faster than the gross domestic product (GDP). According to the actuary’s annual report, by 2026 health spending will reach $5.7 trillion and account for 19.7 percent of GDP. The economists at CMS argue that the increased health care spending growth is driven by income growth across the country. Prescription drug spending is expected to grow 6.3 percent per year on average over the next decade, the fastest spending growth rate among other health care goods and services. The actuaries partially attribute this fact to the influence of more costly specialty drugs. Medicare spending is projected to grow at an annual average rate of 7.4 percent through 2026, outpacing the spending growth of private health insurance and Medicaid largely due to the increasing enrollment of baby boomers. Private health insurance spending is expected to grow at a rate of 4.7 percent, while Medicaid is projected to growth at an average annual rate of 5.8 percent. While enrollment growth in Medicaid is slowing, per-enrollee costs are expected to become more expensive as the share of the aged and disabled increases as a portion of the overall Medicaid population. The slow growth in private health insurance spending is attributed to the proliferation of high-deductible plans and other employer efforts to manage health care costs, as well as the shifting of baby boomers into Medicare. The number of uninsured people is projected to increase from 28.6 million in 2016 to 37.7 million in 2026.

Azar Open to Gun Violence Research

Secretary of the U.S. Department of Health and Human Services (HHS) Alex Azar stated that he would allow federal research to be conducted into the causes of gun violence. The comments were made following a mass shooting at a Florida school on Wednesday, which left 17 people dead and 14 others injured. While Azar was testifying before several congressional committees on the President’s budget, a number of Democratic lawmakers expressed concerns about current restrictions that prevent the Centers for Disease Control and Prevention (CDC) from conducting research into gun violence. The CDC’s ability to study gun violence has been limited by an appropriations provision known as the Dickey amendment, which was devised in 1996 and states “none of the funds made available in this title may be used, in whole or in part, to advocate or promote gun control.” Azar explained that it was his understanding that the two-decades old provision prevents the CDC from taking an advocacy position on the issue, but does not impede the CDC’s ability to conduct research. “We’re in the science business and the evidence-generating business,” Azar stated, “and so I will have our agency certainly working in this field, as they do across the broad spectrum of disease control and prevention.” Azar also made comments in line with the response of the President and GOP leadership to the shooting, focusing on the need for mental health reform.

McCain and Baldwin Urge WH Action on Drug Prices

Sens. John McCain (R-Ariz.) and Tammy Baldwin (D-Wis.) have written to President Trump calling on him to take substantive action to reduce the cost of prescription drugs. They ask that the Administration support their legislation that would require pharmaceutical manufacturers to justify their pricing decisions and be more transparent in providing taxpayers with information on the cost of drug R&D, marketing, and advertising before increasing a medicine’s cost.

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