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May 20, 2019

Inside the House's legislative package to address drug costs and bolster the ACA

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    The House on Thursday voted 284-183 to approve a legislative package (HR 987) intended to address high drug prices and shore up the Affordable Care Act's (ACA) exchange market.

    June 17 webconference: How to stabilize drug prices and reduce shortages

    The vote mostly fell along party lines, with all Democrats and five Republicans voting in favor of the legislative package, according to Politico.

    Legislative package details

    The legislative package, called the MORE Health Education Act, includes a total of seven bills, Inside Health Policy reports.

    How the package would alter the ACA

    Four of the bills are intended to bolster the ACA by reversing certain policies implemented under the Trump administration. Three of those measures were sponsored by Democrats. The measures would:

    • Restore funding for ACA outreach;
    • Provide $100 million annually for the ACA's navigator program; and
    • Reverse the administration's rule expanding short-term health plans.

    The fourth ACA-related bill was sponsored by Reps. Brian Fitzpatrick (R-Pa.) and Andy Kim (D-N.J.) and is intended to support states interested in setting up and operating their own exchanges. Under the bill, the federal government would give states $200 million to launch their own state-run exchange.

    The House also voted to approve various amendments related to the ACA. For example, lawmakers approved an amendment that would require ACA outreach and navigator programs to target low-income regions and support veterans, as well an amendement that would prevent HHS from taking steps to prohibit so-called "silver-loading."

    According to Inside Health Policy, House Republicans opposed those amendments.

    How the package would address prescription drug prices

    The legislative package also includes three bills aimed at reducing prescription drug prices by addressing anticompetitive market practices. For example, the package includes:

    • A bill that would ban so-called "pay-for-delay" agreements;
    • A bill that would discourage drugmakers from abusing the 180-day exclusivity granted to first generic applicants; and
    • The Creating and Restoring Equal Access to Equivalent Samples (CREATES) Act, which aims to bolster generic drug competition.

    The three bills would save about $4 billion over a decade, according to Politico. As such, the three measures would help to offset the cost of the ACA-related bills, which would increase federal spending, Politico reports.

    Other provisions

    Lawmakers also approved some amendments with bipartisan support.

    For example, some House Republicans voted in favor of an amendment sponsored by Rep. Lucy McBath (D-Ga.) that would require the HHS and Department of Education secretaries to conduct outreach on generic drugs at pharmacy schools, as well as an amendment sponsored by Rep. Stephen Lynch (D-Mass.) that would direct the Government Accountability Office to conduct studies for states interested in implementing public option health plans.

    What's next?

    The legislative package now heads to the Senate, where the bills related to the ACA are not expected to pass, Inside Health Policy reports. The Senate is expected to take up the legislative package's measures on drug pricing, according to Inside Health Policy.

    The White House has indicated President Trump would veto the legislative package if Congress approves it in its current state. The White House in a policy statement said the administration supports the bills designed to address drug prices, but does not support the other bills, which it said would limit health coverage options for U.S. residents and hinder efforts to reduce federal spending.


    House Energy and Commerce Committee Chair Frank Pallone (D-N.J.) said the legislative package's passage is "a big step in [lawmakers'] commitment to deliver on [their] promise to make health care and prescription drugs more affordable."

    Rep. Greg Walden (R-Ore.), the ranking member on the House Energy and Commerce Committee, noted that the committee had unanimously passed the legislative package when it included only the three bills designed to address high drug prices. Walden said the new legislative package does not represent the committee's bipartisan collaboration (Lotven, Inside Health Policy, 5/16 [subscription required]; Cancryn/Owermohle, Politico, 5/16; Goldstein, Washington Post, 5/16; Weixel, The Hill, 5/16).

    June 17 webcon: How to stabilize drug prices and reduce shortages

    Civica Rx is a new kind of generic drug company that aims to challenge the pricing practices of incumbent drug makers and to stave off drug shortages. This webconference will explain the company's model and future plans to disrupt the drug market.

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