July 17, 2019

How Harris, Gillibrand, and Klobuchar want to address high Rx costs

Daily Briefing

    Sens. Kirsten Gillibrand (D-N.Y.), Kamala Harris (D-Calif.), and Amy Klobuchar (D-Minn.), who each are seeking the 2020 Democratic nomination for president, have announced separate plans to address high prescription drug costs.

    Where do the 2020 Democratic hopefuls stand on the other pressing issues in health care?

    The candidates' announcements came after a federal judge last week struck down HHS' final rule to require drugmakers to disclose their products' list prices in consumer-directed television advertisements. In addition, the administration last week withdrew its proposed rule to prohibit drugmakers from paying rebates to pharmacy benefit managers under federal health programs.

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    Details on Gillibrand's proposal

    Gillibrand on Thursday announced her plan to address high prescription drug prices by:

    • Allowing the U.S. government to negotiate drug prices with manufacturers;
    • Directing HHS to create guidelines for importing prescription drugs from Canada through licensed vendors;
    • Establishing a U.S. "pharmaceutical czar" to oversee the pharmaceutical industry's audits;
    • Penalizing drugmakers that increase drug prices without justification; and
    • Prosecuting drugmakers that knowingly promote addictive medications.

    According to The Hill, Gillibrand in a campaign statement said, "Far too often, hard-working Americans across the country are forced to make the impossible decision between paying for the medication they need, or keeping food on the table." She continued, "We need to make sure the health care system works for everyone and we will start by actually holding drug companies accountable for their predatory practices and ensuring that people have access to safe and affordable drugs."

    Details on Harris' proposal

    Harris on Tuesday announced her plan to lower U.S. drug prices, which focuses on pinning U.S. drug prices to the prices paid in other developed nations, the Washington Post reports.

    Under Harris' proposal, HHS would establish a "fair price" for prescription drugs that are priced higher in the United States than in other countries, as well as for drugs that have increased in price at a rate higher than inflation in a given year, according to the Post. HHS' "fair price" would not exceed the drug's cost in Canada, Germany, Japan, the United Kingdom, and other industrialized countries that are part of the Organization for Economic Cooperation and Development.

    In addition, Harris said she would implement a 100% tax rate on all of the profits that drugmakers make from selling drugs above the "fair price" in the United States, and would use funds collected from the tax to provide consumers with rebates.

    Harris' proposal also notes that, if Harris becomes president and Congress fails to act on her drug pricing proposals within 100 days of her inauguration, her administration would launch an investigation to determine whether pharmaceutical companies are price gouging and release the investigation's findings to the public. Harris' administration then would demand that drugmakers found to be price gouging drop the prices of their products within 30 days, according to the proposal. If the drugmakers do not lower their prices, Harris said she would direct HHS to import the high-priced drugs from countries where they are priced lower, and she would use her legal authority as president to take punitive action against the companies. For example, Harris said she would revoke a drugmaker's patent for a prescription drug developed with federal funds and then award that patent to another drugmaker that would agree to sell the prescription drug at a fairer price, according to the Post.

    Harris' proposal also states that, if she becomes president, she would appoint an attorney general who will focus on investigating abusive drug pricing practices to ensure drugmakers are not violating federal law or engaging in anti-competitive practices, and close "the pharmaceutical company tax loophole for direct-to-consumer advertising expenses."

    Details on Klobuchar's proposal

    Klobuchar on Friday announced her plan to address prescription drug costs by:

    • Allowing the federal government to negotiate Medicare Part D drug prices;
    • Allowing U.S. residents to order prescription drugs from Canada and other countries; and
    • Cracking down on so-called "pay-for-delay" agreements.

    Klobuchar's proposal also would:

    • Create a new senior fraud prevention office to prevent elder abuse;
    • Expand Medicare-covered services for Alzheimer's disease;
    • Expand Medicare coverage for dental, hearing, and vision services;
    • Implement legislation to help families locate individuals with Alzheimer's or development disabilities who have gone missing;
    • Increase U.S. suicide prevention efforts and expand access to depression treatments;
    • Invest in research to develop a cure for Alzheimer's by 2025; and
    • Provide additional resources for the caregivers to allow patients to stay in their homes for a longer period of time—including creating a loan forgiveness program for care workers, guaranteeing caregivers paid family leave, offering tax credits to caregivers to offset costs, and offering incentives to employers for providing employees with the option for long-term care insurance.

    Booker unveils proposal to lower long-term care costs for seniors

    In related news, Sen. Cory Booker (D-N.J.), who also is seeking the 2020 Democratic nomination for president, on Monday announced a plan to address the cost of long-term health care for seniors by:

    • Allowing individuals who exceed the asset and/or income limits for Medicaid assistance for long-term care services to buy into the program, with their cost-sharing requirements determined on a sliding scale;
    • Implementing a so-called "Rise Credit," which would be an expansion of the Earned Income Tax Credit, that would be available to family caregivers and would provide a credit of up to $4,000 to qualifying caregivers of children and relatives under age 6, disabled children, and elderly spouses or other dependents;
    • Mandating that long-term care service and support staff be paid at least $15 per hour and be offered benefits such as health care, retirement benefits, and paid family and medical leave;
    • Raising asset limits for Medicaid assistance for long-term care services and supports to $200,000 and income limits to 300% of the federal poverty line, which is approximately $49,380 for a family of two; and
    • Requiring all states to offer home-based and community-based services to help eliminate waitlists for institutional care, and to allow individuals to choose where they want to receive care (Gibson, Reuters, 7/13; Frazin, The Hill, 7/11; Gibson, Reuters, 7/12; Dugyala, Politico, 7/12; LeBlanc, CNN, 7/12; Janes, Washington Post, 7/16; Baker, "Vitals," Axios, 7/16; Reid, Reuters, 7/15; Daugherty, The Hill, 7/15; Harris' proposal, accessed 7/16; Booker's proposal, accessed 7/16).
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