Advocacy in Action: Obamacare, Drug Pricing, and More

Here is a quick run down of major issues being discussed by policymakers from an endocrine perspective and the Society’s current advocacy work. Let us know if you would like additional information or have any questions.

What’s Happening in Washington

Appropriations & NIH Funding: Good News/Bad News—This week House Appropriations Committee reported out the Labor-HHS spending bill after a 7-hour markup. Labor-HHS is the first bill to move through the full committee this year. It’s the first time in many years that Labor-HHS has moved first, and so early. Following the Committee’s passage, the House Democratic Leader Steny Hoyer (D-MD) has reserved June for floor action on appropriations bills, Rumor has it the plan is to once again pair Labor-HHS with the Defense spending bill since the minibus pairing strategy was so successful last year.

The Labor-HHS bill strongly supports health priorities, including $41.1 billion for medical research at NIH, an increase of $2 billion over the FY 2019 level, supporting initiatives like the Cancer Moonshot, the BRAIN Initiative; the “All of Us” Precision Medicine Initiative; Alzheimer’s research; and research to develop a universal flu vaccine. It also provides $8.3 billion for CDC, an increase of $921 million, to modernize public health capacity and data infrastructure, and to address costly chronic diseases. The bill and report do not shy away from issues that have proven contentious in the past, providing $50 million in dedicated funding for gun violence research at CDC and NIH, increasing funding for Title X family planning and Teen Pregnancy Prevention, and providing $100 million for Affordable Care Act navigators. For further details, see the summary, bill, and report prepared by the House majority.

But it’s not all good news. Without an agreement raising current statutory budget caps, these health priorities will see a severe decrease in 2020 – not the increases that House Appropriations Committee bill includes. In fact, without a budget agreement enacted into law, ‘sequestration’ will automatically reduce discretionary spending by $126 billion next year, split between defense and non-defense investments. Further, progress in forging a deal to avoid these cuts appears to be nonexistent. President Trump has publicly disparaged the possibility of reaching such an agreement. And when asked today by a journalist how caps negotiations are proceeding, Speaker Nancy Pelosi responded, “Are there caps negotiations?”

Drug Pricing: HHS Finalizes Rule Requiring Manufacturers Disclose Drug Prices in TV Ads to Increase Drug Pricing Transparency—On Wednesday, Health and Human Services Secretary Alex Azar announced a final rule from the Centers for Medicare & Medicaid Services (CMS) that will require direct-to-consumer television advertisements for prescription pharmaceuticals covered by Medicare or Medicaid to include the list price – the Wholesale Acquisition Cost – if that price is equal to or greater than $35 for a month’s supply or the usual course of therapy. He modestly stated, “Requiring the inclusion of drugs’ list prices in TV ads is the single most significant step any administration has taken toward a simple commitment: American patients deserve to know the prices of the healthcare they receive.” Read more about the rule here. While the Administration is singing praises for the rule, Congress continues to pursue additional strategies. This week the Energy & Commerce Committee held a hearing, “Lowering Prescription Drug Prices: Deconstructing the Drug Supply Chain,” and heard from manufacturers, PBMs, insurers, and patients. More information is available here.

Obamacare Debate Continues — The House of Representatives passed legislation to require the Trump administration to rescind a 2018 guidance that made it easier for states to change their individual insurance markets and bypass Obamacare. The passage of the bill (HR 986), with four Republicans supporting it and one lawmaker voting present, comes as Republicans express concerns about Democrats’ plans to combine an upcoming wave of partisan legislation related to the 2010 law with a bipartisan effort to lower prescription drug prices.

What We Are Working On

NIH Funding—This week we met with senior officials at the Office of Management & Budget (OMB) in the White House to discuss the outlook for FY 2020 funding. They believe we will not see a final appropriations bill but rather end up with a Continuing Resolution for a full year because the House, Senate, and White House cannot reach agreement on spending caps. This means it is more important than ever to advocate for Congress to #RaiseTheCaps. If you have not yet done so, please join our online advocacy campaign to protect NIH funding.

Friends of NICHD—The Endocrine Society has a leadership position in a coalition designed to support the Eunice Kennedy Shriver National Institute of Child Health & Human Development (NICHD). This week we hosted NICHD Director Diana Bianchi and coalition partners in our office to hear about the NICHD priorities and ways we can support.

NICHD Director Diana Bianchi speaks at the Endocrine Society about NICHD priorities

Insulin Pricing—The Congressional Hispanic Caucus (CHC) is also interested in the rising price of insulin and contacted us this week to learn more about the issue and how it can try and influence. The CHC addresses national and international issues and crafts policies that impact the Hispanic community. The function of the Caucus is to serve as a forum for the Hispanic Members of Congress to coalesce around a collective legislative agenda. The Caucus plays an important political role in the House of Representatives, so it is good to know it is on our side and wants to help!