The House returns this week with only a few weeks left to come to an agreement on a coronavirus relief package and avert a government shutdown. While the relief package discussions remain stymied with no end in sight, the informal agreement between Speaker Pelosi and the White House on a “clean” continuing resolution (CR) continues to move forward without a hitch. Meanwhile, the President was busy over the weekend with an executive order (EO) tying prescription drug and biologic pricing under Medicare Part B and Part D to the “most-favored-nation (MFN) price.”
Treasury Secretary Steven Mnuchin and House Speaker Nancy Pelosi (D-CA) have informally agreed to a “clean” CR that largely maintains the current funding levels and is free of any poison pills. With the November elections right around the corner, the main point of contention is deciding the duration of the continuing resolution. Republicans are pushing for a CR that funds the government through December and Democrats, feeling bullish about the elections, prefer a January expiration date. The CR is expected to reauthorize a slate of expiring health care extenders, including the following:
- Health care extenders expiring September 30, 2020
- Medicare: MACRA technical assistance to small practices and practices in Health Professional Shortage Areas
- CHIP: 11.5 percentage point increase to E-FMAP
- Health care extenders expiring November 30, 2020
- Medicare: National Quality Forum, Outreach and Assistance for Low-Income Programs, floor on work geographic practice cost indices
- Medicaid: Money Follows the Person program, spousal impoverishment protections, certified community behavioral health clinics
- Public Health: Community health centers (CHCs), teaching health centers, National Health Service Corps, Special Diabetes Program
- Health Services: Sexual Risk Avoidance Education Program, Personal Responsibility Education Program (PREP), demonstration projects to address health professions workforce needs, Temporary Assistance for Needy Families (TANF)
President Trump signed his EO on “Lowering Drug Prices by Putting America First” on Sunday in an attempt give his campaign new focus on an old promise to reduce prescription drug prices. The timing and legality of the Department of Health and Human Services’ (HHS) ability to proceed with rulemaking tying prescription drug and biologic pricing under Medicare Part B and Part D to the MFN price is another question altogether. This effort widens the Administrations executive order introduced on July 24 at a White House signing ceremony to include Part B and D drugs, directing the HHS Secretary to create demonstration projects requiring Medicare to pay the same lower prices for prescription drugs as those sold in Europe and other developed nations.
On Wednesday (September 16), the Senate Appropriations Subcommittee on Labor, Health and Human Services, Education, and Related Agencies will convene a hearing to review coronavirus response efforts. The witness panel includes Assistant Secretary for Health Admiral Brett Giroir, Assistant Secretary for Preparedness and Response Dr. Bob Kadlec, and CDC Director Dr. Robert Redfield. The discussion may signal whether there is still an appetite among Senate appropriators to try to hash out a deal on a coronavirus relief package before the November elections.