Will There Be Drug Pricing Legislation in 2021?
On April 28, 2021, President Joe Biden announced the American Families Plan, which the White House deemed as “an investment in our kids, our families, and our economic future.” The American Families Plan totals $1.8 trillion and is the second half of President Biden’s effort to build back better and make “once-in-a-generation investments in our nation’s future.”
The American Families Plan includes:
• Provides at least four years of free education for Americans
o Universal pre-school to all three and four year olds
o Provide all Americans with two years of free community college
• Provides direct support to children and families
o Direct support to families to ensure that low-income families spend no more than 7% of household income on childcare
o Direct support to families by creating a national paid family and medical leave program that will bring America in line with other comparable nations
o Provide nutrition assistance to low-income families to reduce childhood hunger
• Extends tax cuts for families with children and American workers
o Extend tax cuts that were included in the American Rescue Plan including the Child Tax Credit, Earned Income Tax Credit, and the Child and Dependent Care Tax Credit
Full White House Fact sheet available HERE.
Noticeably missing from the American Families Plan are any major healthcare initiatives, including overhauling Medicare and Medicaid or reducing drug prices. Both of these issues were major aspects of the Biden Presidential campaign, and many in the Democratic party were hoping they would take center stage in President Biden’s economic plans.
Despite failing to include healthcare initiatives in the plan, President Biden and other administration officials have stated that President Biden remains fully committed to lowering drug pricing, referencing the need for the government to be able to directly negotiate drug prices in his address to Congress on April 28, 2021. In his address, President Biden called on Congress to pass comprehensive drug pricing legislation.
You can read President Biden’s full address to Congress HERE.
Congress Calls on President Biden to Address Drug Pricing
Although President Biden failed to include any sort of drug pricing reduction in his most recent economic plan, Congressional leaders have not stopped calling on Biden to include it. In fact, Democrats are bracing for a fight with the administration to include drug pricing, an issue many campaigned on in 2020 and many feel that failure to take action before the 2022 midterm elections could cost the Democrats control of Congress. A divided Congress, should the Democrats lose either the House or Senate, or even both, could make it next to impossible for any significant drug pricing legislation to be passed in the future.
Therefore, Congressional leaders feel that the time to act is now. Senator Ron Wyden (D-OR), Chairman of the Senate Finance Committee, stated that due to the campaigning in the last election, Americans, and especially seniors are going to be looking at drug pricing reform when determining who they vote for in 2022.
Despite President Biden failing to include drug pricing legislation in the American Families Plan, House Democrats are putting the wheels in motion to move forward with their own sweeping drug pricing legislation, H.R. 3, on its own without the help of budget reconciliation. However, it is important to note that while the House of Representatives might be able to pass H.R. 3, it is unlikely that the legislation will be able to make it through the Senate without the help of budget reconciliation, which only requires a simple majority in the Senate rather than 60 votes to beat the filibuster. If H.R. 3 is advanced as a standalone bill, Senate Democrats will need to convince 10 Republicans to join them in supporting the legislation.
On Tuesday, May 4, 2021, the House Energy and Commerce Committee, Subcommittee on Health held a hearing titled “Negotiating a Better Deal: Legislation to Lower the Cost of Prescription Drugs.” Included in the legislation that the committee was examining was H.R. 3, which was recently reintroduced in the 117th Congress. Both Democrats and Republicans stated how drug prices are out of control and need to be addressed. However, Republicans on the committee argued that H.R. 3 was not the answer. Chairman of the House Energy and Commerce Committee, Rep. Frank Pallone (D-NJ), indicated that he was will to use any vehicle available to attach drug pricing legislation, whether it had Republican support or not. This stance makes it clear that Rep. Pallone, joining with Senator Wyden, is willing to attach comprehensive drug pricing legislation to any sort of package, even if it is not included in the President’s American Families Plan.
Read the full newsletter for a quick refresher as to what is included in H.R. 3.
Republican Senator Delays Confirmation of Biden’s CMS Pick: Chiquita Brooks-LaSure
On April 15, 2021, President Biden’s pick to be Administrator of the Centers for Medicare and Medicaid Services, Chiquita Brooks-LaSure, sat in front of the Senate Finance Committee for a hearing on her nomination. The hearing was relatively straight forward, with many on the committee detailing how qualified she is for the job and that she is a solid pick to run the agency.
However, on April 18, 2021 the Biden administration withdrew Texas’s Medicaid waiver on the grounds that the Trump administration did not hold a public comment period before approving the waiver in January of 2021. In response, Senator John Cornyn (R-TX) and the other Republican members of the Finance Committee voted against Brooks-LaSure, causing her nomination to advance out of committee along party lines (14-14). Senator Cornyn also used a parliamentary procedure to put a hold on Brooks-LaSure’s nomination until a solution to the waiver issue could be reached with the Biden administration. It is important to note that Brooks-LaSure, having not yet been confirmed by the Senate to run CMS, did not have any say or participation in the Biden administration’s decision to pull the waiver.
It is unclear how long Senator Cornyn’s hold will last as Majority Leader Chuck Schumer (D-NY) can move to call a vote at any time.
PRG will continue to monitor the situation and provide updates as necessary
On Wednesday, April 28, 2021, the House Ways and Means Committee, Subcommittee on Health held a hearing titled “Charting the Path Forward for Telehealth.” Much of the focus of the hearing was how telehealth has expanded access to care during the COVID-19 pandemic and that there is bipartisan support to extend and potentially make permanent some of the telehealth waivers issued to CMS to allow flexibility to providers on delivering care.
Chairman of the Subcommittee, Representative Lloyd Doggett (D-TX), voiced his support for expanding telehealth and detailed how telehealth reduces health inequities caused by factors such as a lack of transportation. However, it is important to note that Chair Doggett mentioned how increased access to broadband is essential to make telehealth successful and address health inequities an expanded telehealth could potentially cause.