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Tag Archive | "prescription drugs"

At Last – Long-awaited Health Reform Reconciliation Bill Released

Today House Democratic Leadership released the legislative text of the Reconciliation Act of 2010, sponsored by House Budget Chairman John Spratt.  The bill amends a number of provisions in the Senate-passed “Patient Protection and Affordable Care Act,” including:

  • Provides additional subsidies to improve the affordability of coverage for individuals with incomes up to 400 percent of the federal poverty level;
  • Imposes additional requirements for coverage of non-dependent children up to age 26;
  • Closes the Medicare Part D donut hole by 2020 by offering seniors an immediate $250 rebate and subsequently increasing discounts on brand-name drugs;
  • Strikes the controversial 100-percent federal Medicaid matching rate for Nebraska (known as the “Cornhusker kickback”);
  • Delays the annual cap on contributions to health flexible spending accounts (FSAs) by two years until 2013;
  • Delays the excise tax on high-cost health plans to 2018, increases the dollar thresholds and indexes them to inflation;
  • Delays the industry fee on sales of brand name pharmaceuticals by one year to 2011 but increases revenues raised by $4.8 billion;
  • Delays the medical device tax on manufacturers by two years until 2013 and switches the industry fee to an excise tax on the first sale for use of medical devices at 2.9 percent rate; and
  • Delays the health insurance industry fee by three years to 2014.

House Majority Leader Steny Hoyer announced that the House would convene at 1:00 pm on Sunday, but the final vote on the reconciliation bill would likely not begin until later in the day to comply with the Democratic Leaders’ promise to give Members 72 hours to review the final bill text.  The House is expected to approve the Senate-passed health reform bill using a “deem-and-pass” procedure that Republicans protest as unconstitutional.

Since the bill’s release, several House members have switched their previous ‘no’ vote to a ‘yes’ – including Reps. Bart Gordon (D-TN), Luis Gutierrez (D-IL), Betsy Markey (D-CO), and Mike Arcuri (D-NY).  Additionally, Rep. Dennis Kucinich (D-OH) announced yesterday that he will now vote in favor of the bill.

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Extending The Extenders Package

This week the Senate will resume consideration of the “American Jobs and Closing Tax Loopholes Act” (H.R. 4213), a substitute amendment released by Senate Finance Committee Chairman Max Baucus. The legislation would provide a 2.2 percent update to physicians for the remainder of 2010 and a 1 percent increase in 2011 bill at a cost of $144 billion. The key difference in the health provisions of the House and Senate extenders legislation is that the Senate version includes a six-month extension through June 30, 2011 of the enhanced Federal Medicaid Assistance Percentages (FMAP) rate. Senate Republicans introduced an alternative package that reduces the deficit by $55 billion. The amendment extends the “doc fix” an additional year and provides a 2 percent increase in reimbursement levels for 2010, and additional 2 percent increases in both 2011 and 2012.  Other potential amendments filed include an extension of COBRA benefits for unemployed worker health insurance, and adjustments to the 340B inpatient discount program.

The Administration continues to promote the effects of the new health care reform law across the country. President Obama hosted a town hall meeting to announce the mailing of $250 checks to assist seniors whose drug coverage found them in the “dount hole” causing high out-of-pocket costs for prescription drugs.

Chairman of the House Education and Labor Committee George Miller introduced the House’s version of a child nutrition reauthorization bill, the “Improving Nutrition for America’s Children Act.” The legislation would authorize the Department of Agriculture to set nutrition standards for all foods sold or served at schools, as well as raise reimbursement rates for schools that meet higher nutritional standards, and improved food safety requirements for schools meals programs. Additionally, it aims to improve program administration, support services and program access and modernize the WIC program by extending period of certification for children, increasing support for breastfeeding, and transitioning from paper food vouchers to an electronic benefit program. Chairman Miller stated that the legislation mirrors key investments proposed by President Obama and First Lady Michelle Obama in her “Let’s Move” initiative, including reducing childhood obesity and improving school wellness. The Senate version has already been considered by the Senate Agriculture Committee and awaits floor time.

This week, the Health Subcommittee and the Oversight Subcommittee of the House Ways and Means Committee will hold a joint hearing on reducing fraud, waste and abuse in Medicare on Tuesday, and the Health Subcommittee of the House Energy and Commerce Committee will hold a hearing titled “NIH in the 21st Century: The Director’s Perspective” also on Tuesday.

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Industry Pay Up

As congressional leaders continue to negotiate a health care reform bill, sectors of the health care industry are being asked to bring billions of dollars more to the table to pay for reform. For example, the pharmaceutical industry has been asked cough up an additional $10 billion to help pay for health care reform, specifically to help cover the cost of closing the “doughnut hole” in the Medicare prescription drug program.

This request of PhRMA comes on the heels of a Government Accountability Office (GAO) report released this week on brand-name prescription drug pricing. At the request of Sen. Charles Schumer (D-NY), GAO analyzed price increases for brand-name drugs between 2000 and 2008, including the frequency of price increases, the characteristics of the drugs, and the factors that contributed to the price increases. According to GAO, between 2000 and 2008, 416 brand-name drug products representing 321 drug brands had extraordinary price increases. These price increases ranged from 100 percent to 499 percent, but in a few cases were 1,000 percent or more. The price increases occurred in 20 therapeutic classes, but 52 percent were in the following three classes: central nervous system agents, anti-infective agents, and cardiovascular drugs.

A House Energy and Commerce Subcommittee on Health hearing examined recent reports of rapid price increases for brand-name prescription drugs. Chairman Henry Waxman (D-CA) expressed concern regarding the drug industry positioning its pricing to prepare for enactment of the health care reform bill, since it announced it will “give up” $80 billion in profits. Chairman Waxman was referring to the Senate Finance Committee and President Obama’s health reform deal with the pharmaceutical industry that agreed to a 50 percent discount on brand-name drugs for beneficiaries in the doughnut hole. The House health care reform bill does not contain the $80 billion agreement and Chairman Waxman has been a vocal critic of the deal.

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