Health-related earmarks are currently permitted only in the Senate. That could change this year, potentially creating new opportunities for essential hospitals to secure funding for local health projects through the Labor–HHS–Education appropriations bill. If House appropriators allow health earmarks in their next funding measure, millions of dollars could become available for congressionally directed spending on community priorities.
Drug Pricing Hearing
The House Committee on Energy and Commerce Subcommittee on Health held a Feb. 11 hearing focused on the prescription drug supply chain.
Republicans focused on structural problems in the supply chain, arguing that vertical integration, market concentration among PBMs, and opaque rebate and contracting practices distort competition and inflate costs. They emphasized increasing transparency across the supply chain, strengthening employer leverage, supporting independent and rural pharmacies, modernizing FDA processes to accelerate generics and biosimilars, and removing regulatory barriers that limit competition. Republicans repeatedly stressed preserving U.S. pharmaceutical innovation while lowering costs, expressing concern that policies included in the Inflation Reduction Act (IRA) and regulatory unpredictability could discourage investment. They framed PBM reform, competition, and supply chain transparency as key tools to reduce prices without undermining research and development.
Democrats centered their remarks on patient affordability and corporate accountability, arguing that high drug prices stem from systemic pricing strategies, excessive industry profits, and market concentration among PBMs and manufacturers. They defended the IRA’s Medicare negotiation and inflation rebate provisions, called for expanding affordability protections such as enhanced premium tax credits (EPTCs), and criticized reported lack of transparency in administration drug pricing agreements. Democrats also raised concerns about instability at NIH and FDA, warning that research cuts and regulatory interference threaten innovation and public trust. Throughout the hearing, they emphasized that affordability and innovation are not mutually exclusive and advocated building on existing price negotiation authorities to deliver meaningful consumer savings.
Pharmaceutical Research and Manufacturers of America (PhRMA) Chief Operating Officer Lori Reilly, Esq., testified that the 340B program has been exploited by PBMs, private equity firms, and some nonprofit hospitals, and urged the committee to examine the program more closely.
Essential Health System Designation Update
Reps. Lori Trahan (D-Mass.) and David Valadao (R-Calif.) have reintroduced the bipartisan Reinforcing Essential Health Systems for Communities Act (H.R. 7145), which provides a statutory definition for essential hospitals, and others serving a safety-net role in the country. They are joined by a growing bipartisan coalition of original cosponsors, including: Juan Ciscomani (R-Ariz.), Darren Soto (D-Fla.), Troy Carter (D-Lou.), Mark Veasey (D-Tex.), Brittany Pettersen (D-Col.), and Jennifer Kiggans (R-Va.). Access a one-pager on essential health system designation here.
We encourage member hospitals to continue urging their House members to cosponsor this legislation.
Committee Activity This Week
The House and Senate are on recess this week.
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