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On the Hill: DSH Deadline Looms, Drug Pricing Bill

To avoid a federal shutdown, the House this week will consider a stopgap funding measure — a continuing resolution (CR) — to finance government operations from the Oct. 1 start of fiscal year (FY) 2020 through Nov. 21.

The CR is necessary because lawmakers have struggled to pass spending bills to fund the federal government for FY 2020. The Senate has not passed a single spending bill and needs more time to complete the legislative process. The Senate Committee on Appropriations will meet this week to continue its work on the remaining spending bills.

The House already has approved 10 of the 12 federal spending bills and awaits action from the Senate before negotiations to reconcile their respective bills can begin.

Medicaid DSH Funding

Meanwhile, Congress likely will miss the Sept. 30 deadline to stop the scheduled $4 billion cut to Medicaid disproportionate share hospital (DSH) funding.

On Oct. 1, federal Medicaid DSH funding will fall by $4 billion without congressional action. The House Committee on Energy and Commerce has advanced a bipartisan legislative package that would repeal the DSH cuts scheduled for FYs 2020 and 2021 and lower the scheduled reduction in FY 2022 by half, to $4 billion, for a total of $16 billion in DSH relief. The full House must approve the legislative package before the Senate can consider it.

However, Senate leaders have not expressed support for the House proposal. Senate Committee on Finance Chair Chuck Grassley (R-IA) continues to develop his preferred approach for mitigating the Medicaid DSH funding cliff.

Congress will be in session for only eight legislative days before Sept. 30.

House Leadership Drug Pricing Proposal

House Speaker Nancy Pelosi (D-CA) soon will release a legislative proposal to target high prescription drug prices, according to recent media reports.

Pelosi’s proposal is expected to direct the Department of Health and Human Services (HHS) to negotiate the price Medicare will pay for 250 brand-name drugs that do not face competition from at least two generic, biosimilar, or biologic alternatives, among other provisions. Additionally, Pelosi’s plan is expected to target excessive prescription drug price increases. Under her proposal, drug makers would be required to either lower the price or pay a rebate to the federal government for price increases above the rate of inflation.

While President Trump has communicated his support for Medicare negotiation of prescription drug prices, Pelosi’s plan likely would face opposition from Senate Republicans.

Upcoming Congressional Hearings

The House Committee on Appropriations Subcommittee on the Departments of Labor, Health, and Human Services will hold a Sept. 18 oversight hearing on the mental health needs of children in HHS custody. Three HHS officials will testify.

Additionally, the House Committee on Energy and Commerce Subcommittee on Consumer Protection and Commerce will hold a Sept. 19 hearing on how pharmaceutical companies put profit over consumers.

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About the Author

Erin Delaney is the legislative affairs associate at America's Essential Hospitals.

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