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On the Hill: Republican Infrastructure Counteroffer; Rx Drug Pricing Bills

In hopes of reaching a bipartisan compromise, a group of Senate Republicans last week released a $568 billion infrastructure framework to kickstart negotiations with Democrats.

The group, led by Sen. Shelley Moore Capito (R-WV), proposes to direct funding toward physical infrastructure improvements, such as roads and public transit, and expansion of broadband technology. The Republican proposal does not reauthorize the Hill-Burton Act for hospital construction, which was included in Democrats’ Leading Infrastructure For Tomorrow’s America Act (H.R. 1848), introduced last month.

Some Democrats welcomed the Republican proposal as a starting point, but others immediately dismissed it as insufficient compared with Biden’s $2 trillion American Jobs Plan.

Meanwhile, Democrats recently reiterated their support for including health care policies as “human infrastructure,” raising the likelihood that some health care priorities will be included in overall infrastructure legislation. President Joe Biden on Wednesday will address Congress for the first time and discuss his American Families Plan, a proposal expected to include such “human infrastructure” policies on education, paid family leave, child care, and other topics. However, reports indicate Democratic health care priorities, like lowering prescription drug prices and expanding health care coverage through Medicare, might not be part of the president’s proposal.

Rx Drug Pricing Bills Reintroduced

House Democrats and Republicans last week reintroduced their respective prescription drug pricing bills.

Republican leaders of the House committees on Energy and Commerce, Ways and Means, and Education and Labor introduced the Lower Costs, More Cures Act (H.R. 19). This legislation is nearly identical to the Republican bicameral prescription drug pricing legislation from last Congress that was released as a counterweight to House Democrats’ legislation to lower drug pricing.

A day later, Democratic chairs of the same three committees reintroduced the Elijah E. Cummings Lower Drug Costs Now Act (H.R. 3). The marquee policy in this bill would gradually open the door for Medicare to negotiate prescription drug prices, which estimates indicate could save the federal government $450 billion. Of note, the new legislation would not require Medicaid managed care plans to reimburse providers at actual acquisition cost for outpatient drugs — a policy that, if implemented, would negatively impact covered entities in the 340B Drug Pricing Program.

Finance Votes on Health Nominees

The Senate Committee on Finance voted 20–8 to advance the nomination of Andrea Joan Palm as deputy secretary of health and human services (HHS). Her nomination is now eligible for a confirmation vote on the Senate floor.

Separately, a vote to advance the nomination of Chiquita Brooks-LaSure as administrator of the Centers for Medicare & Medicaid Services (CMS) resulted in a 14–14 tie. All committee Republicans voted against her nomination in protest of a recent CMS decision to rescind Texas’ Medicaid waiver, raising concerns about how the Biden administration will work with states on Medicaid priorities.

Despite this setback, Brooks-LaSure’s nomination is not expected to be in jeopardy, just delayed by additional procedural hurdles. Under the Senate’s current power-sharing agreement, Senate Majority Leader Chuck Schumer (D) may issue a discharge petition in a tied committee vote to move the nominee forward. Schumer used this process to approve HHS Secretary Xavier Becerra’s nomination and is expected to do the same for Brooks-LaSure. Her nomination could be approved with the support of all 50 Senate Democrats and Vice President Kamala Harris providing the tie-breaking vote.

Hearings on COVID-19 Long-Haulers, Behavioral Health

The House Committee on Energy and Commerce Subcommittee on Health will hold an April 28 hearing on the long-term effects of COVID-19. One panelist, Steven Deeks, MD, is a faculty member at association member Zuckerberg San Francisco General Hospital and Trauma Center.

The Senate Committee on Health, Education, Labor, and Pensions will meet April 28 to discuss COVID-19 in relation to behavioral health and substance use disorders.

The House Committee on Ways and Means Subcommittee on Health will hold an April 28 hearing on telehealth.

The House Committee on the Judiciary Subcommittee on Antitrust, Commercial, and Administrative Law will hold an April 29 hearing on anticompetitive activity in health care.

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About the Author

Nikki Hurt is a manager of legislative affairs at America's Essential Hospitals.

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