Capitol Hill's often evasive and verbose environment was disrupted last week by some straight talk from a group of bipartisan House lawmakers, joined by a Republican and a Democratic governor.

Their message: The time has passed for bickering over repealing the Affordable Care Act, or ACA, and lawmakers must now put some workable solutions in place to rein in costs and make healthcare more accessible and affordable.

"Enough is enough. It is time to govern for the American people," said Rep. Tom Reed, R-N.Y., co-chair of the so-called Problem Solvers Caucus.

The 40-plus member group's five-point plan to repair rather than dismantle the ACA, unveiled July 31, was backed Sept. 8 by Govs. John Kasich, a Republican from Ohio, and John Hickenlooper, a Democrat from Colorado, who were in Washington pitching their own recently revealed, and somewhat similar, healthcare proposal.

"Get over all of your partisan fighting and your base groups and all this other nonsense. It's ruining the country," Kasich told members of Congress during a Sept. 8 Capitol Hill news conference.

"Democrats have to get over the notion that giving states flexibility with guardrails is somehow anti-good healthcare law," he said. "And what Republicans have to realize is you're going to have to spend some money so the whole darn thing doesn't come crashing down."

Both Kasich and Hickenlooper said they did not support the latest ACA repeal proposal from Republican Sens. Lindsey Graham of South Carolina and Bill Cassidy of Louisiana, who are expected to unveil the most recent iteration of their legislation Sept. 11 or soon thereafter.

While Graham and Cassidy are "proud of the fact that all vestiges of the ACA will be gone in a decade" under their bill, "I don't see the momentum," Hickenlooper told S&P Global Market Intelligence.

"I and most governors are not supportive of Graham-Cassidy," said Hickenlooper, who also testified a day earlier with a group of state chiefs before a Senate panel about ways to fix the current healthcare system.

But Reed told S&P Global Market Intelligence he was willing to back the "hard reforms" in the Graham-Cassidy legislation.

Reed noted that he voted in favor of the House ACA repeal bill that passed May 4 — legislation the nonpartisan Congressional Budget Office estimated would result in 23 million more Americans becoming uninsured if enacted.

He conceded, however, that he did not think it was feasible for a broad healthcare reform effort like Graham-Cassidy to make it through Congress in the current environment.

But allowing Medicare to negotiate prices of prescription drugs to bring down costs could be tackled, Reed said.

"This is an example where I think we can build consensus," Reed said. "If everyone agrees, which we do, that prescription drug prices are too high in America and continue to go up, that forms the common ground upon which we can find a solution."

While most lawmakers agree they want drugmakers to be able to innovate and do that work in the U.S., "it is frankly untenable to continue where we are now, and unfair," Rep. Elizabeth Esty, D-Conn., told S&P Global Market Intelligence.

If Medicare was permitted to negotiate on drug prices, costs would not only fall, but the U.S. government could put the savings toward other necessities, like upgrading the nation's infrastructure, Esty said.

Overall, lawmakers should be unified in a commitment to ensuring better health for Americans and access to affordable, quality care, she said.

"If those are the goals, then we should be open-minded in how to get there," she said. "But everybody's got to be willing to give up some of their prior positions."

At a separate forum later on Sept. 8 hosted by the think tanks the American Enterprise Institute and the Center for American Progress, Kasich said he thought lawmakers could get further in fixing healthcare if they stopped trying to label it.

"Call it a decent healthcare plan for Americans and drop all this Obamacare," he said.

Outspoken on opioids

There were also some frank discussions in Washington last week at the Research!America's Straight Talk 2017 National Health Research Forum about challenging issues impacting the medical community.

Top of the list for the high-ranking government officials, biopharmaceutical executives, patient advocates and academic leaders was the opioids crisis.

"We really need to prevent more people from becoming addicted," said Anne Schuchat, principal deputy director, at the Centers for Disease Control and Prevention.

"This is a catastrophe and we have to do more," Schuchat said.

Prescribers must "think twice before you start" patients on an opioid and "have a plan, follow-up actively" to get them off the drugs, she said.

To address the crisis, FDA Commissioner Scott Gottlieb said his agency plans to take actions to reduce overall exposure to opioids.

"So no more 30-day supplies for tooth extractions," Gottlieb said.

Former Rhode Island Democratic Rep. Patrick Kennedy, who is a member of the White House's commission on opioids, said the epidemic is not getting the attention it deserves.

What has been missing is the political will to say "enough of this," Kennedy said.

Kennedy noted that numerous reports, including one from his commission, have been produced on the topic.

The White House commission in July said the opioid epidemic had reached the point of needing an emergency declaration — an action President Donald Trump told reporters Aug. 10 he was making official.

But a month later, Trump has yet to make that action legal.

The White House said a legal review on the action was ongoing.

FDA chief upfront on science

At the Sept. 7 Research!America forum, Gottlieb was also upfront in acknowledging the FDA has some work to do in making sure its policies and review skills match the complexity of the science now being employed by some drugmakers, such as with gene therapies or clustered regularly interspaced short palindromic repeat, or CRISPR, genome editing technology.

He noted the FDA on Aug. 30 approved its first gene therapy — Novartis AG's Kymriah.

Gottlieb said the FDA needs to confront how it should adjust its approach when the primary complexity and uncertainty inherent in a new product is not just the clinical questions related to whether it works, but the features of its delivery platform or how it is being manufactured.

Over the coming months, the FDA chief plans to lay out the steps the agency will take to adapt its regulatory principles to the new challenges it faces in properly evaluating a different set of scientific opportunities.

He will provide more details on Sept. 11 about some of the steps the FDA will take, he said.

Gottlieb also plans to use a Sept. 29 speech at the National Press Club in Washington to address how the FDA will be approaching its broader role as a medical staff and the postmarket obligations that accompany the agency's stewardship over the evolving and full lifecycle of the products it is charged with regulating.

He also noted the FDA plans to soon unveil a new strategic policy roadmap.

NIH director eye-openers

While National Institutes of Health Director Francis Collins also spoke at the Sept. 7 forum, some of his more revealing and quirky eye-openers came during an interview a day earlier with billionaire David Rubenstein, co-founder and CEO of the global private equity investment company The Carlyle Group.

The longtime NIH chief, who served throughout the Obama administration, disclosed that he took a bus from Washington to New York for his first meeting with Trump on Jan. 11 before he took office and spent less than 30 minutes with him.

"I suspect I may have been the only person who rode the bus to an interview at Trump Tower," said Collins, who was asked in June to stay on under the current administration.

Collins also revealed that when he was a youngster in West Virginia, he met singer/writer Bob Dylan before either one of them were famous.

"He had a terrible voice and no social skills and I was quite sure he had no future at all," Collins said of the 18-year-old Dylan, who won the Nobel Prize in literature last year.

The NIH director, who oversaw the U.S. government's effort to sequence the human genome before becoming head of the agency in 2009, also spoke about his love for riding his Harley.

"It gives you a certain sense of enjoyment of life that's hard to come by in other ways," Collins said.

But the interview was not just about the fun stuff.

Collins addressed a number of serious topics during the interview, including the U.S. opioid crisis, which he said was the single greatest health challenge the nation was facing.

More Americans died last year of opioid overdoses than from car accidents, Collins said.