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Deal struck on surprise bills, medicine prices; House GOP to unveil drug plan


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Deal struck on surprise bills, medicine prices; House GOP to unveil drug plan

U.S. House and Senate health committee leaders said they have struck a deal to end surprise medical bills, lower drug prices, fund community health centers and increase the age from 18 to 21 to buy tobacco products.

Details of the agreement, however, remain unclear.

SNL ImageSens. Patty Murray and Lamar Alexander
Source: AP Photo

The lawmakers said the bipartisan legislation included a "new system of dispute resolution that includes arbitration" for settling surprise medical bills — unexpected high charges from hospitals, doctors and other providers not covered in a person's health plan, or out of network.

The bipartisan agreement is between Senate Health, Education, Labor and Pensions, or HELP, Committee Chairman Lamar Alexander, R-Tenn., and the leaders of the House Energy and Commerce Committee, Reps. Frank Pallone, D-N.J., and Greg Walden, R-Ore.

"I do not think it is possible to write a bill that has broader agreement than this among Senate and House Democrats and Republicans on Americans' number one financial concern: what they pay out of their own pockets for health care," Alexander said in a Dec. 8 statement.

However, Sen. Patty Murray, D-Wash., the Senate HELP ranking member, is waiting until the details are finalized before she signs on to the legislation, her spokeswoman Helen Hare said.

"Senator Murray believes the overall agreement takes important steps forward on a number of issues impacting patients and families and is working with some members of her caucus on concerns they still have," Hare told S&P Global Market Intelligence.

The Senate and House committees each had advanced legislation to their respective chambers over the summer aimed at stopping surprise medical bills and lowering drug prices, but negotiations have been ongoing since then to reconcile the differences among the measures and lawmakers' varying approaches.

The White House has been pressuring Capitol Hill to quickly come to an agreement on the legislation.

Sens. Bill Cassidy, R-La., Maggie Hassan, D-N.H., and Michael Bennet, D-Colo., had objected to the initial legislation's benchmark approach for resolving out-of-network payment disputes between providers and insurers.

They have favored a "baseball-style" arbitration process, meaning the insurer and the medical provider would each submit an offer and an independent dispute resolution entity certified by the federal government would decide which of those offers was more reasonable.

In a Dec. 8 statement, the three lawmakers praised the bipartisan agreement for "adding a simple arbitration safety valve to help providers and plans resolve these billing disputes."

SNL ImageSenate Majority Leader Mitch McConnell
Source: AP Photo

But the arbitration safety valve "isn't great policy, as it unnecessarily risks increased costs for consumers without any clear upside," Loren Adler, associate director of the USC-Brookings Schaeffer Initiative for Health Policy, tweeted Dec. 8. Nonetheless, with the right details, the legislation "can still be a clear improvement over the status quo," Adler said.

The committee leaders said they wanted a vote on their bipartisan legislation by the end of the year.

While Senate Majority Leader Mitch McConnell, R-Ky., praised the legislation's inclusion of the tobacco measure, which he co-sponsored in his chamber with Sen. Tim Kaine, D-Va., he did not commit to bringing the bill to the floor for a vote.

GOP drug pricing bill

It is unclear what drug pricing measures remain under the deal from the bills adopted by the House and Senate committees or if the panel leaders included any provisions from proposals by Speaker Nancy Pelosi, D-Calif., or Senate Finance Committee leaders, who recently revised their legislation.

The House Rules Committee is taking up Pelosi's bill Dec. 10, with a vote from the full chamber expected Dec. 12.

House Minority Leader Kevin McCarthy, R-Calif., said Republicans plan to soon unveil their own drug pricing bill, dubbed H.R. 19, to compete with Pelosi's legislation.

"Every element in it is bipartisan," McCarthy said Dec. 6 on CNBC.

SNL ImageHealthcare protesters in Washington
Source: AP Photo

He said H.R. 19 would include drug pricing measures already adopted by the House in H.R. 987, a package Republicans in the chamber largely objected to because it also included provisions that seek to shore up the Affordable Care Act — the 2010 law the party and the Trump administration have sought to dismantle through lawsuits and administrative and legislative actions.

Universal health hearing

Meanwhile, the House Energy and Commerce Health Subcommittee plans to hold a hearing on Dec. 10 to consider a number of Democratic single-payer and public option measures intended to move the U.S. to a universal healthcare system, including the Medicare for All Act of 2019 from Rep. Pramila Jayapal of Washington and Debbie Dingell of Michigan.

Jayapal noted it will be the fourth hearing on her bill, which was vetted earlier this year by the House Rules, Budget and Ways and Means Committees.