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Capitol Checkup: Pharma influence peddling; ACA turns 8; senator's sly try

While many of the hundreds of thousands of Americans who marched in Washington and elsewhere around the U.S. on March 24 demanded lawmakers stop taking money from the National Rifle Association, or NRA, biopharmaceutical lobbyists ranked higher than the gun lobbying group in a new national survey as holding the most influence on Capitol Hill.

In a new poll from the nonpartisan, nonprofit Kaiser Family Foundation, 72% of responders said drug manufacturers held the most sway over lawmakers, versus 52% for the NRA.

Only large businesses ranked higher than drug companies for having the most leverage in Washington, with 76% of those surveyed saying the former sector had too much influence.

The Kaiser analysts said the reason drugmakers ranked so high on the question about influence peddling in Washington was because a high number of Democrat and Republican responders shared that opinion — 65% and 74%, respectively.

Republicans were far less likely than Democrats to say NRA lobbyists held too much power in influencing legislation, 21% versus 73%, the poll showed.

A large majority of Americans said neither party was doing enough to bring down the costs of prescription medicines, with just over half saying that issue should be the top priority for the White House and Congress. They insisted the matter should rank above other priorities, like passing an infrastructure bill, ending the prescription opioid epidemic and repealing the Affordable Care Act.

Most of the public, or 80%, viewed U.S. prescription drug costs as unreasonable.

More responders trusted the Democrats to lower drug expenses than than Republicans 44% compared with 30% while 21% responded "neither" when asked which party they had the most faith in for bringing down the costs of their medicines.

In addition, 77% said President Donald Trump and his administration were doing an inadequate job on the matter.

The public also had less confidence the administration would deliver on Trump's promises to lower drug costs — with only 39% saying they expected a positive outcome on the issue. An even smaller share of those surveyed — 28% — said they were convinced the administration would end the opioid epidemic as Trump has repeatedly vowed to do.

ACA marks 8 years as law

The ACA, which significantly increased the number of Americans with healthcare coverage, marked its eighth birthday on March 23, though few seemed to be celebrating.

Instead, many on Capitol Hill raised concerns about the potential for premium hikes in the wake of lawmakers being unable to reach an agreement on legislation to stabilize the ACA's individual marketplace.

Republican Sens. Lamar Alexander of Tennessee and Susan Collins of Maine had tried, but failed, to get a measure into the $1.3 trillion omnibus spending bill that would have temporarily restored the ACA's cost-sharing reduction subsidies — funds Trump ended in October 2017 — and provided $10 billion per year over three years in federal reinsurance.

But Democrats refused to support the provision because Alexander and Collins added the so-called Hyde Amendment language, which would have prohibited any insurance policy sold on the ACA marketplaces from covering abortions.

Sen. Patty Murray, D-Wash., said Republicans surprised Democrats with the provision, which was based on legislation she had authored with Alexander — a bill that had bipartisan support and did not include the Hyde language.

But the Washington lawmaker vowed to keep working out a deal with Alexander and Collins.

"We are frustratingly close to an agreement," Murray said on March 22 on the Senate floor.

Few Democrats acknowledged the ACA's eighth anniversary, and those who did focused mostly on the Republicans' and the Trump administration's efforts to dismantle the law.

"Americans are getting a raw deal from a [Republican] Congress and administration obsessed with raising their costs and attacking their healthcare," House Minority Leader Nancy Pelosi, D-Calif., stated.

But the ACA remained strong with Americans overall, with half of those surveyed in the Kaiser poll holding a favorable view of the law, though that was down slightly from the foundation's February survey, when favorability reached an all-time high of 54% overall.

About 43%, however, said they disliked the 2010 law, the March 23 poll showed.

The majority of the Republicans surveyed — 64% — said repealing and replacing the law should remain the party's focus.

About 46% of Democrats, however, said their party should focus on fixing the ACA, while 48% said they should concentrate on passing a national health plan, such as Medicare-for-all, like a proposal from Sen. Bernie Sanders, I-Vt.

The poll found that nearly 60% of Americans favored a national health plan, with that number rising to 75% when they were asked if such a plan was made optional, allowing people to keep their current form of coverage — a concept backed by Sen. Elizabeth Warren, D-Mass.

Senator's late-night right-to-try attempt

Just before the Senate adjourned for its spring recess on March 23, Sen. Ron Johnson, R-Wis., made a stealthy middle-of-the-night attempt to get his chamber to adopt by unanimous consent the House-passed bill to give critically ill patients greater access to experimental drugs beyond the U.S. Food and Drug Administration's current compassionate-use process.

But Senate Minority Leader Chuck Schumer, D-N.Y., quickly objected to the move, shutting the vote down on the so-called right-to-try legislation.

The bill passed the House on March 21 in a 267-149 vote, with 35 Democrats joining 232 Republicans to pass the measure.

Schumer, however, was unwilling to let the measure be voted on in the Senate before the chamber had had a chance to scrutinize the legislation.

"I'm very sympathetic to the goals that my colleagues are trying to accomplish," he said on the Senate floor, adding that he was dedicated to working out a compromise.

"But the key is we need to ensure there are safety mechanisms in place when we do this," Schumer said. "A significant part of that is making sure the FDA is part of the process."

He noted the FDA already has a compassionate-use program, also known as expanded access, and argued the agency needs to ensure "that we're not increasing the risk of patient harm or endangering clinical trials so that lifesaving drugs can continue to be developed and people have access to them."

Schumer tried to assure Johnson and the other right-to-try supporters in the Senate that he would work to "get something done and done quickly because this is an important, important issue."

"People that have terminal illnesses deserve every opportunity and chance at survival," he said.

It is unclear, however, when the Senate may take up the measure, and Johnson was not willing to wait, insisting the right-to-try legislation needed to be enacted as soon as possible.

The Wisconsin senator called on the House to immediately consider, once it returns from its spring break on April 5, a bill he authored that was adopted in the Senate by unanimous consent in August 2017. He said he was disappointed the House did not initially take up his version of the legislation and had instead opted to pass its own measure — a move that added another step to the process with an unknown outcome.

"Don't wait another hour," Johnson said on the Senate floor. "It is well past time to give these terminally patients and their families the right to try, the right to hope."

Opponents of the bill have argued the legislation provides false hope because there are no assurances biopharmaceutical makers will provide access to their experimental drugs under the measure and that even if they did, there are no guarantees the products would work.

They said the legislation was designed simply to weaken the FDA and that the experimental treatments could end up doing more harm than good.