The Weekly Hill Update

Below is the Federal Policy team’s weekly preview, posted when Congress is in session.

HEADLINES

• Congress returns from Thanksgiving break with a full agenda, including working toward a funding bill to keep the government open beyond Dec. 20.

• The House’s impeachment inquiry into President Trump enters a new phase as public hearings move to the Judiciary Committee.

• Trump begins his week traveling to London for a meeting of NATO heads of state.

HOUSE

  • The House is in session Tuesday through Friday. The floor agenda is highlighted by bipartisan legislation targeting robocalls.
  • The Judiciary Committee on Wednesday will hold its first public hearing on impeachment.
  • The House Oversight Economic and Consumer Policy Subcommittee on Wednesday will hold a hearing on the regulation of vaping and flavored tobacco products.
  • The full list of this week’s House committee activity can be found here.

SENATE

  • The Senate will continue voting on Trump’s nominees, including Dan Brouillette to be Energy Secretary.
  • The Senate Commerce Committee on Wednesday will hold a hearing on consumer data privacy.
  • The Senate Banking Committee on Thursday will hold a hearing on financial regulatory oversight with witnesses from the Federal Reserve, Federal Deposit Insurance Corporation and National Credit Union Administration.
  • The current list of Senate committee activity can be found here.

WHITE HOUSE

  • President Trump is on his way to London, where he will meet with NATO leaders through Wednesday.
  • Trump’s schedule includes meetings with the leaders of France, Germany, the United Kingdom, Italy and Poland.
  • Trump on Thursday will participate in the 97th annual National Christmas Tree Lighting outside the White House.

Capitol Hill Healthcare Update

HEALTH PROVISIONS FACE UNCERTAINTY AS CONGRESS RETURNS FOR BUSY DECEMBER

Congress returns to Washington this week after the Thanksgiving holiday with only 18 days before the government runs out of money – and that’s not even the most important issue lawmakers will face in what is shaping up as a cramped year-end calendar.

In addition to scrambling to fund the government, the Democrat-controlled House is likely to vote this month to impeach President Donald Trump.

With lawmakers pushing other key items, such as tax provisions, renewing Pentagon programs and the U.S. trade agreement with Mexico and Canada, what’s the likelihood that healthcare provisions will see congressional action?

House leaders say they will schedule a vote in the coming weeks on legislation that addresses prescription drug prices. Among other things, it would require pharmaceutical manufacturers to negotiate prices with the government on 250 drugs; it also would apply those negotiated prices to private health plans nationwide.

It will likely be a party line vote, with few if any Republicans supporting the House bill. Continue Reading

Capitol Hill Healthcare Update

FDA NOMINATION HEARING DRIVES THE WEEK IN HEALTH POLICY

President Trump’s nominee to lead the Food and Drug Administration, Dr. Stephen Hahn, will appear Wednesday before the Senate Health, Education, Labor and Pensions Committee for a hearing on his nomination.

Hahn, an oncologist and chief medical executive at MD Anderson Cancer Center in Houston, is seen by lawmakers as a blank slate – he has a strong resume as a physician but scant policy experience. However, HELP Chairman Lamar Alexander, R-Tenn., announced he supports Hahn after meeting with the nominee Nov. 6. Meanwhile, Democrats are eager to replace current acting FDA Commissioner Brett Giroir because of concerns over his positions on social issues like abortion.

Still, Hahn is sure to face wide-ranging questions from lawmakers about the mission of the agency he hopes to lead. Senators are also likely to seek commitments from him to focus on certain policy issues.

Given Hahn’s lack of policy track record, senators will want details of his views on regulation of food, drugs and medical devices. Hahn can expect lawmakers to press him on ways the FDA can help to lower prescription drug costs while protecting medical innovation, including Trump’s efforts to allow drug importation. E-cigarettes will be a hot topic, as will cannabis regulation and efforts to stem opioid abuse.

PRESSURE FROM WHITE HOUSE ON DRUG PRICING

Despite bipartisan and bicameral interest, legislation to address prescription drug costs has faced continued delays as lawmakers await budget estimates and struggle with disagreements on policy specifics. President Donald Trump and his deputies are continuing to press the Hill for action.

According to reports from the Associated Press, Trump’s top domestic policy advisor, Joe Grogan, said recently the administration is continuing to press senators to support bipartisan legislation passed by the Finance Committee that would cap seniors’ out-of-pocket costs and require rebates from drugmakers if prices increase faster than inflation. But Grogan also acknowledged the “current complications” including policy disagreements – as well as impeachment consuming the political environment.

Health and Human Services Secretary Alex Azar and other officials have held multiple meetings with Republican lawmakers across the Hill to try to drive support for the Senate bill.

Yet broad legislation on the issue remains a long shot to reach Trump’s desk. Though Trump previously voiced support for direct government negotiation on drug prices, the administration does not support House Democrats’ bill to implement negotiation, currently scheduled for a vote next month.

The White House views Christmas as an effective deadline on getting drug pricing legislation done because the Senate could be consumed by impeachment considerations in January and even into February. Yet December’s legislative calendar will also be crowded by must-pass items, as lawmakers are set this week to pass a short-term government funding extension to Dec. 20.

Despite the administration’s pressure, most stakeholders are skeptical that lawmakers will be able to thread a needle this year with broad drug pricing legislation that can pass the Republican Senate and Democratic House. Continue Reading

The Weekly Hill Update

Washington D.C. The capitol, the seat of the government of the United States.Below is the Federal Policy team’s weekly preview, posted when Congress is in session.

HEADLINES

• The House plans to take up a short-term spending bill to fund the government until Dec. 20.

• President Donald Trump on Wednesday will visit an Apple manufacturing plant in Texas, as House Democrats continue their impeachment inquiry.

• Ten Democrats seeking the nomination to challenge Trump will participate in their fifth debate on Wednesday, in Atlanta.

HOUSE

  • The House is in session tonight through Thursday. Lawmakers will take up a short-term spending bill, as well as a reauthorization of the Terrorism Risk Insurance Act, and legislation aiming to prevent workplace violence in the healthcare and social services industries.
  • The House Financial Services Committee will hold a hearing on the role of big data in financial services.
  • The Energy and Commerce Environment Subcommittee on Wednesday will hold a hearing titled “Building a 100 Percent Clean Economy: The Challenges Facing Frontline Communities.”
  • The full list of this week’s House committee activity can be found here.

SENATE

  • The Senate will continue votes on Trump’s nominees and also plans to process a short-term funding bill.
  • Dr. Stephen Hahn will testify Wednesday before the Senate Health, Education, Labor and Pensions Committee for a hearing on his nomination to be the Food and Drug Administration commissioner.
  • The Senate Finance Committee will hold a hearing Wednesday on Alzheimer’s awareness.
  • The current list of Senate committee activity can be found here.

WHITE HOUSE

  • Trump will meet with his Cabinet tomorrow.
  • Wednesday he will visit Apple’s manufacturing plant in Austin, Texas, with Apple CEO Tim Cook.
  • On Thursday, Trump will present national medals of arts and humanities, including to musician Alison Krauss, actor Jon Voight and author James Patterson.

Capitol Hill Healthcare Update

COMPREHENSIVE DRUG BILL STALLS WHILE HOUSE PUSHES SMALLER MEASURES

House Democrats are planning to take up more narrow bills addressing prescription drug costs while their broad legislation is delayed as the Congressional Budget Office (CBO) works on estimating its budgetary impacts.

Majority Leader Steny Hoyer, D-Md., said the Democrats’ bill now won’t receive a floor vote until December – with some House staff fretting the vote could slip to January as leaders wait for CBO forecasts ahead of tough negotiations with moderate and liberal lawmakers.

CBO last month estimated the bill would save Medicare $345 billion over seven years by forcing manufacturers to negotiate prices with the government on 250 drugs and to apply those discounts to private health plans nationwide. Democrats want to redirect those savings to expand Medicare coverage for dentalvision and hearing services, leading to a delay as CBO figures out how much that would cost.

House Republicans remain unified against the Democrats’ bill, saying it would harm medical innovation. CBO has reported the legislation would cut pharmaceutical industry revenue by as much as $1 trillion over a decade, stifling research and development and ultimately leading to as many as 15 fewer new drugs being approved.

On the other side of the Capitol, broad drug pricing legislation from Senate Finance Committee Chairman Chuck Grassley, R-Iowa, remains stalled, too. The White House last week tried to pump up Grassley’s bill as the only viable legislation that could win bipartisan support. The administration also criticized the House bill as unworkable.

The White House views Christmas as an effective deadline on getting drug pricing legislation done because the Senate could be consumed by impeachment considerations in January and even into February. The administration sees the Senate as the only real opportunity for achieving bipartisan legislation.

Still, there remains pessimism among key stakeholders that a deal can be struck given broad disagreement on policy and the impeachment overhang.

In the meantime, the House Energy and Commerce Health Subcommittee this week plans to vote on a narrower bill that seeks to prevent abuses of the Food and Drug Administration’s citizen petition process, which lawmakers believe may delay the availability of cheaper generic drugs.

Meanwhile, senators are trying to push through smaller-scale bills, too. Sen. John Cornyn, R-Texas, has worked for months on a bill that would curb alleged anticompetitive practices by manufacturers. Last week, Cornyn unsuccessfully sought unanimous consent to pass the legislation, but said he will try again this week. Sen. Richard Durbin, D-Ill., is similarly seeking unanimous consent on his bill, which would require drug prices to be included in advertisements. Continue Reading

The Weekly Hill Update

Washington D.C. The capitol, the seat of the government of the United States.Below is the Federal Policy team’s weekly preview, posted when Congress is in session.

HEADLINES

• The House will vote on a bipartisan bill to sanction Turkey, and is proceeding with its impeachment inquiry after a week of tense moments and explosive testimony.

• President Donald Trump is making his first trip to Chicago as president.

• The Senate plans to take up a package of four appropriations bills.

HOUSE

  • The House is in session tonight through Thursday. The agenda focuses on legislation to sanction Turkey.
  • The House Financial Services Committee Tuesday will mark up legislation to reauthorize the Ex-Im Bank, as well as a reauthorization of the Terrorism Risk Insurance Act.
  • The Energy and Commerce Committee on Wednesday will hold a hearing on safeguarding the pharmaceutical supply chain, focused on ingredients from China.
  • The full list of this week’s House committee activity can be found here.

SENATE

  • The Senate plans to continue votes on appropriations legislation.
  • The Senate Homeland Security Committee will hold a hearing Thursday on supply chain security and 5G.
  • The Senate Judiciary Committee on Wednesday will hold a hearing on patent quality.
  • The current list of Senate committee activity can be found here.

WHITE HOUSE

  • Trump is in Chicago for his first visit as president, speaking at the International Association of Chiefs of Police. Later today he will host Halloween at the White House.
  • Trump on Wednesday will have lunch with Vice President Pence and will award the Medal of Honor to Master Sgt. Matthew Williams for his service during Operation Enduring Freedom.
  • Trump on Friday will travel to Mississippi for a rally in Tupelo.

Capitol Hill Healthcare Update

DEMOCRATS PRESS FOR PRE-THANKSGIVING VOTE ON DRUG PRICING BILL

The House Ways and Means Committee last week approved an amended version of legislation that would overhaul how Medicare and private insurers reimburse for prescription drugs, setting up what Democrats hope will be a pre-Thanksgiving vote on the House floor.

It was the third House committee to vote on the bill, which would direct the government to negotiate prices with manufacturers on several dozen high-cost drugs, saving an estimated $345 billion over 10 years. The committee separately approved three bills that would expand Medicare coverage to include dental, vision and hearing services, and those provisions are expected to be attached to the drug pricing bill.

Republicans criticized Democrats on the substance of the legislation, saying it would harm innovation and delay new treatments. They also rebuked Democrats on process, accusing Speaker Nancy Pelosi, D-Calif., of drafting the bill behind closed doors and without bipartisan input. Still, GOP lawmakers have little ability to stop it in the House, although industry advocates are lobbying to ensure that few if any Republicans vote for the bill.

That means Pelosi will need to craft final legislation that balances the interests of moderate Democrats who want to address drug prices, but are worried about government overreach, with those of progressive lawmakers who want to target the pharmaceutical industry with more adverse provisions.

Liberals including Reps. Lloyd Doggett, D-Texas; Pramila Jayapal, D-Wash.; and Mark Pocan, D-Wis. want more prescription drugs to be eligible for government negotiation, and they want people without insurance to be able to purchase medicine at that government-negotiated price. Jayapal also is pressing Democratic leaders to accept her amendment that would study whether pharmaceutical manufacturers should pay rebates to employer-sponsored health plans for drugs whose prices rise above inflation.

While House leaders work to schedule a vote for next month, the Senate remains stalled on its drug pricing bill. Senate Finance Committee Chairman Chuck Grassley, R-Iowa, has so far been unable to coalesce Republicans around his legislation, which aims to lower list prices and reduce beneficiaries’ premiums and out-of-pocket costs but also impose limits on manufacturers’ annual price increases.

Prospects for congressional approval of comprehensive drug pricing legislation remain dim. Lawmakers are focused on approving a stopgap budget bill next month to prevent a government shutdown, and an increasingly likely House vote to impeach President Donald Trump is expected to make cooperation on substantive year-end legislating even more difficult for Republicans and Democrats on Capitol Hill. Continue Reading

The Weekly Hill Update

Washington D.C. The capitol, the seat of the government of the United States.Below is the Federal Policy team’s weekly preview, posted when Congress is in session.

HEADLINES

• Tension remains high between Capitol Hill and the White House, as the House marches forward in its impeachment inquiry and lawmakers take action to address President Donald Trump’s pullback of U.S. troops from the Turkey-Syria border and Turkey’s incursion into Syria.

• Vice President Mike Pence will deliver a major speech in Washington on Thursday on U.S. policy toward China.

• The House canceled votes Thursday to allow lawmakers to attend services for the late Rep. Elijah Cummings, D-Md., who died late last week.

HOUSE

  • The House is in session tonight through Wednesday. The agenda focuses on legislation aimed at preventing foreign interference in U.S. elections, and may also include sanctions against Turkey.
  • The Ways and Means Committee on Tuesday will take up Democrats’ legislation addressing prescription drug costs, along with bills to expand Medicare to include dental, vision and hearing coverage.
  • Facebook CEO Mark Zuckerberg will testify Wednesday before the House Financial Services Committee regarding Facebook’s impact on the financial services and housing sectors.
  • Cummings will lie in state on Thursday.
  • The full list of this week’s House committee activity can be found here.

SENATE

  • The Senate plans to vote on several appropriations bills as well as the nomination of Andrew Bremberg to be ambassador to the United Nations.
  • The Senate Foreign Relations Committee will hold a hearing Tuesday on Turkey’s military offensive in northern Syria.
  • The Senate Energy and Natural Resources Committee will hold a hearing Tuesday on energy efficiency.
  • The current list of Senate committee activity can be found here.

WHITE HOUSE

  • Trump today will hold a Cabinet meeting and have lunch with Vice President Mike Pence.
  • Later in the week, he will speak at a Pittsburgh conference on shale energy and at a forum on criminal justice in Columbia, South Carolina.
  • Pence will deliver a speech Thursday on China policy at the Wilson Center in Washington.

Capitol Hill Healthcare Update

HOUSE DEMOCRATS PRESS FORWARD ON DRUG PRICING LEGISLATION

Returning from a two-week recess, House Democrats are entering a key phase in their drive to overhaul prescription drug costs, including requiring the government to negotiate prices with manufacturers.

House Majority Leader Steny Hoyer, D-Md., last week said a vote by the end of the month on a drug pricing bill is possible. But that timeline is likely to slip as four committees will have to vote on portions of the bill before Democratic leaders can meld a final draft.

Lawmakers late last week received a preliminary economic analysis from the Congressional Budget Office (CBO), finding that their legislation would lower government spending by $354 billion over seven years, primarily due to the provision on government negotiation. But the CBO report also warned the legislation would reduce manufacturers’ investment in research, leading to 15 fewer new drugs being marketed.

House Republicans immediately howled about both the legislative process and the bill’s projected impact on innovation. But because of House rules, which hand the majority party near-total control of the legislative process, GOP lawmakers have few tools to slow down or shape the final bill.

Last month, subcommittees for the Energy and Commerce Committee and Education and Labor Committee held hearings on the bill, and the panels could vote on the bill as soon as this week. The Ways and Means Committee is holding a hearing Thursday on the legislation.

Despite the action in the House, forwarding drug pricing legislation to the White House for President Donald Trump’s signature remains a long shot. Liberal lawmakers in the House are pressuring Speaker Nancy Pelosi, D-Calif., that the bill doesn’t go far enough to bring down drug prices, but the opposite political dynamic is in play in the Senate.

Rank-and-file Republican senators remain concerned that legislation approved in July by the Senate Finance Committee would harm innovation and give government too big a hand in drug development. Senate Republicans lack unity to bring that legislation to the floor for a vote. Moreover, the House and Senate bills take such radically different approaches that reconciling them would be a difficult task.

Trump had been expected to cajole Senate Republicans into acting this month on drug pricing legislation, but that was before the House’s impeachment inquiry became more energized. Now it’s not clear that Trump would put pressure on senators to act on legislation that currently divides the GOP when he may soon need their votes to block his impeachment.

Finance Committee Chairman Chuck Grassley, R-Iowa, said his bill is key to Republicans maintaining their Senate majority – but he also acknowledged a vote on drug pricing legislation likely won’t come before 2020.

The most likely scenario for drug pricing legislation remains that discrete provisions – such as ensuring generics have access to brand drugs, even those under safety protocols; or addressing “pay for delay” agreements between brand and generic manufacturers – are added to year-end budget legislation, which will likely include a series of extensions for expiring federal healthcare programs.

HOMELAND SECURITY COMMITTEE REVIEWING BIOTERRORISM PREPARATION

A House Homeland subcommittee will hold a hearing Thursday on bioterrorism defense and preparation.

Witnesses include Dr. Asha George, executive director of the Bipartisan Commission on Biodefense; Dr. Umair A. Shah, executive director of Public Health in Harris County, Texas; and Dr. Jennifer Rakeman, director of the Public Health Laboratory at the New York City Department of Health and Mental Hygiene.

At a June hearing on antimicrobial resistance, shortly after President Donald Trump signed the Pandemic and All-Hazards Preparedness and Advancing Innovation Act, Dr. George stated, “The nation is not prepared for biological outbreaks, bioterrorist attacks, biological warfare, or accidental releases with catastrophic consequences.”

AGING COMMITTEE FOCUSING ON FALLS PREVENTION

The Senate Aging Committee will hold a hearing Wednesday on efforts to reduce the incidence of senior citizens falling, which led to millions of emergency room visits last year.

The Senate last month approved a resolution from committee leaders Sens. Susan Collins, R-Maine, and Bob Casey, D-Pa., marking Sept. 23 as National Falls Prevention Awareness Day.

Collins and Casey said that in 2018, about 3 million older adults were treated in emergency rooms after falling. The senators requested information on falls prevention from the Food and Drug Administration, Centers for Medicare and Medicare Services, Housing and Urban Development Department, and the Veterans Affairs Department.

At the hearing, the committee plans to release its report on reducing the risk of falls and fall-related injuries.

The Weekly Hill Update

Washington D.C. The capitol, the seat of the government of the United States.Below is the Federal Policy team’s weekly preview, posted when Congress is in session.

HEADLINES

• Animosity is growing between the White House and Capitol Hill, as the House returns from recess and ramps up its impeachment inquiry and lawmakers from both parties blast President Trump’s decision to allow Turkey to invade Kurdish-controlled territory in northern Syria.

• Trump this week will host the president of Italy at the White House, then travel to Texas for campaign events.

• Democrats seeking the nomination to challenge Trump in 2020 will debate Tuesday outside Columbus, Ohio.

HOUSE

  • The House is in session tonight through Friday. The agenda focuses on legislation addressing SEC disclosure rules and on bipartisan legislation to support pro-democracy protestors in Hong Kong; the House also may take up a resolution opposing Trump’s actions in Syria.
  • The House Administration Committee is focusing on election security, including marking up a bill to stop foreign interference in U.S. elections.
  • The House Financial Services Committee Task Force on Artificial Intelligence will hold a hearing to evaluate how financial data is stored, protected, and maintained by cloud providers.
  • The full list of this week’s House committee activity can be found here.

SENATE

  • The Senate will continue to take up Trump’s judicial nominees as well as the nomination of Barbara McConnell Barrett as Secretary of the Air Force.
  • The Senate Foreign Relations Committee on Wednesday will hold a hearing on U.S. policy toward Iran.
  • The Senate Banking Committee will hold a hearing on the Consumer Financial Protection Bureau’s semi-annual report to Congress, with CFPB Director Kathleen Kraninger.
  • The current list of Senate committee activity can be found here.

WHITE HOUSE

  • President Trump today is hosting the Stanley Cup champion St. Louis Blues.
  • Tomorrow, he will host Italian President Sergio Mattarella for meetings.
  • Thursday, he will travel to Texas for a fundraiser and campaign rally in the Dallas-Fort Worth area.
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