As Congress Quickly Heads Toward Recess, Health-Related Legislation Gets Pushed to Fall

| Brittany McCullough
Gavel and stethoscope

Time has quickly run out for the Senate and the House of Representatives to consider health-related bills prior to the August Congressional recess. While Senate HELP Chairman Lamar Alexander (R-TN) was aiming for a floor vote for his committee’s bipartisan package to reduce healthcare costs in July, he will have to wait until the fall. In a joint statement with Ranking Member Patty Murray (D-WA), the pair noted that they will “continue to work during August and into September to move this legislation forward”.  

You may recall that the Senate HELP committee’s proposal, the Lower Health Care Costs Act, addressed a variety of different items like surprise medical bills, reducing prescription drug costs, and improving healthcare transparency. However, there was a difference of opinion as it relates to surprise medical bills, which likely contributed to the bill never making it to the floor. The House Energy and Commerce Committee added an amendment that included arbitration to their surprise billing measure. This came following pushback that the use of a benchmark rate, the median in-network rate within the local geographic area, heavily favored insurers. Arbitration has been championed by Senator Bill Cassidy (R-LA), one of two physicians on the Senate HELP committee, as a compromise that “gives patients security while having a level playing field for providers, hospitals and insurers.” However, the Senate dropped the arbitration mechanism from their original draft proposal which meant their version is no longer in agreement with the House’s bill.

Many provider groups support arbitration. URAC has also lent support to the model because it “takes into consideration all factors [associated with surprise billing] including payment and the appropriateness of both coding and the care delivered.” But, some have argued that arbitration would increase costs and exclusively favor providers. Senate HELP Chairman Alexander has been in conversation with Senator Cassidy in hopes of finding a compromise, but he hasn’t publicly indicated if he will include arbitration in whatever bill makes it to the Senate floor.

While the Senate HELP bill has shown a difference of opinion, I don’t expect it to cause as much controversy as Senate Finance Chairman Chuck Grassley’s (R-IA) recently introduced bipartisan proposal to reduce drug prices. Some Republicans have argued that the chairman’s plan is “too close to price controls for drugs” as it would cap price increases in Medicare Part D. Because of this, Senate Majority Leader Mitch McConnell (R-KY) may be wary to bring the bill to the floor due to the difference of opinion among his fellow Republicans.

On the House side of things, reports indicate that Democrats will release their drug pricing bill in September. This measure will reportedly include arbitration and give Medicare the power to directly negotiate prices in Part D. We’ll have to wait until the fall to see what exactly is in the bill and more importantly, if the White House will support it.

Brittany McCullough photo

Brittany McCullough, Health Policy Specialist.

Brittany McCullough, URAC's health policy specialist, focuses on tracking and analyzing legislation and regulations of importance to URAC stakeholders. She also helps manage URAC’s public policy external engagement. Most of her policy and research work has been related to the ACA, Medicaid managed care, Part D, telehealth and mental health parity. She holds a B.S. in Neuroscience and a Master of Health Administration.

Views, thoughts and opinions expressed in my articles belong solely to me, and not necessarily to my employer.

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