10.8.18 – 10.12.18 Health Wrap Up

Please find below a summary of the latest major health policy developments in Washington this week. Please let us know if you have any questions.

Scheduling note: the House and Senate are on recess until November 13th.  Unless activity warrants, we will send the next wrap up on November 16th.


Fiscal Year 2020 

On Tuesday, House Appropriations Committee Ranking Member Nita Lowey (D-NY) and House Budget Committee Ranking Member John Yarmuth (D-KY) sent a letter to OMB Director Mick Mulvaney opening the discussion for setting new budget caps for fiscal year 2020 and laying out demands for “a strong investment” in domestic programs.

An agreement on new discretionary limits must be met in order to avoid across-the-board cuts put into place by the Budget Control Act that would go into effect at the end of the current fiscal year. Without a deal, federal spending would be cut by $126 billion in FY20.

The last budget deal raised the caps by $296 billion over two years (FY18 and FY19).  If Congress can come to an agreement on a two-year deal to avert the sequester for FY20 and FY21, it would be the final one needed before the Budget Control Act expires in 2021.


On Wednesday, by a vote of 50 – 50 the Senate failed to pass a resolution authored by Sen. Baldwin (D-WI) that aimed to overturn the Administration’s expansion of short term health plans by using the Congressional Review Act.  Sen. Collins (R-ME) was the only Republican Senator to vote yes with all Democrats. After the vote Sen. Collins told reporters, “we have an affordability problem, but I don’t think the answer is to wipe out protections for people with pre-existing conditions.”

The Administration expanded the availability of short term health plans via a rule, which took effect on Oct. 2.  Under the rule, the plans, which do not have to comply with the Affordable Care Act or other consumer protections such as the Mental Health Parity and Addiction Equity Act, may provide coverage for less 12 months and be renewed for up to 36 months.  Before the rule went into effect, short term plans were limited in duration to 3 months.  While Democrats call such plans “junk health insurance,” most Republicans argue they bring down costs and make health insurance more affordable.

Democrats intentionally forced the vote on the resolution close to the election in order to put pressure on Sen. Heller (R-NV), who is among the most vulnerable Republican incumbents in the Senate up for re-election.


On Wednesday, Senate Finance Committee Chairman Charles Grassley of Iowa called upon the Federal Trade Commission to investigate the relation between hospitals and insurance companies to determine if their contracts are anti-competitive.  Grassley questioned whether the two parties are entering into “restrictive contracts deliberately designed to prevent consumers’ access to quality, lower cost care.”  Further, the letter questions whether consolidation in both the hospital and insurance market “magnifies” the potential for marketplace interference.  With the Department of Justice Antitrust Division currently in litigation with Atrium Health, Grassley’s move could place even greater scrutiny on hospital and insurance companies and increase pressure for greater transparency.


On Friday, news reports indicate that next week the Department of Health and Human Services will issue a proposed rule to require drug companies to transparently disclose the list price of their product in direct-to-consumer television commercials.  Originally floated as part of the President’s Prescription Drug Blueprint in May, the rule has been pending review at the White House since August.  The details of the proposal must address what drugs are covered or exempted, how visually and audibly clear the price is announced, and what list price would be used (based on various doses and various forms of drug administration), among other policy questions. Recently, the Senate included funding in the HHS appropriations bill for FDA and HHS to undertake the rulemaking, but the House successfully removed that funding in the final package.  HHS officials did not respond to media inquiries asking for elaboration on the proposal.

Katie Weyforth Vanlandingham

Van Scoyoc Associates

800 Maine Ave SW

Suite 800

Washington, DC  20024