
Illustration: Natalie Peeples/Axios
The House has a stronger hand to play in upcoming negotiations with the Senate over health price transparency after a big, bipartisan majority endorsed the chamber's package of reforms Monday night.
- But hospital opposition still poses a major hurdle.
Why it matters: The 320-71 vote saw an unusually broad coalition of lawmakers including Lauren Boebert, Matt Gaetz, Alexandria Ocasio-Cortez and Nancy Pelosi align in favor of the bill.
- But there was also some noteworthy opposition from other members. They cited hospital opposition to the way the bill would keep health systems from billing Medicare at a higher rate than independent physicians for certain services.
Between the lines: Pete Aguilar, a member of House Democratic leadership, voted no, breaking from the top two leaders, Hakeem Jeffries and Katherine Clark, who both supported the package.
- Aguilar cited concerns from "local hospitals" when Axios asked him after the vote why he opposed the measure.
- Ways and Means Ranking Member Richard Neal also voted no and has pointed to concerns from hospitals in the past.
What they're saying: "Hopefully it'll give us some leverage with the Senate, for the Senate to say there's something that we can actually get done, because the House was able to do it in a bipartisan way," Rep. Brett Guthrie said after the vote. "I'm gonna reach out to Bill Cassidy this week, and see how we can work together."
- He did note the hospital opposition, though. "There were a couple of people that voted 'no' that I was talking to on the floor, and their hospitals had contacted them, and were concerned about some provisions," he added.
What we're watching: The so-called site-neutral provision, which is modest in scope and applies only to physician-administered drugs, is what is drawing concern and will be something to watch as the House and Senate hash out their differences.
- The Senate has been farther behind on site-neutral policies, but the big vote from the House certainly gives backers across the Capitol some needed momentum.
- The House has a more modest increase in funding for community health centers, compared to the ambitious package in the Senate from Bernie Sanders and Roger Marshall.
- The House has new reporting provisions for PBMs. Senate committees have advanced some even wider-ranging PBM measures.
- The core of the House bill also drew widespread support: codifying and strengthening Trump-era rules that would make hospitals disclose the rates they negotiate with insurers.
Victoria Knight contributed reporting.
