
Illustration: Brendan Lynch/Axios
So, the big health care package didn't come to pass. And it's not clear whether anything of that magnitude can happen in the new year.
Why it matters: Health industries will be watching to see whether PBM reforms, a hospital billing overhaul and drug patent changes can get enacted under the GOP trifecta.
Between the lines: The natural landing place for such policy changes would be the government funding package in March. And much of the script is already written, having been jettisoned only at the last minute from the year-end government funding deal.
- Community health center funding and telehealth flexibilities also are due to expire in March, adding incentives for a new legislative package.
- Eric Fejer, a spokesperson for incoming Senate Finance Chair Mike Crapo, said the senator "remains committed" to passing his health care priorities and that those include policies "that were not included in the most recent government funding package."
Yes, but: Broader congressional dynamics could again doom the health package, just as they did in December.
- Now that Republicans have full control, a partisan push on controversial policies like Medicaid cuts or rolling back the IRA drug pricing provisions could impede bipartisan cooperation on any health care issues.
- It's also not clear whether adding hundreds of pages of health provisions to another government funding extension could draw conservative blowback and sink the package the way it did in December.
- Still, many months of work went into those policies, particularly the PBM changes. The fact they got so close makes it unlikely they'll simply vanish from the radar.
What they're saying: Incoming House Energy and Commerce Chair Brett Guthrie told Axios before the break that he "absolutely" wanted to revisit the broader health care package in the new year.
- He even floated the idea of passing it as a standalone bill. "There's nothing saying that the health care bill has to be part of a big package," he said.
- Still, given the way Congress usually works and the limited floor time in the Senate, adding the measures to the government funding bill in March seems like the likeliest way to get it done.
What we're watching: Republicans also could try to take a bigger bite at some of these issues through the party-line reconciliation process.
- That process is not expected to focus on health care, though the need for payfors could push health system overhauls onto the scene at some point.
- Lawmakers have left the door open to Medicaid changes, for example.
