Axios Pro: Health Care Policy

January 17, 2024

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Happy Wednesday! With another CR teed up, health care dealmakers are shifting their focus to a prospective March government funding deal, aware that it could be the last chance to get legislation passed before the elections.

🚨 Situational awareness: The House's COVID Select Subcommittee is aiming for an early summer public hearing with former NIAID director Anthony Fauci, who sat this month for a two-day interview with lawmakers about the pandemic's origins and the government response.

1 big thing: Health care deal hopes shift to March

Illustration: Natalie Peeples/Axios

Now that the suspense around the Jan. 19 government funding deadline is easing, the focus for health care dealmakers is shifting to the new funding deadlines of March 1 and 8, Peter reports.

Why it matters: Assuming the CR passes this week, March could be the last chance for any significant health care provisions until the lame duck session.

  • That means lawmakers will be jockeying for everything from PBM reforms to price transparency to a narrow site neutral hospital payment overhaul.

What they're saying: House Energy and Commerce Chair Cathy McMorris Rodgers told Peter after a GOP conference meeting this morning that health care talks are occurring with the Senate, though there is no certain path forward yet.

  • The site neutral provision, which applies only to physician-administered drugs, was included in the House's health cost transparency bill but faces a rocky outlook in the Senate. The Senate Finance Committee has not formally considered the policy and hospitals strenuously oppose it.
  • As for site neutral chances in the Senate, Rodgers said: "We're in active negotiation, there's a lot of momentum, we're going to keep working it."

Between the lines: Senate HELP Chairman Bernie Sanders has also been championing significantly increased funding for community health centers, which could pose a stumbling block in negotiations with the House.

  • The CR unveiled over the weekend included another temporary funding extension for the health centers, until March 8. A longer-term extension could come then, if lawmakers can agree on how much.
  • Sanders's ambitious primary care bill with GOP Sen. Roger Marshall laid down a marker for a major funding increase, but that measure has long odds and still is not fully paid for.
  • "It's a great idea; it's a great concept: expanding primary care opportunities for people across America," Marshall told Axios last week when asked about the bill's prospects. "But it's tough up here to find any money right now."

The bottom line: Some PBM changes and price transparency measures could be easier to agree on, though the Senate would go farther regulating PBMs than the House-passed transparency bill does.

  • Doctors had also been pushing for relief this month from Medicare payment cuts that took effect at the start of the year. Now, it looks like that won't happen at least until March.
  • Any asks that don't make it in March might have to wait until a post-election session in December, when expiring Medicare telehealth flexibilities could help force action.

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