Week in Washington: Major Prescription Drug Plan Unveiled

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Week in Washington: Major Prescription Drug Plan Unveiled

Pelosi Plan

Today, House Speaker, Nancy Pelosi, unveiled a major change to prescription drugs. You can read a good summary here or the full plan here. The plan has three main components: 1) Instructs the Secretary of HHS to negotiate the price of drugs (authority limited to 250 drugs); 2) the bill would limit raising of list prices; and 3) restructure the part D benefit to include an out-of-pocket limit ($2,000 per year).  Part 2 and 3 of the proposal are similar to what is currently being considered in the Senate. The proposal would have implications for the private market. That said, Senate Leader Mitch McConnell stated today that Pelosi’s policy would not pass the Senate (i.e., it’s a very low probability that the bill would pass in the current form). 

Medicaid Block Grant

Big policy doings that I thought were worth flagging. The state of Tennessee today officially announced a Medicaid waiver to convert its Medicaid program into a block grant. If approved, the Federal government would provide a fixed dollar amount to the state, who would share in the savings if expenditures are below the fixed amount. Drugs are excluded from the block grant but otherwise

1 million of the 1.4 million TN beneficiaries would be under the block grant.

In case it helps frame things at a political level, this may work out like work requirements. This is a policy proposal attractive to conservative states that will have lots of legal challenges but may be approved by CMS and if so, then emulated by other conservative states.

You can read the Washington Post write up here.

You can read the full TN proposal here. 

Odds and Ends

  • Generics – A good piece on problems in the supply chain for generic drugs.
  • RWJ Market Participation Tracker- RWJ has an outstanding interactive county level map of ACA market participation. It includes data on-Exchange, off-Exchange, and by carrier type for 2015 to 2020. It’s best viewed on Chrome.
  • STLDI – There has been an increasing number of articles of unhappy consumers who had signed up for short-term duration plans. You can read one of them here.

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