Week in Washington: Health Legislation Takes Center Stage

Week in Washington is brought to you by Michael Cohen, PhD. Tune in each week to read the latest on healthcare policy and get a glimpse of what’s on the horizon.

Week in Washington: Health Legislation Takes Center Stage


Health Finance

There is a bipartisan bill (Sens. Grassley/Wyden) in the Senate Finance Committee that would change a number of things (you can read in detail here) but two things that bear watching is that the bill proposes to redesign Part D benefits (one main change includes shifting catastrophic coverage phase costs from members and Medicare to manufacturers and Part D plans). The bill would require rebates by manufacturers to Medicare if list prices for Part B and Part D drug costs exceed inflation (CPI-U). A layman’s summary of the bill, courtesy of the Washington Post, can be found here. The White House has expressed support for the bill although conservatives have expressed opposition. A good take on the downsides of the bill can be found here, written by Scott Gottlieb. 


There is a separate prescription drug bill in the House that will be released after Congress comes back from recess (early September). While the exact details are scarce one key component is the House version will include language giving CMS the authority to directly negotiate prices. This provision failed in the Senate. 

Surprise Billing

Surprise billing legislation (currently being considered in the health committee) has stalled. Senator Cassidy is leading a charge to make the bill more provider friendly.

The voting on the Senate bills may occur late in the night (before everyone goes on vacation) so the next blog will have a recap of the state of all legislation.

Executive Order on Drugs?

The Trump Administration is considering an executive order to tie drug prices in Part D to lower costs in other countries. It is also considering using price controls for Tricare and the Department of Affairs. Several reports indicated that the Administration is considering this action if Congress fails to act on prescription drugs (i.e., pass something). 

Stock Watch

Several insurance companies had a rough week on Wall Street as investors punished them for medical costs which rose faster than projected so far this year. 

Research You Can Use

  • High Spenders An analysis of persistently high spenders (over a three-year period). What do they spend, what conditions they have, and other useable bits of information.
  • Immigration Utilizer Trends: Changes in federal immigration policies have reduced immigrant families’ usage of health services. An Urban Institute study shows that nearly one in seven adults in immigrant families report that they or a family member did not participate in a noncash government benefit program in 2018 for fear of risking future green card status as the administration considered changing rules for “public charge” determinations.

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