A guide to today's health hearings on The Hill

Sep 19, 2023

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By Chelsea Cirruzzo and Ben Leonard

Presented by

With Robert King and Megan R. Wilson

Driving the day

An aide prepares documents for lawmakers in the House Energy and Commerce Committee hearing room.

An aide prepares documents for lawmakers in the House Energy and Commerce Committee hearing room. | Energy and Commerce Committee/Facebook | Energy and Commerce Committee/Facebook

A CAPITOL HILL LENS ON HEALTH CARE — Congress is holding several health care hearings today focused on lowering costs. No one likes paying more for health care so this is a layup for members but don't expect radical changes to the cost curve any time soon.

One hearing is expected to cover how the Medicare drug rebate program may not help beneficiaries enough to seek new therapies while another is set to highlight challenges in the implementation of a 2020 law that to prevent surprise medical bills.

Here’s a primer:

— House Ways and Means Committee on the No Surprises Act implementation

Since the No Surprises Act passed in 2020, court battles have stymied its implementation. Republicans on the Ways and Means Committee are critical of the administration’s rollout. Last year, then-committee Chair Kevin Brady (R-Texas) told HHS Secretary Xavier Becerra that delaying implementation and appealing lawsuits wastes resources and “flies directly in the face of the law that Congress passed.”

What to expect: The committee is likely to hear from insurers who want changes made to the backed up payment dispute process to better track progress and allow for appeals.

— Senate Finance Committee on access to home health care

With the home health sector expected to grow over the next 10 years, Medicare advocates and home health groups want access issues ironed out.

What to expect: Bill Dombi, president of the National Association for Home Care and Hospice, will ask Congress for legislation to restrict the Centers for Medicare and Medicaid Services from cutting funding to home health, as the agency proposed for 2024. The agency says the cuts are the results of reforms made to the payment system in 2020.

— House Energy and Commerce Health Subcommittee on Medicare innovation

This hearing has more than two dozen bills on the agenda, including legislation to limit cost-sharing for durgs covered by Medicare and to increase transparency on supplemental benefits under Medicare Advantage plans.

What to expect: One witness, John Dicken, an official with the Government Accountability Office, Congress’ watchdog arm, is expected to point to GAO findings that highlight the need for CMS to better monitor how rebate programs impact Medicare spending on pharmaceuticals.

— House Veterans’ Affairs Health Subcommittee on the federal supremacy initiative

The House Veterans' Affairs Committee will hold a hearing on the VA's Supremacy Project, which entails crafting national standards of practice for providers.

Kathleen McCarthy, a spokesperson for committee Republicans, said the hearing would examine how the agency assesses licensure requirements and jurisdiction of care.

What to expect: The proposal is controversial and Jesse Ehrenfeld, president of the American Medical Association, as well as leaders of several other major provider groups are expected to testify.

“Since the [Veterans Health Administration] is such a large health care system, the actions it takes, especially in terms of the scope of practice of its non-physician providers, could have an immense impact on health care in its entirety,” Ehrenfeld is expected to say.

The VA has said it's doing so to better facilitate access to care across state lines.

WELCOME TO TUESDAY PULSE. Currently reading “The Art of Gathering” by Priya Parker, which encourages readers to really think about why we gather and how to make every single meeting purposeful. Initial thoughts: Would Congress benefit from this book?

Send your tips, scoops and feedback to bleonard@politico.com and ccirruzzo@politico.com and follow along @_BenLeonard_ and @ChelseaCirruzzo.

A message from PhRMA:

Here’s another way insurance companies and their pharmacy benefit managers (PBMs) put their profits before your health.

POLITICO is hosting a health care event, Site-Neutral Payments & Billing Transparency, on Wednesday, September 20, starting at 8:30 a.m. ET. Join POLITICO to explore how site-neutral payments could reduce health care spending and whether bipartisan legislation that would align costs for services across hospitals and doctors' offices will survive a polarized Congress.

TODAY ON OUR PULSE CHECK PODCAST , host Ben Leonard talks with POLITICO health care reporter Chelsea Cirruzzo about the new CDC director's plans to improve communication and transparency at the agency.

Listen to today’s Pulse Check podcast

In Congress

GOP HEALTH VOTE NIXED — A vote on a GOP-led health care package was canceled on Monday afternoon, Megan reports. The legislation, which combined the efforts of the three committees with jurisdiction over health issues, was going to be voted on under rules that would have required it to receive support from two-thirds of House lawmakers.

It was among several other measures that were nixed from the schedule, and one House staffer told POLITICO that Republican leadership has expressed an interest in having efforts focused on passing a government funding bill. Meanwhile, a Democratic House aide said that there was a sense that Speaker Kevin McCarthy was rapidly losing support for the measure, including from Republicans.

The health legislation — which focused on strengthening disclosure requirements for hospitals, insurers and pharmacy benefit managers — split the Democratic leadership on the committees of jurisdiction. Most of the provisions were lifted from a bipartisan bill advanced by the House Energy and Commerce Committee, and ranking member Frank Pallone (D-N.J.) lent his support.

However, House Education and the Workforce ranking member Bobby Scott (D-Va.) had not signed onto the final package. The measure also divided the House Ways and Means Committee, wherein Democrats, including ranking member Richard Neal (D-Mass.), were concerned about the removal of a provision that would require private equity firms to disclose purchases of health care facilities.

Medicare

CMS Administrator Chiquita Brooks-LaSure speaks at an American Hospital Association meeting.

Centers for Medicare and Medicaid Services Administrator Chiquita Brooks-LaSure participates in the American Hospital Association's annual membership meeting at the Marriott Marquis on April 25, 2022 in Washington, D.C. | Chip Somodevilla/Getty Images

CMS TACKLES MEDICARE SAVINGS PROGRAM RED TAPE — CMS finalized a rule Monday seeking to ease paperwork burdens low-income seniors face signing up for a Medicare aid program.

The rule seeks to streamline enrollment in the Medicare Savings Program, which offers cost-sharing for seniors and people with disabilities who have low incomes, Robert writes.

One of the key changes is to automatically enroll Medicare-eligible people who get Supplemental Security Income (SSI) from Social Security. While all individuals on SSI are eligible for the Medicare Savings Program, “many are not enrolled because of burdensome and duplicative paperwork,” according to a CMS press release.

The rule also expands eligibility for Medicare Part D’s Low-Income Subsidy that helps lower drug costs. The expansion, which could benefit an estimated 300,000 people, was part of the Inflation Reduction Act.

“This final rule will help hundreds of thousands of people access health care while also freeing up already limited income for food, housing, and other life necessities,” said CMS Administrator Chiquita Brooks-LaSure in a statement.

A message from PhRMA:

Artificial Intelligence

TRUST IN HEALTH AI DIPS — A smaller share of Americans trust the use of artificial intelligence in health care this year compared with last year, according to a new MITRE-Harris Poll of more than 2,000 Americans released Tuesday, Ben reports.

Last year’s poll found that 49 percent of respondents said they’d be OK with artificial intelligence serving as a chatbot for “routine health questions” or being used in processing federal benefits like Medicare. The new poll found a statistically significant drop in trust, falling to 43 and 42 percent of respondents saying the same this year. The margin of error was 2.7 percent.

That shift comes after ChatGPT and other AI tools capable of answering questions became widely available.

The poll also found broad bipartisan support for federal government funding for research on AI and close collaboration between the government and industry to ensure AI works well.

Why it matters: Funding has flowed into artificial intelligence in health care, and lawmakers and CEOs are optimistic that it can transform care, but are concerned the technology could run amok without guardrails.

Senate Majority Leader Chuck Schumer held AI forums last week, and Senate HELP ranking member Bill Cassidy (R-La.) has floated changes to how AI in health care is regulated. The Coalition for Health AI — whose members include MITRE, Google, Microsoft and Stanford — has put forward a blueprint to bolster trust in AI in the sector.

JOIN US ON 9/20 FOR A TALK ON TRANSFORMING HEALTHCARE BILLING: Bipartisan legislation in the House and Senate would align costs for services across hospitals and doctors’ offices and reduce out-of-pocket spending that could potentially save the federal government billions of dollars. Can this legislation survive a polarized Congress? Join POLITICO on Sept. 20 to explore this and whether site-neutral payments and billing transparency policies could help ease health care costs. REGISTER HERE.

Providers

FEW NURSING HOMES MEET PROPOSED REQUIREMENTS — Fewer than 1 in 5 nursing homes now meet a staffing standard the Biden administration has proposed, according to a new KFF analysis.

Background: The administration proposed new minimum staffing rules for nursing homes earlier this month in a bid to improve the quality of care.

A KFF analysis out Monday found that more than 80 percent of facilities would need to hire nursing staff, including 90 percent of for-profit facilities and 60 percent of non-profit and government facilities.

There’s also variability across the states, with all facilities in Alaska meeting the requirements while almost none in Louisiana do.

On the consumer side: Most Americans have a poor view of nursing homes, according to a recent Gallup poll, which could bolster the administration’s case for the rules, POLITICO’s Daniel Payne has reported.

A message from PhRMA:

Your prescription might have different out-of-pocket costs at different pharmacies. Why? Because insurance companies and their pharmacy benefit mangers (PBMs) can make more money if you use the pharmacies they own. So they’ll try to steer you to what’s best for them, instead of what’s best for you. It’s another way that insurance companies and their PBMs put their profits before your health. See what else Middlemen are up to.

WHAT WE'RE READING

NBC News reports that Republican presidential candidate Vivek Ramawamy regrets his Covid vaccine, but his surgeon wife doesn’t.

The Washington Post reports on Medicaid fraud in sober homes in Arizona that led to hundreds of suspensions.

ABC News reports on a Virginia congressperson’s diagnosis of a rare neurological disorder and her decision not to run for reelection.

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