This week, the House Energy and Commerce Committee approved sweeping health care legislation as part of the Democratic Congress’ plan to enact a $3.5 trillion legislative package through budget reconciliation. The committee considered six subtitles that contained health-related legislation: Drug Pricing, Affordable Care Act, Medicaid, CHIP, Medicare and Public Health . Notably, the committee did not approve the proposed drug pricing plan, which would allow for negotiation of drug prices in Medicare Part D, with three Democrats voting in opposition. This puts a signature piece of the Democrats’ proposal, which would save close to $500 billion to pay for other priorities, in peril.
The Energy and Commerce Committee legislation proposes to spend $190 billion for Home- and Community-Based Services (HCBS), closing the Medicaid gap (no known score, estimated to be ~$300 billion), and $300 billion to expand Medicare benefits to include vision, dental and hearing. In order to offset this spending, they propose fully repealing the rebate rule, which will raise about $170 billion as well as prescription drug reforms that would save approximately $500 billion. While the Energy & Commerce Committee voted the drug provisions down, the House Ways and Means Committee adopted legislative recommendations containing identical language for drug pricing. This gives the drug provisions a path forward in the process, though it may not have enough support to ultimately pass the House. None of the costs or savings of the programs are official yet; the Congressional Budget Office will publish their estimates in upcoming weeks.
The legislative recommendations approved by the Energy and Commerce Committee will be combined with the recommendations from the other House committees by the House Budget Committee. Following a markup by the House Budget Committee, the combined legislation will be transmitted to the House Rules Committee where it will receive its own hearing. During this hearing, amendments can be introduced or made to adjust the bill. It is anticipated that the drug pricing language will be renegotiated over the coming weeks. House Democrats will need the savings generated from these provisions in order to pay for their other health care priorities included in the reconciliation bill.
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