Legislative Update

CONGRESS ACE Kids Act Enacted On April 18, the President signed into law H.R. 1839, the "Medicaid Services Investment and Accountability Act of 2019." The new law includes the most recent version of the ACE Kids Act, which gives states the option to create Medicaid health homes for children with complex medical conditions in order to improve care coordination for this particularly vulnerable subset of CYSHCN. See U.S. Congress Passes ACE Kids Act (Children's Hospital Association, 4/3/19); New Medicaid Funding Could Help States Better Integrate Care for Children with Medical Complexity (National Academy for State Health Policy, 4/15/19). Among other things, the law also provides an additional $20 million to the $120 million allocated earlier this year to fund the "Money Follows the Person" program until September 30, 2019.   Prescription Drug Prices On April 4, the full House Energy & Commerce Committee reported out several billsaimed at reducing drug prices. On April 2 and April 10, Energy & Commerce Subcommittee on Oversight and Investigations held hearings on the rising cost of insulin. See What They're Saying: E&C Members Agree the Price of Insulin is Out of Control (press release from the Energy & Commerce Committee Republicans, 4/12/19). And, according to an article in Axios - Washington's major push to lower drug prices (Axios, 4/21/19) - "The White House and top lawmakers from both parties think a bill to lower drug prices has a better chance of becoming law before the 2020 election than any other controversial legislation." The article describes some of the bills introduced by Republicans to address this issue.   In related news: According to a recent article, Drugmakers Reveal List Prices Online After Pressure From Trump (Bloomberg, 4/18/19), drug manufacturers are beginning to voluntarily post their prices online in response to a proposed regulation issued in October 2018. Under the proposed rule, drug companies would be required to post the Wholesale Acquisition Cost (WAC) for drugs covered in Medicare or Medicaid in direct-to-consumer television advertisements. The rule has not yet been finalized.   Bill To Reverse Rule on Short-Term, Limited Duration Plans On April 9, the House Education & Labor Committee reported out a bill (H.R. 1010; fact sheet) that would reverse the administration's final rule permitting the sale of "short-term, limited duration" (STLD) plans that do not meet the standards of the Affordable Care Act (ACA). Healthcare and consumer advocates are concerned that such plans (like the Association Health Plans that were struck down by a court last month; see "Courts," above) would leave consumers without the coverage they expected when they purchased the plans, and would undermine the stability of the insurance pool by drawing away healthier consumers who want to purchase cheaper, less robust plans than those comporting with ACA standards.   Bipartisan Lifespan Respite Care Reauthorization Act introduced On April 2, Senators Susan Collins (R-ME) and Tammy Baldwin (D-WI), and Representatives Jim Langevin (D-RI) and Cathy McMorris Rodgers (R-WA) introduced the bipartisan Lifespan Respite Care Reauthorization Act of 2019 (S.995, H.R.2035). The bill would reauthorize, through 2024, the Lifespan Respite Care Program,which provides grants to states to help them develop coordinated respite care programs for family caregivers.   Congress May Act to Curtail Surprise Medical Bills According to Politico Pulse (4/15/19), the House Energy & Commerce Committee held a bipartisan briefing on surprise medical bills on April 5 with health aides and stakeholders, including the Federation of American Hospitals, the American Medical Association, Families USA and America's Health Insurance Plans. Politico Pulse notes that other committees are examining this issue as well - the House Ways & Means Committee, and Education & Labor Committee, which held an April 2 hearing on the topic, and the Senate Health, Education, Labor & Pensions (HELP) Committee. Reportedly, an earlier bill is being revised by a bipartisan group of Senators, and HELP Committee Chairman Lamar Alexander (R-TN) and Ranking Member Patty Murray (D-WA) have developed some legislative options to address the problem.   Medicare for All There are number of bills referred to as "Medicare-for-All" legislation. See Compare Medicare-for-all and Public Plan Proposals (Kaiser Family Foundation, last updated 4/11/19). The bill introduced on April 10 by Senator Bernie Sanders (I-VT), the "Medicare for All Act of 2019" (S. 1129), may be the best known. Original cosponsors of the bill were Senators Tammy Baldwin (D-WI), Richard Blumenthal (D-CT), Cory Booker (D-NJ), Kirsten Gillibrand (D-NY), Kamala Harris (D-CA), Mazie Hirono (D-HI), Martin Heinrich (D-NM), Patrick Leahy (D-VT), Edward Markey (D-MA), Jeff Merkley (D-OR), Brian Schatz (D-HI), Tom Udall (D-NM), Elizabeth Warren (D-MA) and Sheldon Whitehouse (D-RI). See Sanders, 14 Senators Introduce Medicare for All (Sanders press release, 4/10/19). The bill would divorce insurance from employment, and set up a system under which the government would be the single payer for the healthcare costs of all Americans. See Bernie Sanders's Medicare-for-all plan, explained (Vox, 4/10/19). In February, Rep. Pramila Jaypal (D-WA) had introduced a bill also called the "Medicare for All Act of 2019" (H.R. 1384). See Rep. Jayapal's website.