Health Care Debate ‘Sucking the Life’ Out of Other Initiatives

Friday, July 7, 2017

Republicans’ scramble to come to an agreement in July on overhauling Obamacare is pushing back several must-pass health bills, creating a backlog of legislation lawmakers must act on in coming weeks.

Bills allowing the FDA to collect user fees, fund medical research, and ward off cuts to Medicare are being delayed by the health-care reform debate. Lobbyists worry lawmakers may miss crucial deadlines to pass some of this legislation if the debate lingers to the end of July, when Congress leaves for the month-long August recess.

All the attention on ACA reform is “really sucking all the life out of other initiatives, including appropriations,” a former House appropriations staffer who asked not to be identified told Bloomberg BNA in a July 5 interview.

Congress broke for the July 4 recess with Senate Republicans divided over a proposed repeal bill (H.R. 1628). According to Senate aides, when Congress returns July 11, Republican leaders hope adding new money for opioid programs to the legislation and making tax credits for insurance more generous for some will win over some reluctant lawmakers.

The scramble by Republicans to pass a replacement health-care bill comes with just a little more than a dozen working days left before the August recess.

Optimism for User Fees

Meanwhile, another important health-care bill, the user fee legislation (S. 934), must pass Congress before the current agreement expires Sept. 30. If there's no action by the end of July, the Food and Drug Administration will have to begin the process of furloughing roughly 5,000 employees.

User fees are negotiated rates that makers of drug, device, and biologic products agree to pay to help fund the FDA's operations. The Senate version of the user fee legislation (S. 934) was approved May 11 by the Senate Health, Education, Labor and Pensions Committee and awaits full Senate action. The House Energy and Commerce Committee approved the House version of the legislation (H.R. 2430) June 7.

“I don't think there's any real controversy about the base user fee bill itself,” Bloomberg Intelligence senior health-care analyst Brian Rye told Bloomberg BNA July 3.

The user fee legislation often comes with FDA policy riders, but Rye said the 21st Century Cures law (Pub. L. 114-255) enacted in December to spur new drugs and devices already tackled these issues, and much of the Cures language appears in the latest user fee agreement. “If they needed to, they could probably pass this pretty quickly. But again that's still on the backseat right now,” Rye said about the user fee bill. “A lot of things are going on behind the scenes trying to get something that 50 senators can agree on the Obamacare front.”

Ellie Dehoney, vice president of policy and advocacy for Research!America, said she believes lawmakers will make the user fee deadline.

Research!America is an umbrella group of organizations that advocate to make health research a higher national priority.

Sudip Parikh, senior vice president and managing director of the nonprofit drug development group Drug Information Association for the Americas, told Bloomberg BNA, “By any rational measure, [the user fee bill] should pass and go into effect in the way that it's already been negotiated.”

At the same time, he noted that the same congressional committees that are overseeing health-care reform are also overseeing the user fee bill.

“So it just becomes a question of bandwidth, when can folks work on these different things?” Parikh said.

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