Policy Updates: Hill Happenings and Administration Activities

By Mike Weir May 14, 2018

With the upcoming Annual Meeting and Memorial Day holiday, the Policy and Legislative Affairs team will not be releasing a Policy Newsletter (PNL) on May 21 or 28. The next PNL will be released on June 4.  

Hill Happenings

FY2018 Rescissions Package          

House Republican leaders are moving quickly on the White House's $15.4 billion rescissions package. Congress has 45 days of continuous session (including weekends and holidays, but not days when lawmakers are in recess for four days or more) to examine the package before its expiration, during which time the funding will be frozen for the programs, projects, and activities listed below. Republican leadership has indicated the measure could move directly to the House floor without going through the Appropriations Committee, as soon as next week. 

The package would, among other things, cut $7 billion from the Children's Health Insurance Program (CHIP), $800 million from the Center for Medicare and Medicaid (CMS) Innovation, and $252 million from USAID funds to address Ebola which remained from 2015.

The Coalition for Health Funding put out a statement on "the detrimental effects that rescissions will have on public health and health research." The NDD United Steering Committee sent a letter to all Members of Congress urging them to oppose the rescission package being proposed. NDD United also released a one-pager on this seldom used procedure to cut already appropriated money.

Opioids

The House Energy and Commerce Committee advanced 25 measures that address the opioid crisis, all of which won bipartisan support. The committee will mark up another batch of opioid bills next week that could contain more controversial ideas, like a proposal allowing states to partially lift a Medicaid restriction on payment for some inpatient treatment. We are pleased that the Eliminating Opioid Related Infectious Diseases Act of 2018 was included in the package. This bill would bring needed attention and funding to rising hepatitis C infections related to injection drug use.  

During the mark-up, Congresswoman Kathy Castor (D-FL-14) said that current efforts do not go far enough and suggested that Congress consider a program like the Ryan White HIV/AIDS program for people with substance abuse. Senator Elizabeth Warren (D-MA) and Representative Elijah Cummings (D-MD-7) introduced the Comprehensive Addiction Resources Emergency (CARE) Act, a bill that would spend $100 billion over 10 years to combat the opioid epidemic—primarily through formulaic grants to states and counties based on the recorded rates of overdoses. The legislation is modeled after the Ryan White Comprehensive AIDS Resources Emergency Act of 1990. The bill includes $1 billion for the National Institutes of Health (NIH) and $400 million for the Centers for Disease Control and Prevention (CDC). Of the bill’s grant funding, $2.6 billion would be awarded on a competitive basis to states and counties that apply for additional funds. 

FY2019

Health and Human Services (HHS) Secretary Alex Azar testified before the Senate Appropriations Labor, Health and Human Services, Education, and Related Agencies subcommittee on the department's FY2019 budget. Secretary Azar was confronted by Democrats over the Title X family planning program and whether HHS will erect new barriers to comprehensive care for the program. 

Drug Pricing 

Ahead of the anticipated rollout of President Trump's drug pricing plan, nine House Democrats on the Affordable Prescription Drug Task Force offered their list of must-haves for the proposal. On the list: allow Medicare to negotiate prescription drug prices; force drug companies to reveal the true cost of producing their products; end tactics that thwart completion like pay-for-delay deals, patent evergreening and REMS abuses; allow the importation of prescription drugs from other countries; and craft fair trade agreements.  The task force is led by Congressmen Lloyd Doggett (D-TX-35), Peter Welch (D-VT-At-Large), and Elijah Cummings (D-MD-7).

Administration Activities 

Drug Pricing

On Friday, President Trump unveiled his blueprint, American Patients First, that aims to lower prescription drug prices. Ahead of the speech, HHS Secretary Alex Azar, CMS Administrator Seema Verma, and FDA Administrator Scott Gottlieb published an op-ed. The blueprint aims to address the lack of affordable medicines and treatments, seniors and government programs overpaying for drugs, high out-of-pocket costs for consumers, and foreign governments "free-riding" off of American innovation. Many of the policies listed in the 44-page blueprint are either modest steps the administration has already taken, or policies that it has identified as needing further time and study.

HHS identified four strategies in the blueprint to address the above challenges, which include, improved competition, better negotiation, incentives for lower list prices, and lowering out-of-pocket costs. The department's plan is divided into two phases: 1) the actions the President can instruct HHS to take immediately and 2) actions HHS is actively considering, on which feedback is being asked. The plan also includes changes to Medicare that could reduce out-of-pocket costs for seniors, recommendations to drug makers to disclose their prices in TV ads, and discussions about changing the complicated rebate negotiations off of drugs' list prices.

Medicaid Lifetime Limits  

The Trump administration has rejected a proposal from Kansas to implement the first-ever lifetime limits on Medicaid enrollment, CMS Administrator Seema Verma announced. The HIV Health Care Access Working Group has sent a letter to CMS urging CMS to oppose“work requirements and time limits on vulnerable populations.” 

Peace Corps

The HIV Medicine Association (HIVMA) and NASTAD submitted a letter to the Peace Corps Director raising concerns regarding the Peace Corps’ policies for volunteers diagnosed with HIV during their service and coverage of HIV prevention interventions.  Recently, a Peace Corp volunteer seroconverted during their placement in Cambodia. As a result, the individual was placed on “medical separation” from the Peace Corp and sent back to the United States. 

2018 National STD Prevention Conference

The 2018 STD Prevention Conference will be held August 27-30, 2018 in Washington, DC. Registration for the conference is now open. Early registration ends on May 31.

Hepatitis Awareness Month

May is Hepatitis Awareness Month, and May 19thmarks the 7th annual Hepatitis Testing Day in the U.S. The CDC has provided free tools in the Hepatitis Awareness Month and Testing Day Resource Center helpful in supporting your awareness activities and testing events. 

2019 National HIV Prevention Conference

The 2019 National HIV Prevention Conference (NHPC) will be held March 18-21, 2019 in Atlanta, Georgia. Check out the updated website for more information about tracks, session and abstract formats, and to view the tentative conference schedule. Abstracts will open May 21, 2018.

Resources

2018 340B Coalition Summer Conference

AVAC has prepared an HIV Vaccine Awareness Day (May 18) toolkit – as well as a webinar scheduled for Thursday, May 17.

NYC Vital Signs: Opportunities for HIV Prevention: Screening for Rectal Chlamydia and Gonorrhea among Men Who Have Sex With Men in New York City

Access to Syringe Services Programs — Kentucky, North Carolina, and West Virginia, 2013–2017

Uninsured Rate Rises in 17 States in 2017

To Lower Drug Costs at Home, Trump Wants Higher Prices Abroad

News Bulletin

Drug executives express regret over opioid crisis, one tells Congress his company contributed to the epidemic

“A major distributor of powerful painkillers apologized Tuesday for the company’s role in facilitating the flow of highly addictive painkillers into U.S. communities, the first time a corporation has expressed regret for involvement in the opioid crisis.”

Patients sue Gilead, saying drug company intentionally delayed safer HIV medicine

“Two Southern California men filed suit against Gilead Sciences on Tuesday, saying they were harmed when the drug company intentionally delayed development of a safer version of a crucial HIV medicine so that it could continue to profit from its lucrative monopoly.”

Nurse accused of using her own drug needles on patients – and exposing them to hepatitis C

“The state health department and Centers for Disease Control and Prevention determined through genetic tests that the two patients derived the disease from a common source, and “charges say Weberg was the only nurse or physician at the hospital who treated both patients,” the statement read.”

STDs in L.A. County are skyrocketing. Officials think racism and stigma may be to blame

“The focus on stigma is just one of many ways Los Angeles County health officials are trying to think outside the box as they struggle to curb rising STD rates. It’s clear that the traditional ways of preventing disease — patients seeing a doctor regularly to get screened and treated — have not been working, said Dr. Jeffrey Gunzenhauser, L.A. County’s interim health officer.”

Trump challenge to Native Americans' health splits HHS, alarms Hill GOP

“HHS leaders want states to settle the contentious question of whether Native Americans should get jobs in order to keep their health care — a move that likely won't resolve the underlying challenge to tribal sovereignty and was sparked by an unusual split between the agency's politically appointed administrators and legal counsel.”