House Education & the Workforce Health, Employment, Labor, and Pensions Subcommittee Holds Hearing on ERISA’s 50th Anniversary. The hearing focused on balancing the advantages of ERISA’s federal preemption with the need for reforms to tackle inefficiencies and rising healthcare expenses.
Many Republicans criticized proposals for government-run healthcare models such as Medicare for All, arguing that they could undermine private insurance and increase costs. Conversely, many Democrats defended government reforms, citing successes in reducing drug prices and increasing coverage through the Affordable Care Act (ACA). Committee members discussed reforms that support small businesses, such as expanding access to association health plans and improving price transparency to help manage costs and enhance coverage options.
House Budget Committee Examines Possible CBO Improvements. During the hearing, some members questioned Swagel on issues related to previous CBO analyses, such as the Inflation Reduction Act’s impact on drug research and development and the impact of permanently extending enhanced advanced premium tax credits. Members and Swagel noted the importance of longer-term CBO analyses, particularly for preventive health policies. The House-passed Preventive Health Savings Act would require CBO, if requested by Congress, to estimate the impact of legislation focused on preventive healthcare over a 30-year period. Swagel indicated that CBO is already working to conduct some health analyses beyond the 10-year budget window to better account for future savings. Members listed a few additional legislative and oversight reforms they support, with which Swagel concurred:
House Education & the Workforce Committee Advances Health-Related Bills. The markup included three bills described as bolstering employer-sponsored healthcare. All passed out of committee, although one was passed along party lines. The vote outcomes for these bills are below:
For more information about the bills and amendments, view the hearing website.
House Energy & Commerce Oversight Subcommittee Holds Hearing on OPTN. The purpose of this hearing was to hear from experts and stakeholders about how the Securing the U.S. Organ Procurement and Transplantation Network Act is being implemented and what challenges remain. Committee members largely emphasized their support for the legislation but noted their concerns about how effective the statute has been in assisting patients and battling corruption. Members from both parties asked about disparities in the organ transplantation network, particularly among people of color and those living in rural areas, and they appeared to be troubled by threats made to individuals who have expressed criticism of the OPTN process.
House Judiciary Administrative State, Regulatory Reform, and Antitrust Subcommittee Holds Hearing on PBMs. The hearing highlighted the high level of market concentration among PBMs, which many committee members and witnesses argued contributes to reduced competition and potential conflicts of interest in drug pricing and access. Representatives discussed how vertical integration among PBMs, insurance companies, and pharmaceutical manufacturers may negatively impact patient outcomes and increase costs. They emphasized the need for better alignment of financial incentives. The hearing also discussed challenges faced by independent pharmacies, especially in rural areas, with members and witnesses touching on how PBM practices and pricing structures could be adjusted to better support these providers.
HHS, Labor, and Treasury Release Mental Health Parity Final Rule. The US Departments of Health and Human Services (HHS), Labor, and the Treasury released final rules on September 9, 2024, requiring certain health plans and issuers to collect and evaluate data and take reasonable action to address material differences in access to mental health and substance use disorder benefits compared to medical and surgical benefits. The rules codify changes to the Mental Health Parity and Addiction Equity Act of 2008 (MHPAEA) made by the Consolidated Appropriations Act, 2021. The final rules add protections against more restrictive non-quantitative treatment limitations (NQTLs) for mental health and substance use disorder benefits compared to medical and surgical benefits. Health plans and issuers subject to the final rules will have to submit an NQTL comparative analysis to demonstrate compliance.
The final rules apply to group health plans and group health insurance coverage on the first day of the first plan year beginning on or after January 1, 2025. The final rules apply to individual health insurance coverage for policy years beginning on or after January 1, 2026. The Departments also issued a request for comments on proposed new templates for states to document compliance with the MHPAEA in Medicaid and the Children’s Health Insurance Program. Comments on these templates are due to the Centers for Medicare & Medicaid Services (CMS) by October 29, 2024.
The press release can be found here, and a fact sheet can be found here.
Both the House and Senate are in session next week as lawmakers seek an agreement on a continuing resolution to prevent a government shutdown at the end of the month. Healthcare activity is anticipated at the committee level, including a potential markup in the House Energy & Commerce Committee. The House Ways & Means Health Subcommittee has noticed a hearing on chronic care. The Senate Finance Committee will hold a hearing on implementation of the Inflation Reduction Act, and various Senate Judiciary Subcommittees will hold hearings on reproductive rights and artificial intelligence. The House has also placed several bills on next week’s suspension calendar, including legislation related to chronic disease coverage, Medicaid, public health research and programs, and telehealth.
For more information, contact Debra Curtis, Kristen O’Brien, Erica Stocker, Julia Grabo, or Maddie News.
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