Can you believe we’ve almost made it to the end of the year?

I’m sure I don’t have to tell you about all that’s been going on at the Hill the past few months because it’s taken over the news cycle, but I did want to mention a few things that I myself am keeping an eye on.First and foremost – drug pricing.

While there has been a lot of energy in both parties around passing federal legislation to reduce the cost of prescription drugs, the odds of any meaningful measure(s) getting passed this year are slim to none. There is still strong disagreement about how aggressive Congress should be and PhRMA is not sparing a cent in making sure that whatever reaches the President’s desk is only a modest proposal. It’s worth noting that many Senate Republicans aren’t standing firmly behind Senate Finance Chair Chuck Grassley’s (R-IA) bill in part because it would require drug manufacturers to reimburse CMS if their prices for Medicare drugs rise faster than inflation. (Did I mention how powerful PhRMA’s lobbyists were?)  The only possibility I see for drug pricing legislation to see the light of day before 2020 is to peel off some of the less controversial measures and attach them to a government funding bill or larger health care costs bill.  

Up next – surprise billing. 

Again, there was and still is a good amount of bipartisan support to pass a bill making surprise bills a thing of the past, but as always, great lobbying has thrown a wrench into things. Providers favor independent dispute resolution (IDR) while the plans want the benchmark rate. There have been some measures that incorporate both such as the House Democrats’ proposal, but folks still aren’t entirely happy with it. As it stands today, the Senate bill includes the benchmark rate but there are talks to include IDR for certain instances. However, a recent CBO analysis showed that IDR would actually add to the deficit, so a lot of cold water is being thrown on it. But I think in the end, IDR will find its way into the Senate’s bill because the optics of siding with plans over docs just doesn’t look good.

Third – impeachment.

Impeachment is the one thing that can and will stand in the way of Congress making progress on the two topics above and just about everything else. Senate Republicans in particular have been annoyed (for lack of better words) at House Democrats taking this on so it has stalled progress on bipartisan efforts. I will admit, though, even if the inquiry wasn’t ongoing the Senate likely wouldn’t take up any of the more progressive measures coming out the House. Why, you ask? Politics as usual.