United States: Capitol Hill Healthcare Update- February 2017

GOP leaders delay ACA action amid "repeal," "repair" debate

House Speaker Paul Ryan last week set a deadline of the end of March for repealing most of the Affordable Care Act (ACA), as other Republican leaders and conservative rank-and-file lawmakers advocated competing policy alternatives for what would follow the health law.

Congressional Republicans had hoped to fast-track ACA repeal by passing legislation repealing most of the law by early February. Although Congress last month authorized the use of filibuster-proof legislation known as budget reconciliation, the GOP has been hampered trying to determine which parts of the ACA can be repealed and what new parts can be included in the reconciliation bill.

Senate HELP Committee Chairman Lamar Alexander (R-Tenn.) continued to propose a methodical approach, saying during a committee hearing last week that he favored "repairing" the ACA and detailing what Republicans would do next before repealing the law.

Senate Finance Committee Chairman Orrin Hatch (R-Utah) last week said he could support efforts to repair the law rather than scrapping it totally and starting from scratch. Hatch, during a speech before the U.S. Chamber of Commerce, also endorsed Speaker Paul Ryan's (R-Wis.) plan of offering a framework for the GOP's replacement plan at the same time as the underlying law is repealed, and then debate other replacement provisions separately.

President Trump, during a pre-Super Bowl interview Sunday, also seemed to reset expectations for when Republicans' full ACA replacement would be implemented. "Maybe it'll take till some time into next year," Trump said. "I would like to say by the end of the year, at least the rudiments, but we should have something within the year and the following year."

While the ACA repair rhetoric is gaining traction among key Republican committee chairmen, it's politically toxic to House conservatives, who believe it is akin to lawmakers breaking their promise to voters to fully repeal the law. Rep. Mark Meadows (R-N.C.), the leader of the conservative House Freedom Caucus, told reporters last week that the ACA was "unrepairable."

GOP advances Price's nomination

With Democrats boycotting and effectively blocking a Senate Finance Committee vote on Rep. Tom Price's (R-Ga.) nomination to be secretary of the U.S. Department of Health and Human Services (HHS), Republicans suspended the panel's rules last week and voted to send the nomination to the full Senate.

Finance Committee Chairman Orrin Hatch defended suspending the committee's rules by saying the panel wouldn't be held hostage by Democrats' "political stunt." Democrats are demanding more information from Price on his investment in an Australian biotechnology manufacturer.

Republicans have the votes in the Senate to approve Price, and Republicans leaders say a vote could come as early as this week but is likely to slip into the following week.

Price's confirmation is critical to President Trump's and congressional Republicans' plans to unwind portions of the ACA that can be affected by HHS regulations. Price also will play a critical role in crafting what policies will be included in the GOP's plans to replace the health law.

Hatch, Brady: Repeal all ACA taxes now

Congress' top tax writers left no doubt where they stand on the fate of provider taxes and fees included in the Affordable Care Act – they should be repealed immediately.

While congressional Republicans are still trying to figure out a path forward on what parts of the law to repeal and when, House Ways and Means Chairman Kevin Brady (R-Texas) and Senate Finance Committee Chairman Orrin Hatch said last week that the taxes on pharmaceutical and medical device manufacturers, hospitals, and insurers should be stricken right away.

Hatch, during a speech last week at the U.S. Chamber of Commerce, called for all ACA taxes to be repealed effective as soon as Congress repeals most of the health law using budget reconciliation, likely in March.

Still, some Republicans say the GOP should keep the taxes in place to help finance a transition to a new plan and also to provide revenue for whatever health policy Congress passes to replace the ACA. Brady, in a media interview last week, acknowledged a split among Republicans over the issue, but said, "Personally, I don't want any more small businesses or patients or medical device makers to suffer under the burden of Obamacare taxes any longer."

House leader outlines timeline for health bills

House Majority Leader Kevin McCarthy (R-Calif.) last week sketched out the schedule for considering major healthcare legislation, beginning with a vote next month on repealing most of the ACA.

McCarthy, the No. 2 Republican in the House, also said he hoped Congress would complete consideration of pharmaceutical, generic, biologic, and medical device user fees for FDA by the end of June. Although Congress has until Sept. 30 to reauthorize the user fees, the law requires that lay-off notices be sent to FDA employees in August, warning that jobs could be jeopardized if Congress doesn't meet the deadline.

The House Energy and Commerce Committee is expected to begin hearings on the user fees – starting with the medical device industry's – in mid-February.

McCarthy pegged July as the target date for renewing the Children's Health Insurance Program, which also expires September 30.

House panel delays vote on drug pricing bill

House Energy and Commerce Committee Chairman Greg Walden (R-Ore.) said his panel will delay a scheduled vote this week on legislation to lower prescription drug prices by incentivizing generic drug development.

The bipartisan legislation, backed by Reps. Gus Bilirakis (R-Fla.) and Kevin Schrader (D-Ore.), calls on FDA to expedite generic drug applications when drugs are in short supply or when there are limited manufacturers in the market. It's similar to bipartisan legislation introduced last week in the Senate by Sens. Susan Collins (R-Maine) and Claire McCaskill (D-Mo).

Democrats on the committee asked Walden to delay a vote on the bill. Democrats hope to gain Republican support for adding other provisions to the legislation and also want a more thorough vetting of the bill and the underlying issue.

Walden attended a White House meeting last week with President Trump and pharmaceutical industry executives. Trump previously said the industry was "getting away with murder," and he vowed to require Medicare to negotiate directly with manufacturers over drug prices. The president backed off that rhetoric in the meeting, and instead focused on the need to consider speeding generic drug applications.

Emerging from the White House meeting, Walden announced his committee would vote on the generic drug pricing bill. Now that the vote has been delayed, the panel's Subcommittee on Health will vote Tuesday on legislation designed to tighten financial eligibility for Medicaid, including banning state lottery winners from being eligible.

Pascrell praises UDI device proposal

Rep. Bill Pascrell (D-N.J.), one of Congress' leading voices on unique device identifiers for medical technology, praised a decision last week from the standards committee ASC X-12 that UDIs should be included on insurance claims forms.

Pascrell has previously advocated that Congress enact legislation mandating the change, which he said would allow FDA and others to track defective implantable devices like cardiac stents and artificial hips. Opponents argue the data could be misleading because it wouldn't take into account the overall condition of the patient, the skill of the surgeon or other unique factors.

The standards committee's proposal faces a three-month public comment period as well as final approval by HHS and the Centers for Medicare and Medicaid Services. HHS secretary nominee Rep. Tom Price (R-Ga.) previously voiced opposition to efforts by Pascrell; CMS administrator nominee Seema Verma's position on the issue is not clear.

Both Price and Pascrell are senior members of the House Ways and Means Subcommittee on Health, which has jurisdiction over Medicare Parts A and B as well as CMS.

The content of this article is intended to provide a general guide to the subject matter. Specialist advice should be sought about your specific circumstances.

To print this article, all you need is to be registered on Mondaq.com.

Click to Login as an existing user or Register so you can print this article.

Similar Articles
Relevancy Powered by MondaqAI
In association with
Related Topics
Similar Articles
Relevancy Powered by MondaqAI
Related Articles
Related Video
Up-coming Events Search
Font Size:
Mondaq on Twitter
Register for Access and our Free Biweekly Alert for
This service is completely free. Access 250,000 archived articles from 100+ countries and get a personalised email twice a week covering developments (and yes, our lawyers like to think you’ve read our Disclaimer).
Email Address
Company Name
Confirm Password
Mondaq Topics -- Select your Interests
 Law Performance
 Law Practice
 Media & IT
 Real Estate
 Wealth Mgt
Asia Pacific
European Union
Latin America
Middle East
United States
Worldwide Updates
Registration (you must scroll down to set your data preferences)

Mondaq Ltd requires you to register and provide information that personally identifies you, including your content preferences, for three primary purposes (full details of Mondaq’s use of your personal data can be found in our Privacy and Cookies Notice):

  • To allow you to personalize the Mondaq websites you are visiting to show content ("Content") relevant to your interests.
  • To enable features such as password reminder, news alerts, email a colleague, and linking from Mondaq (and its affiliate sites) to your website.
  • To produce demographic feedback for our content providers ("Contributors") who contribute Content for free for your use.

Mondaq hopes that our registered users will support us in maintaining our free to view business model by consenting to our use of your personal data as described below.

Mondaq has a "free to view" business model. Our services are paid for by Contributors in exchange for Mondaq providing them with access to information about who accesses their content. Once personal data is transferred to our Contributors they become a data controller of this personal data. They use it to measure the response that their articles are receiving, as a form of market research. They may also use it to provide Mondaq users with information about their products and services.

Details of each Contributor to which your personal data will be transferred is clearly stated within the Content that you access. For full details of how this Contributor will use your personal data, you should review the Contributor’s own Privacy Notice.

Please indicate your preference below:

Yes, I am happy to support Mondaq in maintaining its free to view business model by agreeing to allow Mondaq to share my personal data with Contributors whose Content I access
No, I do not want Mondaq to share my personal data with Contributors

Also please let us know whether you are happy to receive communications promoting products and services offered by Mondaq:

Yes, I am happy to received promotional communications from Mondaq
No, please do not send me promotional communications from Mondaq
Terms & Conditions

Mondaq.com (the Website) is owned and managed by Mondaq Ltd (Mondaq). Mondaq grants you a non-exclusive, revocable licence to access the Website and associated services, such as the Mondaq News Alerts (Services), subject to and in consideration of your compliance with the following terms and conditions of use (Terms). Your use of the Website and/or Services constitutes your agreement to the Terms. Mondaq may terminate your use of the Website and Services if you are in breach of these Terms or if Mondaq decides to terminate the licence granted hereunder for any reason whatsoever.

Use of www.mondaq.com

To Use Mondaq.com you must be: eighteen (18) years old or over; legally capable of entering into binding contracts; and not in any way prohibited by the applicable law to enter into these Terms in the jurisdiction which you are currently located.

You may use the Website as an unregistered user, however, you are required to register as a user if you wish to read the full text of the Content or to receive the Services.

You may not modify, publish, transmit, transfer or sell, reproduce, create derivative works from, distribute, perform, link, display, or in any way exploit any of the Content, in whole or in part, except as expressly permitted in these Terms or with the prior written consent of Mondaq. You may not use electronic or other means to extract details or information from the Content. Nor shall you extract information about users or Contributors in order to offer them any services or products.

In your use of the Website and/or Services you shall: comply with all applicable laws, regulations, directives and legislations which apply to your Use of the Website and/or Services in whatever country you are physically located including without limitation any and all consumer law, export control laws and regulations; provide to us true, correct and accurate information and promptly inform us in the event that any information that you have provided to us changes or becomes inaccurate; notify Mondaq immediately of any circumstances where you have reason to believe that any Intellectual Property Rights or any other rights of any third party may have been infringed; co-operate with reasonable security or other checks or requests for information made by Mondaq from time to time; and at all times be fully liable for the breach of any of these Terms by a third party using your login details to access the Website and/or Services

however, you shall not: do anything likely to impair, interfere with or damage or cause harm or distress to any persons, or the network; do anything that will infringe any Intellectual Property Rights or other rights of Mondaq or any third party; or use the Website, Services and/or Content otherwise than in accordance with these Terms; use any trade marks or service marks of Mondaq or the Contributors, or do anything which may be seen to take unfair advantage of the reputation and goodwill of Mondaq or the Contributors, or the Website, Services and/or Content.

Mondaq reserves the right, in its sole discretion, to take any action that it deems necessary and appropriate in the event it considers that there is a breach or threatened breach of the Terms.

Mondaq’s Rights and Obligations

Unless otherwise expressly set out to the contrary, nothing in these Terms shall serve to transfer from Mondaq to you, any Intellectual Property Rights owned by and/or licensed to Mondaq and all rights, title and interest in and to such Intellectual Property Rights will remain exclusively with Mondaq and/or its licensors.

Mondaq shall use its reasonable endeavours to make the Website and Services available to you at all times, but we cannot guarantee an uninterrupted and fault free service.

Mondaq reserves the right to make changes to the services and/or the Website or part thereof, from time to time, and we may add, remove, modify and/or vary any elements of features and functionalities of the Website or the services.

Mondaq also reserves the right from time to time to monitor your Use of the Website and/or services.


The Content is general information only. It is not intended to constitute legal advice or seek to be the complete and comprehensive statement of the law, nor is it intended to address your specific requirements or provide advice on which reliance should be placed. Mondaq and/or its Contributors and other suppliers make no representations about the suitability of the information contained in the Content for any purpose. All Content provided "as is" without warranty of any kind. Mondaq and/or its Contributors and other suppliers hereby exclude and disclaim all representations, warranties or guarantees with regard to the Content, including all implied warranties and conditions of merchantability, fitness for a particular purpose, title and non-infringement. To the maximum extent permitted by law, Mondaq expressly excludes all representations, warranties, obligations, and liabilities arising out of or in connection with all Content. In no event shall Mondaq and/or its respective suppliers be liable for any special, indirect or consequential damages or any damages whatsoever resulting from loss of use, data or profits, whether in an action of contract, negligence or other tortious action, arising out of or in connection with the use of the Content or performance of Mondaq’s Services.


Mondaq may alter or amend these Terms by amending them on the Website. By continuing to Use the Services and/or the Website after such amendment, you will be deemed to have accepted any amendment to these Terms.

These Terms shall be governed by and construed in accordance with the laws of England and Wales and you irrevocably submit to the exclusive jurisdiction of the courts of England and Wales to settle any dispute which may arise out of or in connection with these Terms. If you live outside the United Kingdom, English law shall apply only to the extent that English law shall not deprive you of any legal protection accorded in accordance with the law of the place where you are habitually resident ("Local Law"). In the event English law deprives you of any legal protection which is accorded to you under Local Law, then these terms shall be governed by Local Law and any dispute or claim arising out of or in connection with these Terms shall be subject to the non-exclusive jurisdiction of the courts where you are habitually resident.

You may print and keep a copy of these Terms, which form the entire agreement between you and Mondaq and supersede any other communications or advertising in respect of the Service and/or the Website.

No delay in exercising or non-exercise by you and/or Mondaq of any of its rights under or in connection with these Terms shall operate as a waiver or release of each of your or Mondaq’s right. Rather, any such waiver or release must be specifically granted in writing signed by the party granting it.

If any part of these Terms is held unenforceable, that part shall be enforced to the maximum extent permissible so as to give effect to the intent of the parties, and the Terms shall continue in full force and effect.

Mondaq shall not incur any liability to you on account of any loss or damage resulting from any delay or failure to perform all or any part of these Terms if such delay or failure is caused, in whole or in part, by events, occurrences, or causes beyond the control of Mondaq. Such events, occurrences or causes will include, without limitation, acts of God, strikes, lockouts, server and network failure, riots, acts of war, earthquakes, fire and explosions.

By clicking Register you state you have read and agree to our Terms and Conditions