COMPREHENSIVE DRUG BILL STALLS WHILE HOUSE PUSHES SMALLER MEASURES

House Democrats are planning to take up more narrow bills addressing prescription drug costs while their broad legislation is delayed as the Congressional Budget Office (CBO) works on estimating its budgetary impacts.

Majority Leader Steny Hoyer, D-Md., said the Democrats' bill now won't receive a floor vote until December – with some House staff fretting the vote could slip to January as leaders wait for CBO forecasts ahead of tough negotiations with moderate and liberal lawmakers.

CBO last month estimated the bill would save Medicare $345 billion over seven years by forcing manufacturers to negotiate prices with the government on 250 drugs and to apply those discounts to private health plans nationwide. Democrats want to redirect those savings to expand Medicare coverage for dentalvision and hearing services, leading to a delay as CBO figures out how much that would cost.

House Republicans remain unified against the Democrats' bill, saying it would harm medical innovation. CBO has reported the legislation would cut pharmaceutical industry revenue by as much as $1 trillion over a decade, stifling research and development and ultimately leading to as many as 15 fewer new drugs being approved.

On the other side of the Capitol, broad drug pricing legislation from Senate Finance Committee Chairman Chuck Grassley, R-Iowa, remains stalled, too. The White House last week tried to pump up Grassley's bill as the only viable legislation that could win bipartisan support. The administration also criticized the House bill as unworkable.

The White House views Christmas as an effective deadline on getting drug pricing legislation done because the Senate could be consumed by impeachment considerations in January and even into February. The administration sees the Senate as the only real opportunity for achieving bipartisan legislation.

Still, there remains pessimism among key stakeholders that a deal can be struck given broad disagreement on policy and the impeachment overhang.

In the meantime, the House Energy and Commerce Health Subcommittee this week plans to vote on a narrower bill that seeks to prevent abuses of the Food and Drug Administration's citizen petition process, which lawmakers believe may delay the availability of cheaper generic drugs.

Meanwhile, senators are trying to push through smaller-scale bills, too. Sen. John Cornyn, R-Texas, has worked for months on a bill that would curb alleged anticompetitive practices by manufacturers. Last week, Cornyn unsuccessfully sought unanimous consent to pass the legislation, but said he will try again this week. Sen. Richard Durbin, D-Ill., is similarly seeking unanimous consent on his bill, which would require drug prices to be included in advertisements.

FDA NOMINEE TO GO BEFORE SENATE COMMITTEE NEXT WEEK

The Senate HELP Committee will hold a hearing on Nov. 20 on oncologist and hospital executive Dr. Stephen Hahn, whom President Donald Trump earlier this month nominated to lead the Food and Drug Administration (FDA).

Committee Chairman Lamar Alexander, R-Tenn., praised Hahn as "well qualified to lead the FDA." Hahn is currently the chief medical officer at the University of Texas MD Anderson Cancer Center in Houston.

Hahn has been meeting privately with individual senators. It's not clear whether the Senate will vote on Hahn's nomination before the end of the year.

CONGRESS SCRAMBLES TO AVOID GOVERNMENT SHUTDOWN

Faced with a pre-Thanksgiving deadline to approve new government funding, Congress appears poised to extend current spending to just before Christmas – a move that could create an opportunity for year-end passage of health spending and tax provisions.

With funding due to expire Nov. 21, lawmakers appear to be zeroing in on extending current-year funding through Dec. 20 or 21, giving Congress more time to approve the 12 individual fiscal 2020 spending bills for various departments and agencies.

Congress has been stalled over how to allocate the $1.37 trillion for domestic programs as well as policy issues, such as President Donald Trump's demand for border wall funding.

A December funding deadline would create a new opportunity for lawmakers to add other provisions to another stopgap funding bill. Lead candidates to be added include renewing expired programs like community health centers and suspending the medical device tax, which is scheduled to go into effect Jan. 1

But Congress in December may be in the middle of impeachment proceedings against Trump, complicating efforts to add provisions to a must-pass spending bill.

SUBCOMMITTEE TO VOTE ON MATERNAL HEALTH LEGISLATION

The House Energy and Commerce Health Subcommittee will vote Wednesday on two bipartisan bills that aim to improve maternal care.

Legislation by Rep. Eliot Engel, D-N.Y., would create several new maternal health programs, including one that would improve access in rural areas and address racial and ethnic disparities in outcomes.

Legislation by Rep. Robin Kelly, D-Ill., would create a new state plan option to extend continuous Medicaid or Children's Health Insurance Plan eligibility for one year postpartum. Current law allows coverage for 60 days postpartum.

The subcommittee also will vote on legislation to address youth tobacco use, and the Senate HELP Committee will hold a hearing Wednesday on vaping.

SMALL BUSINESS COMMITTEE TO REVIEW INNOVATIVE SOLUTIONS TO DOCTOR SHORTAGE

The House Small Business Committee will hold a hearing Wednesday on promoting hiring of new medical workers.

According to the committee, the U.S. could face a shortage of 100,000 doctors in a decade. The committee plans to discuss how technological innovation can help address shortages by enabling providers to use innovative practices and technologies to "lower costs, incentivize start-ups, and provide quality care."

Witnesses include Dr. Matthew Conti, a New York orthopedic surgery resident; Dr. Ingrid Zimmer-Galler, associate professor of ophthalmology at Johns Hopkins; Dr. Nancy Fahrenwald, dean of the Texas A&M College of Nursing; and Michael Hopkins, CEO of Ohio-based True Concepts Medical.

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