Without enough votes to begin debate on the July 13th version of the “Better Care Reconciliation Act of 2017” on Monday, July 17, Republican leaders in the Senate called for the repeal of the Affordable Care Act (ACA) without an immediate plan to replace the ACA. According to a report issued by the Congressional Budget Office (CBO) on Wednesday, July 19, a repeal only bill would reduce the federal budget by $473 billion over the next 10 years and result in an increase in the number of uninsured Americans by 17 million in 2018 and 32 million by 2026. The CBO also estimated that premiums for individual health insurance would increase by 25 percent in 2018, 50 percent in 2020, and double by 2026. On Thursday, July 20, Senate Republican leadership released an updated version of the Better Care Reconciliation Act that includes additional Medicaid funding and an amendment allowing plans with cheaper premiums but fewer benefits. The CBO estimated that the latest version of the Better Care Reconciliation Act would still result in 22 million more Americans being uninsured in 2026 relative to the ACA. While Senate Republican leadership intends to begin debate this week on health care reform legislation, it remains unclear whether the Senate will consider repeal only legislation or some version of the Better Care Reconciliation Act.
On July 19, the House Budget Committee marked up and approved a FY 2018 budget resolution entitled “Building a Better America.” The budget resolution would balance the federal budget in 10 years. The budget resolution incorporates the American Health Care Act as passed by the House of Representatives, which includes a reduction of about $800 billion in Medicaid spending over the next 10 years. The budget resolution also proposes moving Medicare to a premium support system.
On July 18, the Oversight and Investigations Subcommittee of the House Energy and Commerce Committee held a hearing entitled “Examining HRSA’s [Health Resources and Services Administration] Oversight of the 340B Drug Pricing Program. One focal point of the hearing was the lack of reporting requirements in the 340B statute. Committee Chairman Greg Walden questioned witnesses about how participating entities spent 340B savings, which range from 25 to 50 percent of the average wholesale price for covered outpatient drugs. In response to the chairman’s question, a witness from the Office of Pharmacy Affairs at HRSA acknowledged that HRSA did not know how particular entities spent 340B savings or whether such savings were passed on to patients in the form of reduced drug prices.