On Tuesday, September 26, Senate Republican leadership decided not to hold a full Senate vote on the Graham-Cassidy Affordable Care Act (ACA) repeal and replace legislation. The previous day, Monday, September 25, the Senate Finance Committee held a hearing on the Graham-Cassidy bill. Following the hearing, Senator Susan Collins (R-ME) announced her opposition to the legislation. Senators Rand Paul (R-KY) and John McCain (R-AZ) had already indicated they would not support the Graham-Cassidy bill. Under Senate budget reconciliation rules Republican leadership could only lose two Republicans and still pass the legislation. Consequently, Senate Majority leader Mitch McConnell (R-KY) decided against holding a full Senate vote on the bill. Later in the week Senate Health, Education, Labor, and Pensions Committee Chairman Lamar Alexander (R-TN) and Ranking Member Patty Murray (D-WA) resumed their discussions regarding a possible bipartisan agreement to fund the ACA’s insurance subsidies for two years and provide states with more flexibility in obtaining waivers from ACA requirements.

On Friday, September 29, Department of Health and Human Services’ Secretary Tom Price resigned under pressure from the White House following public disclosure of his repeated use of chartered flights and racking up in excess of $400,000 in travel expenses. President Trump announced that Don J. Wright, a deputy assistant secretary for health and the director of the Office of Disease Prevention and Health Promotion, will serve as Acting Secretary.  Possible successors to Dr. Price reportedly include Seema Verma, Administrator for the Centers for Medicare & Medicaid Services (CMS), and Scott Gottlieb, Commissioner of the Food and Drug Administration.

On Thursday, September 28, the Health Resources and Services Administration (HRSA) delayed to July 1, 2018 the effective date of its January 5, 2017 final rule on 340B drug pricing program ceiling prices and civil money penalties for manufacturers. HRSA’s announcement was published in the Federal Register on Friday, September 29.

In a letter dated Wednesday, September 27, over two hundred Members of the House of Representatives urged CMS to abandon its proposal to cut payments for 340B drug pricing program drugs from the current rate of Average Sales Price (ASP) plus six percent to ASP minus 22.5 percent, an effective reduction in payments of 26.8 percent.