Overnight Health Care — Presented by National Taxpayers Union — Drug pricing fight centers on insulin | Florida governor working with Trump to import cheaper drugs | Dems blast proposed ObamaCare changes

Welcome to Wednesday's Overnight Health Care.

Lawmakers are beginning to seriously target insulin price hikes, Florida's Republican governor says he will get the administration to approve a drug importation plan, and top Democrats are urging the Trump administration not to proceed with proposed changes to ObamaCare.

We'll start with insulin:


Drug pricing fight centers on insulin

Lawmakers are zeroing in on the skyrocketing cost of insulin as they work to combat high drug prices. Congressional Democrats, Republicans and the Trump administration say that lowering drug prices is a priority, and drugmakers are on the hot seat.

Insulin could prove an easy target in that push. The drug hasn't changed much since it was first discovered nearly 100 years ago, and as newer forms of the drug have been introduced, the price has climbed.

What's the state of play? There are now simultaneous bipartisan and bicameral probes from the top health care committees. In the House, the Energy and Commerce Committee's oversight subcommittee, led by Rep. Diana DeGetteDiana Louise DeGetteCrucial for Congress to fund life-saving diabetes research Overnight Health Care — Sponsored by Campaign for Tobacco-Free Kids — White House withdraws controversial rule to eliminate drug rebates | Grassley says deal on drug prices moving 'very soon' | Appeals court declines to halt Trump abortion referral ban Overnight Energy: Top EPA official stepping down amid ethics probe | Critics slam EPA for rolling back union protections | Trump officials open door to controversial Alaska mining project MORE (D-Colo.), is investigating the main insulin makers over "skyrocketing costs." In the Senate, bipartisan Finance Committee leaders have also pledged to investigate spiking insulin prices. Committee Chairman Chuck GrassleyCharles (Chuck) Ernest GrassleyThe peculiar priorities of Adam Schiff Advocates frustrated over pace of drug price reform Trump drug pricing setbacks put pressure on Congress MORE (R-Iowa) is a free-market Republican who has long been an adversary of the drug industry.

Will the attention lead anywhere? Sen. Ron WydenRonald (Ron) Lee WydenHillicon Valley: Twitter says Trump 'go back' tweet didn't violate rules | Unions back protests targeting Amazon 'Prime Day' | Mnuchin voices 'serious concerns' about Facebook crypto project | Congress mobilizes on cyber threats to electric grid Top Democrat demands answers on election equipment vulnerabilities Advocates frustrated over pace of drug price reform MORE (D-Ore.), the top Democrat on the Finance Committee, said he is optimistic the bipartisan interest in reducing drug prices will lead to action, especially with insulin. DeGette said she thinks the findings of the investigation will lead to substantial policy reforms, especially since Energy and Commerce is the committee of record on health care issues. The goal is to hold a hearing on the issue "soon," DeGette said, but noted the investigation will be much larger.

More on their efforts here.





And some related insulin news:

A bill introduced by Rep. Peter WelchPeter Francis WelchSanders: 'I'm only grumpy most of the time' Hillicon Valley: Hacker group targeted electric grid | House Democrats press CBP over facial recognition program | Senators offer bill to protect health data | Groups file FCC complaint over carriers' use of location data Lawmakers grapple with deepfake threat at hearing MORE (D-Vt.) on Wednesday would let patients import cheaper insulin from Canada and other countries.

"Prices for insulin have gone through the roof and are hammering diabetes patients who cannot live without this life-saving medicine yet cannot afford to pay for it," Welch said in a statement.

The bill would legalize importation of insulin from Canada by patients, pharmacists and wholesalers for two years before expanding to other countries with safety standards similar to the U.S.

Welch's proposal would require that the Food and Drug Administration certify and inspect all foreign exporters of insulin, and patients would still need prescriptions to buy it.

Context: A similar bill introduced last month by Rep. Elijah CummingsElijah Eugene CummingsLawmakers pay tribute to late Justice Stevens House poised to hold Barr, Ross in contempt Trump's family separation policy has taken US to 'lowest depth possible,' says former immigration lawyer MORE (D-Md.) and Sen. Bernie SandersBernie SandersSanders to call on 2020 Democrats to reject money from drug, health insurance industries The hidden connection between immigration and health care: Our long-term care crisis Harris tops Biden in California 2020 poll MORE (I-Vt.) is more broad and would allow the importation of qualifying prescription drugs, excluding controlled substances. Welch co-sponsored that measure.

Given the current makeup of Congress, it's not clear if either can pass. But Senate Finance Chairman Chuck Grassley (R-Iowa) supports importation in some circumstances. Trump said he supported drug importation while running for president but has since backed off. Meanwhile, the FDA is looking at allowing importation in very limited circumstances.

More on Welch's bill here.


Talking about drug importation, this would be pretty big news if it pans out...


Florida GOP governor working with Trump to import cheaper drugs from Canada

Florida Gov. Ron DeSantisRonald Dion DeSantisDeSantis wants statue of civil rights activist to replace Confederate figure on Capitol Hill Florida couple wins right to plant vegetables in front yard after years-long legal battle Former sheriff running for reelection after suspension over Parkland shooting MORE (R) on Wednesday proposed importing cheaper prescription drugs from Canada into the state and said that President TrumpDonald John TrumpPompeo changes staff for Russia meeting after concerns raised about top negotiator's ties: report House unravels with rise of 'Les Enfants Terrible' Ben Carson: Trump is not a racist and his comments were not racist MORE had given his support to the idea.

Why it matters: Importing drugs from abroad is traditionally a Democratic idea. But here two Republicans, DeSantis and Trump, are giving their support to the proposal.

"I want you to know I spoke personally to President Trump on both Sunday and Monday about this," DeSantis said. "He's not only supportive, he's enthusiastic, and he wanted me to tell all of you here today that he supports what we're doing and he will take the necessary executive actions to make sure that we can act under this 2003 law."

What to watch: This proposal is still in its early stages. DeSantis needs to work with the state legislature. But he says Trump's on board. Will the Trump administration really end up approving the move?

Read more here.


Health spending on the rise

U.S. health expenditures are projected to grow at an average annual rate of 5.5 percent every year for the next decade and will represent 19.4 percent of gross domestic product in 2027, according to estimates from the Centers for Medicare and Medicaid Services (CMS).

Among the major payers, average annual spending growth in Medicare (7.4 percent) is expected to exceed that in Medicaid (5.5 percent) and private health insurance (4.8 percent) over the same period, mostly as a result of higher enrollment growth.

On prescription drugs, spending is expected to rise an average of 5.6 percent annually between 2018 and 2027. According to CMS, the rise is due to employers and insurers pushing patients with chronic conditions to adhere to medications better, and higher utilization of new, expensive drugs on the market.


The industry group for pharmacy benefit managers is urging Congressional leaders to speak out against HHS' proposed rebate rule

The proposal, released last month, aims to lower drug prices by eliminating some of the rebates drug manufacturers give PBMs and insurers. Drug companies would instead be encouraged to pass those discounts directly to patients instead.

But the Pharmaceutical Care Management Association (PCMA) says these rebates are a "key tool" PBMs use to save consumers and patients money.

"By eliminating this cost-saving tool and not replacing it with a viable alternative to allow continued negotiation, the administration risks substantially increasing premiums for Medicare beneficiaries," PCMA President and CEO JC Scott wrote in the letter to House and Senate leadership.

"HHS is moving forward with this proposal on an unprecedented and unrealistic timeline. We ask you to urge HHS not to finalize the proposed rule and to oppose legislation that would broaden its scope." 

HHS officials argue the proposal wouldn't significantly raise premiums, and it would force companies to lower their sticker prices.




What we're reading

On health care, 2020 Democrats find their first real fault lines (The New York Times)

Industry, analysts clash over scope of balance billing legislation (Modern Healthcare)

Ebola vaccine will be provided to women who are pregnant, marking reversal in policy (Stat)


State by state

Florida bill aims to protect pre-existing conditions from 'catastrophic' ObamaCare repeal (South Florida Sun Sentinel)

Hundreds protest bill to repeal Arizona law on babies born alive during abortions (Arizona Republic)


From The Hill's opinion page:

Life-saving gene therapies are here -- we need to get them to patients