Overnight Health Care: Senators grill drug execs over high prices | Progressive Dems unveil Medicare for all bill | House Dems to subpoena Trump officials over family separations

Overnight Health Care: Senators grill drug execs over high prices | Progressive Dems unveil Medicare for all bill | House Dems to subpoena Trump officials over family separations
© Stefani Reynolds

Welcome to Tuesday's Overnight Health Care.

It was a big day of health care news. Drug company executives took center stage in the Senate, while two HHS officials testified in the House about the administration's family separation policy. In addition, House progressives introduced their Medicare for all bill.

We'll start with drug prices:


Drug companies had lots of ideas about how to lower prices that didn't involve actually lowering list prices.  

The leaders of seven drug companies told members of the Senate Finance Committee on Tuesday they want to do something about high prescription costs but wouldn't commit to dropping list prices.


That's not surprising. Drug makers, insurers, and pharmacy benefit managers have all been blaming each other for high drug costs for years, with drug makers arguing that list prices don't actually mean much because they don't reflect what most patients actually pay at the pharmacy counter. Wide scale reform of the whole supply chain is needed before they can drop list prices, they said.

But drug makers publicly telling members of Congress that they can't lower list prices probably isn't a good look.  

What they said: "If you bring a drug to the market with a low list price in this system, you get punished financially and you get no uptake because everyone in the supply chain makes money as a result of a higher list price," Merck CEO Kenneth Frazier told senators.

"The system itself is complex and interdependent and no one company can unilaterally lower list prices without running into financial and operating disadvantages that make it impossible to do that."

But Senators from both parties weren't buying it: "I think that you charge more here because you can," said Sen. Debbie StabenowDeborah (Debbie) Ann StabenowACLU calls on Congress to approve COVID-19 testing for immigrants Senators press IRS chief on stimulus check pitfalls Democrats warn Biden against releasing SCOTUS list MORE (D-Mich.)

"American taxpayers are subsidizing all of you to be able to have incredibly high profits."

What drugmakers want: They said they support a proposal from the Trump administration that would eliminate Medicare rebates paid by drug manufacturers to insurers and industry middlemen and give them directly to patients at the pharmacy counter. If the proposal is implemented, most of them said they would try lowering list prices.

In a turnaround, most of the execs present also said they support Chairman Chuck GrassleyCharles (Chuck) Ernest GrassleyTrump administration to impose tariffs on French products in response to digital tax Big Ten moves to conference-only model for all fall sports Republicans considering an outdoor stadium for Florida convention: report MORE's CREATES Act, which would speed the development of generic drugs.

The generic drug lobby, the Association for Accessible Medicines, said they welcomed this "newfound support" of the bill after the pharmaceutical industry spent "years of spending millions lobbying."

But PhRMA, the lobbying group for branded drug companies, appears to be breaking from the execs, releasing a statement saying that it supports a "modified version" of the bill it worked on with AAM, which hasn't been released yet. It's not clear how it differs from Grassley's bill.

"The modified version of the CREATES Act protects patient safety by amending the Federal Food, Drug, and Cosmetic Act to clarify FDA's role in the process. It also includes safeguards to protect against frivolous litigation," a PhRMA spokesperson told The Hill.

But AAM doubled down, saying they only support the Grassley bill and not a "diluted version" of it.

Read more here.


Progressive Democrats unveil Medicare for all plan in House

It's here: The updated Medicare for all bill.

Rep. Pramila JayapalPramila JayapalDemocrats fear US already lost COVID-19 battle Progressive lawmakers call for conditions on Israel aid Hillicon Valley: Democrats introduce bill banning federal government use of facial recognition tech | House lawmakers roll out legislation to establish national cyber director | Top federal IT official to step down MORE (D-Wash.) on Tuesday announced the legislation had more than 100 cosponsors, as the idea gains steam among leading Democrats.

The bill from Jayapal, a progressive leader in the House, would replace private insurance companies with a government-run health insurance system. She plans to formally introduce the measure in the House on Wednesday.

"We are very excited to get to work on providing true universal coverage for everyone in this country," Jayapal told reporters on a call Tuesday.

The politics: The measure has no chance of making it into law at the moment but serves as a marker of where progressives want to steer the conversation ahead of the 2020 election.

Also that 'how to pay for it' thing...: The bill does not spell out how it would be paid for, a major question given that similar versions have been estimated to cost the government around $30 trillion over 10 years.

Read more here.


Officials says he never warned the Trump administration about the health effects

of family separations

The controversial former head of the HHS Office of Refugee Resettlement told a House panel Tuesday that he did not pass along warnings about the psychological impact of separating children from their families.

Under questioning from Democrats on the House Judiciary Committee, Scott Lloyd said he did not tell his superiors that separating children from families could have lasting health consequences.

Scott White, a top career official in the public health service corps, told lawmakers he repeatedly raised concerns with Lloyd as far back as 2017, when the policy was first being discussed internally. White said he told Lloyd family separation would be inconsistent with the agency's legal requirement to act in the best interests of children.

White said that Lloyd assured him that no family separation policy would be implemented.

Lloyd was grilled by Rep. Pramila Jayapal (D-Wash.) about his conversations with White.

"Did you ever say to the administration, this is a bad idea, this is what my child welfare experts have told us, we need to stop this policy? Did you once say that to anybody above you?" Jayapal asked.

"To answer your last question, I did not say those words," Lloyd said.

Lloyd, who joined HHS in March 2017, was effectively removed from his post in November.

More on Lloyd's testimony here.


In the same hearing ...


A House Democrat released internal HHS documents showing allegations of sexual assault against unaccompanied minors in U.S. custody.

The documents released by Rep. Ted DeutchTheodore (Ted) Eliot DeutchThe Hill's Coronavirus Report: Teachers' union President Randi Weingarten calls Trump administration plan to reopen schools 'a train wreck'; US surpasses 3 million COVID-19 cases US lawmakers call on EU to label entire Hezbollah a terrorist organization 189 House Democrats urge Israel to 'reconsider' annexation MORE (D-Fla.) showed there have been more than 4,500 allegations of sexual abuse committed against unaccompanied minors in HHS custody over the past four years. In addition, the documents showed more than 1,000 cases were reported to the Department of Justice.

The allegations include rumors of sexual relationships between staff and minors and reports of staff forcibly touching the genitals of minors, as well as inappropriate touching between staff and minors.

Deutch said the agency provided the documents in response to a request for information from the House Judiciary Committee.

The numbers: The documents show that from October 2014 to July 2018, the HHS Office of Refugee Resettlement received 4,556 complaints, and the Department of Justice received 1,303 complaints. The allegations go back to the Obama administration. This includes 178 allegations of sexual abuse by adult staff. In many of those cases, the staff member was eventually terminated from his or her position.

HHS response: "The safety of minors is our top concern when administering our unaccompanied alien children program. Each of our grantees running standard shelters is licensed by the respective state for child care services. In addition to other rigorous standards put in place by the Office of Refugee Resettlement (ORR) at HHS' Administration for Children and Families, background checks of all facility employees are mandatory," HHS spokeswoman Caitlin Oakley said.

More on the allegations here.




House Democrats to subpoena Trump administration over family separations

The House Oversight and Reform Committee on Tuesday voted to subpoena the Trump administration over documents related to the policy of separating children from families at the southern border.

Chairman Elijah CummingsElijah Eugene CummingsFacial recognition tools under fresh scrutiny amid police protests The sad spectacle of Trump's enablers Democrat Kweisi Mfume wins House primary in Maryland MORE (D-Md.) said the committee has been asking the departments of Justice, Homeland Security, and Health and Human Services (HHS) for information for seven months.

"I did not make this decision lightly," Cummings said. "I believe it is a true national emergency when our own government rips vulnerable children from the arms of their mothers and fathers with no plans to reunite them. That is government-sponsored child abuse."

The response from HHS: Agency spokeswoman Caitlin Oakley said HHS "has communicated regularly and in good faith" with Oversight Committee members, and has provided 792 pages of documents related to the Committee's request. Oakley said HHS has also offered committee staff a review of the Office of Refugee Resettlement portal, which is used to help track the children in HHS custody.

Read more here.


Measles outbreaks lead states to reconsider vaccine exemptions

Measles outbreaks across the nation are prompting state lawmakers to consider eliminating vaccination exemptions for religious and personal beliefs that have been claimed by the parents of some children.

Lawmakers in Iowa, New Jersey and Vermont, which already ban personal or philosophical exemptions, are now debating proposals to eliminate religious exemptions.

Proposals in Maine and Oregon would eliminate both exemptions, while measures in Minnesota, Colorado, and Washington state, where there are 66 confirmed measles cases this year, would only eliminate personal exemptions and leave religious exemptions in place.  

Why it matters: The CDC says there are six outbreaks in four states, and 159 confirmed cases of measles. Many public health officials point to non-medical exemptions as part of the problem.

Read more here.


The Hill event

On Wednesday, March 6th, The Hill hosts "Overcoming Obstacles: Patient Access to Innovation" at the Newseum. Speakers include FDA Commissioner Scott Gottlieb and Matt Salo, executive director of the National Association of Medicaid Directors. Editor-in-Chief Bob Cusack and Peter Sullivan will sit down with our speakers and moderate a series of discussions about keeping the patient at the center of the drug delivery system. RSVP here.


What's on our calendars for Wednesday:

Senate health Chairman Lamar AlexanderAndrew (Lamar) Lamar AlexanderRepublicans considering an outdoor stadium for Florida convention: report Sixth GOP senator unlikely to attend Republican convention Coronavirus Report: The Hill's Steve Clemons interviews Randi Weingarten MORE (R-Tenn.) and Energy & Commerce Chairman Frank Pallone (D-N.J.) are speaking about health care at an event hosted by The Atlantic tomorrow. 8-10 a.m. at AJAX in Washington.  


The Energy & Commerce oversight panel will look at the measles outbreaks in the U.S. 10 a.m. in 2123 Rayburn House Office Building.

The New Democrat Coalition will hold a press conference at 1:15 about their health care goals for the new Congress. Studio B in the House Visitors Center.


What we're reading:

Cancer complications: confusing bills, maddening errors and endless phone calls (Kaiser Health News)

Pro-vaccination advocates struggle to be heard online (NBC News)

Double-booked surgeons: study raises safety questions for high-risk patients (NPR


State by state

Tennessee lawmaker introduces bill to ban abortions after heartbeat is detected (AP)

Sen. Kennedy: Louisiana may have 'wasted' $2 million on Medicaid (thenewsstar.com)

West Virginia lawmakers delay action on Medicaid work requirements (register-herald.com)


From The Hill's opinion page:  

Washington state health secretary: we're falling short on vaccine-preventable diseases