U.S. House Energy & Commerce Republicans yesterday filed, but majority Democrats did not consider, four 340B-related amendments to budget legislation integral to enacting congressional Democrats and the Biden administration’s Build Back Better plan.
The amendments that the House Republicans filed yesterday would have:
- Imposed additional sanctions on 340B covered entities for noncompliance after receiving adverse audit findings related to duplicate discounts or drug diversion
- Required 340B disproportionate share (DSH) hospitals to limit the price of insulin or EpiPen-like devices to “consumers” to the difference between the drug’s average manufacturer price and Medicaid rebate percentage
- Extended the 340B duplicate discount prohibition to a proposed expansion of Medicaid
- Protected DSH hospitals from losing their 340B eligibility during the COVID-19 pandemic due to changes in patient and payer mix, but only if they limited the price of insulin and EpiPen-like devices to consumers to the difference between the drug’s average manufacturer price and Medicaid rebate percentage.
340B providers opposed the amendments and they were not brought up.
The outlook for congressional passage of drug pricing legislation is less clear today following action yesterday in the E&C and Ways and Means committees.
The E&C Committee voted 29-29 on budget reconciliation legislative recommendations relating to drug pricing, which means those E&C committee recommendations did not advance to the Budget Committee, scuttling a potential full House vote. Three moderate E&C Democrats joined with all the committee’s Republicans in opposition.
The Ways and Means Committee yesterday included measures to lower prescription costs—including letting the U.S. Health and Human Services (HHS) negotiate for lower drug prices—in passing budget reconciliation legislative recommendations under its jurisdiction. However, the rebellion by the three E&C Democrats—Reps. Scott Peters (Calif.), Kurt Schrader (Ore.), and Kathleen Rice (N.Y.)—makes it unlikely that Democrats can pass their drug pricing package in the full House as written. The U.S. Senate Finance Committee is also expected to tackle drug pricing legislation in the coming weeks.
In 2017, Peters co-sponsored legislation with GOP Rep. Larry Bucshon (Ind.) that would have implemented a two-year moratorium on DSH hospital parent and child site enrollment in 340B. Their 340B PAUSE Act also would have imposed major data reporting requirements on 340B DSH, children’s, and free-standing cancer hospitals. The PAUSE Act was one of 15 340B-related bills and discussion drafts that the then GOP-led E&C Health Subcommittee discussed during a July 2018 hearing on 340B.