on the hill
Health care advocates grow tired of funding slog
Doctors' groups scored a win this weekend when Congress struck a partial deal to fund the government that includes a 1.68% pay bump for physicians serving Medicare patients. But few others are happy with the now monthslong battle over the 2024 budget — or with what's been left out.
For instance, as my colleagues Rachel Cohrs and John Wilkerson previously reported, lawmakers punted on new rules for pharmacy benefit managers. "The definition of dysfunctional is when Congress can't pass reforms that majorities on both sides support," National Community Pharmacists Association CEO B. Douglas Hoey said in a statement Monday warning that independent pharmacies could close without change.
Research science lobbyists are also griping about the now five-month delay of a true 2024 budget, saying this weekend's deal is "nothing to celebrate" and just further delays needed funding increases (that Republicans, in an effort to bring down spending, haven't committed to). "Congress yet again takes only one step back from the brink of effectively surrendering our global leadership in science and technology to other nations," AAAS CEO Sudip Parikh said.
This weekend's deal — which also includes provisions for community health centers and substance use disorder medications — comes days before the latest budget deadline. It's also just in time for the president's State of the Union address, where he's expected to tout health care wins like Medicare drug negotiations and push Congress to fund a raft of 2024 priorities. More on the budget agreement.
the opioid crisis
Welcome to the War on Recovery
For decades now, there have been two highly effective, cheaply made medicines to curb opioid overdose deaths and help people fighting addiction. But in the face of policy roadblocks, social stigmas and provider barriers, barely one-fifth of the roughly 2.5 million Americans with opioid use disorder receive medication, and tens of thousands have died for lack of it.
A yearlong investigation by STAT's Lev Facher shows that virtually every sector of American society is obstructing the use of methadone and buprenorphine, medications that could prevent tens of thousands of deaths each year. There have been moderate steps in Washington:
Congress eliminated the x-waiver; the FDA made naloxone available over the counter; and SAMHSA rewrote methadone treatment rules. But in Lev's new series, War on Recovery, he sheds light on a fundamentally broken system that federal oversight has barely begun to touch.
Future installments of Lev's series will dive into these policy challenges and the myriad ways the lawmakers, providers, pharmacies and support groups have bucked more access to these meds. Stay tuned here.
PBM reforms
'Everything wrong with this industry'
The White House on Monday held a listening session aimed at finding ways to reign in big PBMs themselves. The panel — a small group of state and federal policymakers plus notable people in the pharmaceutical business — quickly turned to complaints about the 'big three,' CVS Health, OptrumRx, and Express Scripts.
Billionaire entrepreneur Mark Cuban, who more recently founded a direct-to-consumer generic drug retailer, called the PBMs "everything wrong with the industry." The group also heard from Kentucky Gov. Andy Beshear, the state's AG, HHS Sec. Xavier Becerra, and Biden domestic policy adviser Neera Tanden.
The PBM lobby, PCMA, was not thrilled: In a statement to Ed, they called the meeting "biased and unproductive." More from Ed on what happened at the White House.
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