Washington Summary August 2019 

House and Senate return from recess 

Bthe time you read this, the House and Senate will have returned from their annual summer recess. Many representatives and senators held constituent or political events during this period. We hope that you took the time to contact them and to discuss PKD issues. If you did, please email to tell us! PKDAdvocacy@pkdcure.org 

What to expect in September 

The Senate Appropriations Committee is drafting its 12 funding bills. Congress needs to approve the 12 bills before the beginning of Fiscal Year 2020 on September 30. If full-year funds are not provided by that time, Congress most likely will approve a continuing resolution (or CR) that will fund activities at the current lower dollar figure for several months. Barring continued funding, a shutdown of certain programs remains a possibility. 

Congress and health insurance

The phrase “Medicare for All” continues to receive a lot of attention in the media. That is a simplified phrase that covers a broad range of legislative proposals to increase access to health insurance. Some would create a single-payer national program; others would expand Medicare or Medicaid. Some bills would eliminate private insurance (even policies provided now by employers; others would retain some private plans). The devil is in the details. 

Here are some of the major bills: 

  • HR 1384, Medicare for All 
  • S 470 and HR 1346, Medicare at 50 
  • S 489 and HR 1277, buy-in option for Medicaid 
  • S 981, Medicare X, allowing anybody to buy into Medicare 
  • S 1129, Medicare for All 
  • HR 1884, Protecting Pre-Existing Conditions & Making Health Care More Affordable 
  • S 1125, the Protect Act 
  • HR 2452, Medicare for America Act 
  • S 1261, Choose Medicare Act 

Nobody expects the Senate to consider any major health insurance measure that the House may pass. Health and political analysts believe that these proposals are laying the groundwork for the 2020 campaign and the next Congress in 2021. 

Some information may be found in a previous Monthly Summary. For specific information on the provisions in any of the bills mentioned above, go to congress.gov or to the sponsor’s official website at house.gov or senate.gov

Health insurance:  Affordable Care Act (ACA), essential health benefits, preexisting conditions, and more 

PKD patients and their families need to continue to monitor state and administration activities to change ACA’s guaranteed access to affordable health insurance for persons with preexisting conditions such as PKD.   

The administration is working on a health insurance plan that President Trump is expected to announce in September. According to one report, the administration is considering expanding health savings accounts and allowing the sale of health insurance across state lines.   

Drug prices

Many PKD patients need prescription drugs to treat PKD and/or deal with symptoms associated with their disease. Medicare, group insurance through employment, or private insurance plans may cover a portion of the high cost of some of these drugs. 

House Democrats plan to release their proposal to reduce out-of-pocket drug costs in early September. Details have not been made public.  According to some reports, the bill would authorize Medicare to negotiate drug prices and would impose tough standards on drug manufacturers. A number of House Democrats believe that the proposal may not do enough to reduce drug prices. Any bill that the House passes will face a difficult time in the Republican-controlled Senate. 

The administration is drafting regulations that would allow states to import prescription drugs as an effort to lower prices for patients. At this time, Florida is the only state planning to take advantage of the proposed importation policy. 

In August, the administration clarified restrictions on the use by patients of drug companies’ copay coupons. In 2020, health insurance companies could exclude these coupons from counting against a patient’s annual out-of-pocket payments for prescription drugs.   

States and health insurance 

North Carolina has a new law allowing associations to provide non-traditional health insurance plans that may not include the ACA’s essential health benefits. The bill became law without the signature of Gov. Roy Cooper.   

Delaware Governor John Carney signed a bill that would place the ACA’s preexisting conditions provisions into state law.   

The Trump administration approved Rhode Island’s request to create a state individual health reinsurance fund. The state believes that the fund will reduce individual insurance premiums and increase enrollment in 2020. 

Surprise medical bills 

In response to the July bill approved by the House Energy & Commerce Committee, the House Ways & Means Committee is drafting its own bill to protect patients from surprise medical bills. The main issue is how to resolve payment disputes between health insurance companies and providers (hospitals, physicians, etc.).   

Bills of importance to the PKD community 

The Living Donor Protection Act, which would remove barriers to living organ donation, was introduced in both the House and Senate. Reps. Jerrold Nadler (D-NY) and Jaime Herrera Beutler (R-WA) introduced HR 1224. Sens. Kirsten Gillibrand (D-NY) and Tom Cotton (R-AR) introduced S. 511. PKD advocates may want to urge past supporters to again cosponsor this legislation.   

New cosponsor of S. 511, the Living Donor Protection Act 

Sen. Marsha Blackburn (R-TN) 

Stay alert 

When the time comes, we will ask PKD advocates to immediately contact their elected officials to protect your interests. Your voice needs to be heard.

 

UPDATED:  August 30, 2019