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This Week in Health Care Reform - December 12th, 2014

Sovaldi threatens to overwhelm the VA budget; the incoming Senate majority party already mapping out health care strategy for the new Congress; telehealth continues to attract stakeholders; U.S. health care spending growth is the lowest on record; and, a House hearing provides one Committee a final parting shot at the health care law.


Week in Review

VA Budget: By now, we’ve seen the scope and scale of the damage that the price of Gilead’s hepatitis C drug, Sovaldi, has wrought on a diversity of bottom lines.  The latest reminder of just how pervasive the $1,000-a-pill’s reach has become came by way of a recent Senate Committee on Veterans’ Affairs hearing where the staggering cost of the drug was, once again, brought into sharp relief.  Despite the Department of Veterans Affairs (VA) negotiating a $500 price cut for Sovaldi, the $1.3 billion in additional funding that the VA is requesting from Congress would only cover treatment for about 30,000 of the estimated 114,000 veterans with hepatitis C.  In order to provide the drug to the remainder of those infected, the VA would need another $2.6 billion.  Separately, it was announced this week that a lawsuit had been filed against Gilead, challenging the “exorbitant pricing” of Sovaldi.  Lawyers for the Southeastern Pennsylvania Transportation Authority (SEPTA) cited the $84,000 pricetag for a typical 12-week course of treatment as being far above what other countries are being charged for the drug.   

Senate Focus:
Poised to assume the majority in the Senate once Congress reconvenes in the New Year, Republicans are beginning to piece together their approach to health care and the divisive Affordable Care Act.  At a recent panel discussion in Washington, hosted by the American Enterprise Institute, experts focused on exactly this topic, considering what the GOP might do next year in regards to health care.  While it remains to be seen whether or not an out-and-out repeal vote is in the offing, what is clear to outside observers is that Republicans will likely return to Washington with a full menu of options on where they’d like to go with health care reform, a preview of which, was offered in an Energy & Commerce Health Subcommittee hearing earlier this week on health spending priorities.

Digital Health: At a recent briefing on Capitol Hill, the focus of discussion was on the landscape for digital health.  Hosted by the Alliance for Health Reform, the session brought together a variety of perspectives, from providers to payers to even the one-time National Coordinator for Health Information Technology.  While the panelists approached the topic from different directions, what they all shared was the common belief that, for our health system to realize true and sustainable improvement, digital technology must play a part.  However, despite doctors’ willingness to embrace the promise of digital health, regulatory barriers remain.  But, as more stakeholders dip their toes in the digital pool, there’s a growing sense that the sheer demand for telehealth will force a comprehensive reworking of the tangled web of regulations currently standing in the way of its ubiquity.  And, as more Americans gain access to coverage through the Affordable Care Act, some feel that that day isn’t too far off.

Lowest Growth:
It was announced last week that U.S. health care spending growth had registered its smallest increase in over 50 years.  Government officials released details from their latest trend analysis in which health care spending in this country was shown to have increased only 3.6 percent last year from 2012.  While there’s some debate as to what’s responsible for the historically slowed rate of growth, there’s growing consensus that newly-realized “efficiencies” throughout our health care system, combined with a focus on cost-containment, have been instrumental in bending the curve.

Transparency Hearing:
When video surfaced last month featuring one of the ‘architects’ of the Affordable Care Act stating that the passage of the health care law was a function of, both, a “lack of transparency” and the “stupidity of the American voter”, you knew it was only a matter of time before Congress got involved.  In what was repeatedly referred to as their last bit of business under outgoing Chairman Darrell Issa (R-California), the House Committee on Oversight & Government Reform held a hearing this past Tuesday, ostensibly to examine the transparency failures in the health care law’s implementation, but, what many would characterize as mere political theatre meant to call Jonathan Gruber, whose predictive modeling served as the foundation for the Affordable Care Act, and the person responsible for the offending comments, before the Committee for, what amounted to, a public flogging.  Despite efforts to downplay his role in the crafting of the health care law, opponents seized upon multiple candid remarks Gruber had made discussing the law’s passage.  While some of the comments could be dismissed as glib, idle chatter, one set of problematic remarks surfaced from early in 2012, in which Gruber seems to advance the idea that tax subsidies would only be made available through state-based exchanges and not the federally-facilitated marketplace, the central argument in the case currently before the Supreme Court.

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Looking Ahead

With a little more than two days to spare, the House of Representatives released their $1.1 trillion spending bill on Tuesday, in what essentially represents a last marker for the imminently-adjourning Congress and a step towards control for the GOP in the next one.  And, whether owing to retirement or the electoral winds of change, a number of health care stalwarts will be leaving Capitol Hill once the 113th Congress closes shop, leaving some to wonder where the next generation of visionary leaders for Democrats will come from. 

With the holidays upon us and Congress set to adjourn, we're taking a break of our own. But, we'll be back on the other side of the New Year. Until then, you can keep up with the latest by following the Health Action Network on Twitter and by liking us on Facebook.