Framing the Week

An extraordinary week lies ahead – Iowa caucuses today, State of the Union tomorrow, President Trump’s expected acquittal on Wednesday, and a House vote on a resolution to disapprove the Trump administration’s new Medicaid block grant guidance on Thursday.

State of the Union

During the SOTU, President Trump will likely speak on his health care priorities to lower prescription drug prices – possibly highlighting the forthcoming International Pricing Index (IPI) model – and efforts to stop surprise medical bills, as he did last year; take jabs at Medicare-for-all; and tout the administration’s Medicaid funding overhaul and response to mitigate the spread of the coronavirus. Michigan Gov. Gretchen Whitmer will deliver the Democratic response.

Surprise Medical Billing

Feeling antsy over the looming May 22 deadline, House Democratic leadership is pushing House health committee leaders to coalesce behind a single solution to stop surprise medical bills – ideally by the end of this work period on February 13 – in order to have enough time to negotiate a deal on drug pricing. Nearly two months after announcing their vaguely described arbitration plan, the House Ways and Means (W&M) Committee is expected to finally release its legislative text ahead of a markup on February 12. A potential wild card, the House Education and Labor Committee also plans to mark up their own surprise medical billing fix next week, though the Committee has not clearly indicated which payment mechanism they prefer – arbitration, benchmark payments, or both.

How these proposals diverge from the hybrid approach – benchmark payments and arbitration for out-of-network services for which the median in-network rate exceeds $750 – pushed by the House Energy and Commerce (E&C) Committee and Senate Health, Education, Labor and Pensions (HELP) Committee will soon become clearer.

Drug Pricing

As for drug pricing, the W&M Health Subcommittee will convene a hearing on Wednesday to discuss legislation aimed at overcoming pharmaceutical barriers and increasing access to medicines. The Subcommittee will examine the effectiveness of federal policies intended to facilitate research and improve access.


Following the World Health Organization’s decision to declare the 2019 novel coronavirus a “Public Health Emergency of International Concern,” HHS Secretary Alex Azar declared coronavirus a public health emergency in the United States. The Trump administration also formed the President’s Coronavirus Task Force, which includes HHS Secretary Alex Azar, CDC Director Dr. Robert Redfield, NIH’s NIAID Director Dr. Anthony Fauci, and other senior officials. On Wednesday, the House Foreign Affairs Subcommittee on Asia, the Pacific, and Nonproliferation will hold the first congressional hearing on coronavirus to assess the outbreak, response, and regional implications.

E-cigarettes & Tobacco

Five e-cigarette manufacturer executives – Juul, Logic, NJOY, Fotem, and Reynolds American – will testify Wednesday before the E&C Oversight and Investigations Subcommittee. This marks the first time that lawmakers will have an opportunity to directly question and admonish executives on their role for igniting the youth vaping epidemic. The recent FDA flavored e-cigarette policy – which includes a carveout for menthol and tobacco-flavored products, as well as open-tank vaping systems – will also be at the center of their discussion.

A floor vote on the Reversing the Youth Tobacco Epidemic Act of 2019 (H.R. 2339), which was approved by E&C by a voice vote, may be a next step. H.R. 2339 contains a provision prohibiting flavoring of tobacco products, including menthol, as well a provision raising the minimum legal tobacco sale age to 21. The latter was included in the FY 2020 appropriations package (H.R. 1865) signed into law last December.

Veteran’s Health

The Senate Veterans’ Affair Committee will convene a hearing to receive an update on the implementation of the Community Care Network formed under the VA MISSION Act on Wednesday. Last June, the Department of Veteran Affairs issued a final rule replacing the VA’s existing private care programs with the newly consolidated Community Care Network. Specifically, the final rule codified criteria for covered veterans to receive necessary hospital care, medical services, and extended care services from non-VA entities or providers in the community.

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Alyssa Llamas has a diverse background in health policy and public health, with seven years of experience in government, research