Health policy impacts everyone, but it can be hard to know what is important. If you can only read three things about health policy this week, I suggest...

The Top Three...

Roll Call: Health Deadlines Pile Up As Congress Adjourns For August Lawmakers leave town at the end of this week with a lengthy to-do list, several health programs expiring Sept. 30 and very few work days left. ... Looming expirations include laws to fund the government and community health centers, reauthorize emergency response and pandemic preparedness programs and renew substance use and mental health aid. The bills are also lawmakers’ best chances of attaching other related policy riders, but the partisan divide on some could further threaten the bills’ odds of passing. (Clason, Cohen, Hellmann and Raman, 7/27)

Modern Healthcare: Key House, Senate Committees Advance PBM Reform Bills Two influential congressional committees on Wednesday passed bills aimed at reigning in pharmacy benefit managers’ operations, signaling that lawmakers' scrutiny of the prescription middlemen is here to stay. With the Senate Finance and House Ways and Means committees' action, every congressional committee focused on healthcare has now passed proposals to increase oversight of PBMs, which negotiate prescription prices with drugmakers on behalf of insurers. More than 80% of the PBM market is controlled by CVS Health’s Caremark, UnitedHealth Group’s OptumRx and Cigna’s Express Scripts. The three parent companies that also operate some of the largest insurers, provider groups and retail pharmacy networks. (Tepper, 7/26)

Axios: Health Care "Poison Pills" Complicate Congressional Spending Process House GOP appropriators are loading up their spending bills with anti-abortion and anti-gender affirming care measures that threaten Speaker Kevin McCarthy's goal of passing 12 separate appropriations bills. Unless the full Republican conference and the Democratic Senate are in agreement on the riders, it's time to start planning for a government shutdown at the end of September. (Knight, 7/26)

For a Deeper Dive...

Reuters: White House Launches New Pandemic Office To Be Led By Retired General The White House had been expected to cut down its COVID response team after the U.S. government in May ended its COVID Public Health Emergency. Biden said in September last year he believed the coronavirus pandemic was over in the United States. In June, the White House announced the departure of Ashish Jha, the last of the Biden administration's rotating COVID response coordinators. (Singh, 7/21)

KFF Health News: Everything Old Is New Again? The Latest Round Of Health Policy Proposals Reprises Existing Ideas Forget “repeal and replace,” an oft-repeated Republican rallying cry against the Affordable Care Act. House Republicans have advanced a package of bills that could reduce health insurance costs for certain businesses and consumers, partly by rolling back some consumer protections. Rather than outright repeal, however, the subtler effort could allow more employers to bypass the landmark health insurance overhaul’s basic benefits requirements and most state standards. (Appleby, 7/24)

AP: The Biden Administration Proposes New Rules To Push Insurers To Boost Mental Health Coverage President Joe Biden’s administration on Tuesday is announcing new rules meant to push insurance companies to increase their coverage of mental health treatments. The new regulations, which still need to go through a public comment period, would require insurers to study whether their customers have equal access to medical and mental health benefits and to take remedial action, if necessary. The Mental Health Parity and Addiction Equity Act requires that insurers provide the same level of coverage for both mental and physical health care — though the administration and advocates argue insurers’ policies restrict patient access. (7/25)

KFF Health News: A Year With 988: What Worked? What Challenges Lie Ahead? The Suicide & Crisis Lifeline’s 988 hotline marked its one-year milestone this month. Mental health experts say the three-digit number made help more accessible than before. The hotline was designed with the idea that people experiencing emotional distress are more comfortable reaching out for help from trained counselors than from police and other first responders through 911. (DeGuzman, 7/26)

Stat: Mental Illness, Drug Addiction Must Be Tackled Together, Top U.S. Official Says At a House oversight hearing Thursday, the Biden administration’s top drug policy official emphasized the need to address both mental illness and drug addiction simultaneously to reduce fentanyl deaths. According to a 2021 survey by the Substance Abuse and Mental Health Services Administration, over nine million adults in the U.S. have this co-occuring disorder. (Bajaj, 7/27)

NBC News: Bipartisan Senate Bill Aims To Bolster Drug Supply Chain By Prioritizing U.S. Manufacturing A bipartisan group of senators aims to strengthen the pharmaceutical supply chain with a bill that focuses on boosting stockpiles through increased drug manufacturing in the U.S. and allied countries. The legislation, introduced Thursday and first shared with NBC News, was drafted in response to a report published in March that found more than 295 medications, including lifesaving treatments, are in short supply nationwide. (Tsirkin, 7/27)

Stat: Dems Pitch Expanding Medicare Power To Negotiate Drug Prices It’s drug pricing déjà vu: Just as they did in 2019, House Democrats are pushing a bill that would allow Medicare to negotiate dozens of drug prices a year, offer those prices to all insurers, and crack down on price hikes. Unlike then, Democrats have a starting place: the new bill represents an expansion of the major drug pricing legislation the party passed last year. But the first round of drug price negotiations hasn’t even started yet, and the law is under attack from the pharmaceutical industry in court. (Cohrs and Wilkerson, 7/26)

Axios: First Look: A New Republican Health Care Plan A trio of policy experts from Stanford’s Hoover Institution are launching a new free-market health care plan this week that they're hoping will become the go-to Republican message for 2024 campaigns, with a focus on expanding health care choices. Ever since the Affordable Care Act "repeal and replace" effort failed in 2017, Republicans have struggled to find a unifying vision for health care they can put forward in presidential and congressional races. (Knight, 7/27)

The Hill: More Than A Third Of Rural Americans Skip Needed Care Because Of Cost: Study More than one third of Americans living in rural areas skipped medical care they needed due to the costs, according to a new study. The Commonwealth Fund’s 2020 International Health Policy Survey found that 36 percent of rural Americans did not get the care they needed due to costs, which is more than double the rate for rural residents in six of the other countries the study looked at. Less than 10 percent of rural residents in the United Kingdom, Norway and Sweden reported that they did not get medical care due to costs. (Sforza, 7/25)

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A few years ago I started a weekly e-mail for friends and colleagues who want to keep up on major federal health policy developments but did not have time to plod through all the minutiae--they were busy doing important things like running organizations and taking care of patients! Much to my surprise, it became pretty popular. I have now converted to a weekly newsletter format so you can manage your own subscription preferences and forward to others that might be interested.

These summaries represent my judgement on health policy issues that may not on the front pages, but are relevant to clinicians, administrators, and educators. I monitor many news sources and clipping services to identify content for this newsletter and I try hard to be as factual, balanced, and non-partisan as possible. While the articles are written by others (with credit attributed), the choice of what to include is entirely mine. If you are interested in receiving a daily summary of health policy news, you might consider signing up for the KHN Morning Briefing. If you enjoy podcasts, I suggest What the Health? and Tradeoffs.

-Gregg S. Margolis, PhD