Republican and Democratic senators clashed over the Biden administration’s record on lowering drug prices during a Senate Finance Committee hearing on Thursday centered on the fiscal year 2025 proposed budget for the Department of Health and Human Services (HHS).
Some Republican senators blasted the administration’s proposed nursing home requirements, and one raised concerns over Title X funding requirements, saying they unfairly stripped his state of critical preventive care services.
Lowering Drug Prices
The Inflation Reduction Act (IRA) of 2022 allowed Medicare to negotiate lower drug prices directly with drug manufacturers for the first time.
The proposed budget aims to go even further in lowering drug prices by calling for Medicare to negotiate prices for another 50 drugs each year — up from 10 in 2024.
Committee Ranking Member Sen. Mike Crapo (R-Idaho) questioned HHS’s decision to “double down on a price control policy that polarizes members in both chambers,” arguing that this would lead to fewer treatment options for patients with rare diseases.
The budget also excludes two pharmacy benefit manager (PBM) reform bills that passed through the committee “nearly unanimously,” Crapo said, “sending a troubling signal to the patients and community pharmacies, and frontline healthcare providers across the country.”
Asked what steps the administration plans to take to move the bill “expeditiously,” HHS Secretary Xavier Becerra said the administration is “absolutely ready” to work with Congress on PBM reform.
“I think we all agree there’s no reason to have middlemen in the healthcare system if they’re not going to provide healthcare,” he added.
Minimum Staffing for Nursing Homes
On the issue of nursing homes, Sen. John Barrasso, MD, (R-Wyo.) pointed to a Centers for Medicare & Medicaid Services (CMS) proposed rule, which includes a requirement for a registered nurse to be present 24 hours a day, as opposed to 8 hours a day — the current minimum standard.
Four out of five nursing homes have said they aren’t going to be able to comply with these rules, Barrasso noted. A Republican-controlled House committee passed a bill last week in an effort to block the rule.
Barrasso also pointed out that CMS Administrator Chiquita Brooks-LaSure said the agency has committed $75 million to support staffing in nursing homes.
“How do you plan for these funds to reach these rural communities that are really getting hammered by these additional rules?” Barrasso asked.
CMS has worked to try to ensure funding reaches communities that need it most, Becerra said.
“But … if you’re going to call yourself a nursing home, you should have a nurse that’s present to provide care to the families that are leaving their loved ones there,” he added, reminding the committee that one in five people who died from COVID-19 did so in a nursing home.
Restricting Title X Funds
On a separate issue, Sen. James Lankford (R-Okla.) brought up a rule that took effect last year that required any state that receives Title X funds to include information about ways to access abortion on health pamphlets and brochures.
Title X, as the HHS budget document noted, “is the only federal grant program dedicated to providing individuals with comprehensive family planning and related health services.”
Without the inclusion of a certain 1-800 number, HHS threatened to pull states’ funding, Lankford said.
“You followed through on your threat, and you took away Title X funding from my state,” which meant stripping Oklahoma of dollars for county health departments and for services including HIV testing and cancer screening. (Oklahoma Attorney General Gentner Drummond sued HHS over Title X funding last year.)
“Why would you take away that funding?” Lankford asked.
Becerra noted that “we’re just simply saying a person should be informed of the services that could be available to them under Title X. And if a state wants to not abide by the law, they understand the consequences. They won’t get their money.”
Lankford said that withholding funding for services for failing to do something that isn’t in statute was “a pretty big bully tactic.”
“Senator, we follow the law,” Becerra said. “We expect those who want federal dollars to follow the law.”
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