Overnight Health Care — Presented by That’s Medicaid — House panel unveils rival fix for surprise medical bills | Democrats punt vote on youth vaping bill | Pelosi drug bill poised for passage after deal with progressives

Welcome to Wednesday’s Overnight Health Care.

A House committee has come up with a new fix for surprise medical bills, and a bill aimed at reducing youth vaping rates won’t get a vote until next year. 

We’ll start with surprise billing…

 

Ways and Means Committee announces rival surprise medical billing fix

The Energy and Commerce Committee has already announced a deal on surprise medical bills, but the Ways and Means Committee doesn’t want to be outdone. They announced their own bill on Wednesday. 

Why it matters: The rival proposal from Ways and Means could throw an obstacle into speedy passage of legislation. Neal said Wednesday that he thinks his proposal will be better than the Energy and Commerce bill. 

“I’ve been consistent in my career that my approach is better than everybody else’s,” Neal said with a laugh. 

The details: The Ways and Means bill would at first let insurers and doctors try to work out payment on their own, and if they cannot come to agreement, an arbitration process would begin. The full text of the proposal is not yet available.

The Energy and Commerce proposal, in contrast, relies in large part on essentially setting a payment rate based on the average price for that service in the geographic area. 

A spokesman for Energy and Commerce Republicans on Wednesday defended their committee’s legislation. “The White House backs our bill. Bipartisan House and Senate Committee leaders back our deal. This is the only bipartisan package that can become law, and we need to act now,” the spokesman said.  

In a statement, top Ways and Means Republican Rep. Kevin Brady (R-Texas) pumped the brakes on passing anything quickly, saying he hoped to take up the legislation early next year. 

The bipartisan Energy and Commerce leaders have said the goal is to have their bill, which also has the backing of bipartisan Senate Health Committee leaders, passed as part of a year-end spending bill.  

Read more on the rival bills here. 

 

House to vote on drug pricing bill tomorrow… and it should pass easily thanks to a last-minute deal with progressives

Speaker Nancy Pelosi (D-Calif.) reached a deal with progressive leaders on Tuesday night to avert a showdown over her signature bill to lower drug prices. 

The deal with Reps. Pramila Jayapal (D-Wash.) and Mark Pocan (D-Wis.), the co-chairs of the Congressional Progressive Caucus, will include two changes that progressives have been pushing for over the course of weeks.

Those changes are: 

• Increasing the minimum number of drugs subject to negotiation under the bill from 35 to 50. 
• Restoring the implementation of Jayapal’s amendment, which would extend protections against drug price spikes to people on employer-sponsored health insurance plans, not just those on Medicare. 

The deal prevents a showdown on Thursday when the bill will come to the floor for a vote. Progressive leaders had been contemplating a rare full-scale rebellion against Pelosi, thinking of blocking a vote on her drug pricing bill by trying to vote down a procedural motion. 

Read more here.

 

Democrats punt vote on bill aimed at preventing youth vaping to next year 

A bill aimed at curbing youth vaping rates by banning flavored e-cigarettes will not get a vote in the House until next year, according to one of the measure’s co-sponsors. 

Rep. Donna Shalala (D-Fla.), who co-sponsors the bill with Energy & Commerce Chairman Frank Pallone (D-N.J.), told The Hill Wednesday she has a “promise” from leadership for a vote “early” next year. 

Shalala had previously said the bill would get a vote by the end of the year. But Congress has a limited number of working days left this month, and it’s racing to avoid a government shutdown. 

She blamed the delay on the lack of time, and also said she wanted to make sure the bill got “good visibility.” 

The measure would ban flavored e-cigarettes and other tobacco products that advocates argue are appealing to kids while increasing the tobacco purchasing age to 21 and banning online sales of e-cigarettes.

Some House Democrats have pushed for a vote on the bill as the Trump administration delays action on youth vaping rates. 

President Trump announced in September his administration would clear the market of all flavored e-cigarette products. But Trump now says he wants to find a compromise that will appease both public health advocates, who want a full flavor ban, and vaping advocates, who say flavors are key to helping adults quit smoking. 

Why it matters: Research from the federal government shows the number of kids who are vaping reached an all-time high this year: 27.5 percent of high school students said they have recently used an e-cigarette, compared to the 20.8 percent who said the same in 2018. The same survey showed kids who vaped said mint and fruit flavors were their favorite. 

Read more here. 

 

South Carolina expecting green light on Medicaid work requirements 

South Carolina Gov. Henry McMaster (R) is expected to announce that the Trump administration has approved the state’s request to impose work requirements on Medicaid beneficiaries, according to multiple sources.

McMaster will make a public appearance on Thursday in Greenville, where he is expected to make the announcement.

Unlike many of the other states that already have been granted permission for work requirements, South Carolina did not expand Medicaid under ObamaCare.

Adults in the state who are able to qualify for Medicaid must earn below 67 percent of the federal poverty level — which is $12,490 for an individual, or $21,330 for a family of three. 

The Trump administration has approved work requirements in 10 states to date, but has suffered a series of setbacks in the courts.

A federal judge blocked implementation of work requirements in Kentucky and Arkansas, and an appeals court recently seemed skeptical of the administration’s arguments in the case. New Hampshire suspended its work requirements in July, and they were also later blocked by a judge.

 

What we’re reading 

‘A f–ing soap opera’: The health care drama riveting the White House (Politico)

It’s a bonanza: With drug pricing bill up for a vote, D.C. news outlets are drowning in advocacy ads (Stat News)

Patients, insurers seen as biggest winners in surprise medical bill deal (Bloomberg) 

 

State by State

Californians without health insurance will pay a penalty — or not (California Healthline)

This map shows how the opioid epidemic varies in different parts of the US (Boston Globe) 

Community health centers are again on the brink of a federal funding lapse (North Carolina Health News)

 

From The Hill’s opinion page:

This bipartisan plan is the most progressive approach to paid parental leave