By Peter
Sullivan and Jessie Hellmann - 12/29/19 08:33 PM EST 327
Advocates hope
lawmakers can beat the odds and move major health care legislation in the new
year.
2019 opened with
bipartisan talk of cracking down on drug prices and surprise medical bills. But
it ended without major legislation signed into law on either front, and a host
of other health care battles, including a lawsuit threatening the entire
Affordable Care Act, looming over the coming election year.
Here are five health
care fights to watch in 2020.
Drug pricing
Lowering drug prices
was supposed to be an area for potential bipartisan action in 2019, but the
effort ran into a brick wall of industry lobbying and partisan divisions.
There is a push to
finally get legislation over the finish line in 2020, though.
Speaker Nancy Pelosi (D-Calif.) is
calling for attaching drug pricing legislation to a package of expiring health
care programs, like community health center funding, that must be renewed by
May 22. She hopes the pressure from that deadline helps carry a larger package,
but that is far from certain, especially as the election gets closer.
Democrats point to President Trumpvow to
support allowing the government to negotiate drug prices during his 2016
campaign. While Trump backed off that pledge this year, they hold out hope he
might come back around. Senate Majority Leader Mitch McConnell (R-Ky.) is
also strongly opposed to the idea, and has concerns about a more modest bill
from Sens. Chuck Grassley
(R-Iowa) and Ron Wyden
(D-Ore.) that could provide a more realistic bipartisan path.
“The president said
when he ran and until relatively recently that he would support negotiated
prices and I expect at some point he will go back to that, and we're just going
to keep pushing the Senate to try to achieve that,” said House Energy and
Commerce Committee Chairman Frank Pallone Jr. (D-N.J.).
Surprise billing
The other major health
care initiative that Pelosi says she wants in the May package is protecting
patients from surprise medical bills.
That effort has also
fallen prey to intense industry lobbying and congressional infighting.
Backers of a bipartisan
bill from the House Energy and Commerce Committee and Senate Health Committee
on the issue pushed for including the measure in a year-end spending and were
deeply frustrated when it was left out.
A key factor was House
Ways and Means Committee Chairman Richard Neal (D-Mass.)
putting forward the outline of a rival plan days before this month’s funding
deadline, showing a split on the way forward.
“It’s certainly going
to be harder [next year],” said Shawn Gremminger, senior director of federal
relations at Families USA, a liberal health care advocacy group.
“You are now under six
months out from the general election,” he said about moving legislation in May
2020.
Backers have a tough
road ahead. They will have to bridge the divide between the competing plans and
overcome lobbying from powerful doctor and hospital groups, who worry the
legislation could lead to damaging cuts to their payments.
ObamaCare
Outside of Capitol Hill
negotiating rooms, the GOP lawsuit to overturn the Affordable Care Act is
looming large.
A federal appeals court
last week issued a long-awaited ruling on the fate of the law, though it did
little to settle the issue. The 5th U.S. Circuit Court of Appeals ruled
that the law’s mandate to have health insurance is unconstitutional, but punted
on the question of whether any of the rest of the law should also be struck
down, instead sending it back to the lower court.
The most tangible
effect of the move could be to push a final Supreme Court decision on the fate
of the law past the 2020 elections, though it’s possible the justices could
still choose to take the case sooner.
Democrats intend to
hammer Republicans over the lawsuit during next year’s campaign, though, a
strategy that paid off for the party during the 2018 midterms when they focused
on health care.
The Democratic group
Protect Our Care launched a national TV ad on Friday, saying “President
Trump and Republicans just won a major decision in their lawsuit to repeal
health care from millions of American families,” and warning of the loss of
pre-existing condition protections.
Medicare for All
In the Democratic
presidential race, "Medicare for All" is a central dividing line.
How the issue plays out
in 2020 will depend in large part on who wins the Democratic nomination. If progressives
like Sens. Bernie Sanders
(I-Vt.) or Elizabeth Warren
(D-Mass.) win the nomination, Republicans will be able to go full bore on their
attacks that private health insurance would be eliminated under the proposal.
Even more moderate
candidates like former Vice President Joe Biden and South Bend,
Ind., Mayor Pete Buttigieg
would face attacks that their public option plans are a step down the road
toward eventually implementing full-scale single payer.
The internal debate on
the issue has faded somewhat from its peak. Health care has not featured as
prominently in the last two debates, and some of the fighting has shifted to
other areas, like candidates' fundraising practices.
But the issue is still
simmering and could burst back to open warfare among Democrats at any
point.
Vaping
The battle over
e-cigarette flavors will likely resume in 2020 as the Trump administration and
Congress try to cut rising youth vaping rates.
Public health advocates
are pushing the administration to clear the market of flavors like mint and
fruit that they argue are fueling a youth vaping epidemic.
Trump said he would
eliminate those flavors in September, but has appeared to back down after
backlash from vaping advocates and the e-cigarette industry.
Now he says he would
like to find a compromise that preserves such flavors for adults while keeping
them away from kids.
Advocates like the
Campaign for Tobacco-Free Kids plan to pressure Trump to follow through on his
word, though it’s looking unlikely.
However, the
e-cigarette market could also look vastly different after May 2020, when
companies must apply to the Food and Drug Administration to stay on the market
The industry must
prove its products benefit public health, a big ask for companies like
Juul, whose products are favored by kids who vape.
House Democrats also
plan to vote on a bill that would ban flavored e-cigarette and tobacco
products, but it’s not clear if it will get a vote in the Senate.
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