House Democrats unveil proposals on drug prices, Medicaid expansion

MM Curator summary


The health spending legislation is shaping up differently in the two chambers, notably with a reduced planned HCBS Medicaid funding amount than previously expected.


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House Democrats on Thursday unveiled a range of health care measures to be included in their coming $3.5 trillion package, including provisions to lower prescription drug prices and expand Medicaid in the 12 GOP-led states that have refused to do so. 

The measure unveiled by the House Energy and Commerce Committee ahead of consideration next week includes House Democrats’ signature legislation to allow the Secretary of Health and Human Services to negotiate lower drug prices, known as H.R. 3. 

That is a contrast with Senate Democrats, who are working on their own proposal to lower drug prices, which is expected to be less far-reaching than the House bill, given the need to win the votes of some more moderate Senate Democrats. The final bill is expected to be closer to the Senate version, but for now House Democrats are sticking with their measure. There also is no text available yet for the Senate proposal, which Democrats say they are still working on. 

The House measure unveiled Thursday would also create a new federal health insurance program to provide Medicaid coverage in the 12 states that have refused to expand Medicaid under the Affordable Care Act, providing insurance to more than 2 million people. 

The new federal program would begin in 2025, with a transition period before then of subsidized private coverage in the ACA marketplaces. Creating a new federal health insurance program has drawn some pushback from the health care industry, which worries it could be a step toward a larger-scale public option for health insurance. 

The proposal includes $190 billion to provide care at home for seniors and people with disabilities, a cut from the White House’s initial proposal of $400 billion, as Democrats look to fit a range of priorities into the package. 

The measure would put $15 billion towards preparing for future pandemics, with steps including shoring up the Strategic National Stockpile and investing in vaccine manufacturing. That is in line with the latest White House request, a down payment on a $65 billion total pandemic preparedness plan. But it is below the $30 billion that had been sought by advocates and was initially proposed by the White House. 

On drug prices, House and Senate negotiations lie ahead on bridging the gap between the proposals, though the final version is expected to hew closer to the Senate version. One major difference is that the House bill sets a cap on drug prices using the prices paid in other wealthy countries. 

Some more moderate Senate Democrats have objected to that idea, and the Senate is instead looking at using a “domestic reference price,” which sources say could include using a version of lower prices paid by the Department of Veterans Affairs, which was first reported by Stat on Thursday. But that measure is still not finalized. 


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