Congress focused on mental health, Medicare price negotiations as 2023 approaches

With the midterms in the rearview, the lameduck Congress is focused on a handful of healthcare priorities heading into 2023, including mental health and implementing recent Medicare price negotiations afforded in the Inflation Reduction Act (IRA).

The priorities were laid out by two congressional members at an event this week hosted by Axios in Washington, D.C. Rep. Brett Guthrie (R-Ky.), Rep. Robin Kelly (D-Ill.) and Deputy Asst. to the President for Health and Veterans Affairs Christen Linke Young each discussed the current healthcare agenda for the Republican and Democratic parties, as well as the White House during the lame-duck session and beyond.

According to Young, the White House is focused on implementing changes from the IRA, including capping out-of-pocket costs for Medicare beneficiaries on prescription medications and giving Medicare the power to negotiate its own drug prices. Adding negotiation power has been a long-time goal among Democrats that aims to lower the cost of drugs for beneficiaries and save the Medicare program money. Both were achieved in the IRA.

“One of the biggest priorities for us right now is the change to the Part D [Medicare] benefit so seniors have a $2,000 cap at the pharmacy,” she said during the conversation. “Making that change inside the Part D program is a big lift. It’s an easy talking point. Inside CMS [the change] involves both the pharmaceutical companies and the drug plans themselves. CMS is committed to moving that out quickly and efficiently in a way that works for beneficiaries. [We’re] also setting up the bones at which Medicare will negotiate prescription drug prices.”

Among Republicans, however, there is a major concern that the Medicare negotiations granted in the IRA will lead to less innovation, as pharmaceutical companies will have less incentive to invest in research and development of new drugs, treatments and therapies if prices are capped by the government. Instead, Republicans see a path forward to lowering drug prices through patent reforms and driving competition through enabling new innovations to get approved quicker. 

“Patent reform, those things to bring pharmaceuticals into the marketplace sooner so people get lower prices and more options,” Guthrie said.

In addition, Guthrie, who is the top Republican on the Energy and Commerce Committee’s Health Subcommittee, is focused on investigating the origins of the COVID-19 virus, stating that he wants to get to the bottom of whether the virus originated in a Wuhan lab. The topic has been debated back and forth since the start of the pandemic, when origin theories pointed to a wet market in Wuhan China. Other rumors that the virus escaped from a lab accidentally have since surfaced, and the World Health Organization (WHO) reopened an investigation about the origin late last year. Prior investigations determined it was unlikely the virus escaped from a Wuhan lab.

According to Guthrie, the investigation is important in how the United States will respond to future pandemics. He also questioned whether WHO “covered up” the origin of the virus.

“What is the value in participating in these world organizations if you can't have faith and trust in them,” he said. “We need to see reform if we're going to continue to fund them. … Looking at it from the perspective of what role do we have in it… the world needs to know the answer.”

As for Democrats during the lame-duck session, they are focused on continuing to improve maternal mortality rates by expanding the post-partum period to a full year following birth, as well as staving off a nationwide abortion ban from Republicans, which some Congressmen have floated. Republicans are unlikely to push for a national abortion ban with Democrats in control of the Senate and President Biden in office next year.

“They might push for [a national abortion ban], but I don’t think it's going to go anywhere,” Kelly said. “We have a slim majority in the Senate and President Biden, two stopgap measures.”

In addition, Democrats and Republicans are both looking at mental health legislation before the end of the term.

“[Around] mental health we have seen tremendous bipartisan interest in shoring up and broadening access to mental health [care], and I think you could see that getting done in the end-of-year legislation,” Young predicted.

Amy Baxter

Amy joined TriMed Media as a Senior Writer for HealthExec after covering home care for three years. When not writing about all things healthcare, she fulfills her lifelong dream of becoming a pirate by sailing in regattas and enjoying rum. Fun fact: she sailed 333 miles across Lake Michigan in the Chicago Yacht Club "Race to Mackinac."

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