Policy Corner: October 25, 2019

Senate Chairman Expects Another Continuing Resolution After Nov. 21

Senate Appropriations Committee Chairman Richard Shelby (R-Ala.) said that as the result of a deadlock over spending negotiations, Congress will likely pass a new funding continuing resolution to prevent a shutdown after Nov. 21. The House of Representatives has passed 10 of the 12 annual spending bills, while the Senate has yet to pass any. The Senate introduced a package of four smaller, noncontroversial spending bills earlier this week and is expected to begin the process of voting on amendments next week.

House Promotes Drug Pricing Bill

The House Committee on Energy and Commerce has approved the Lower Drugs Cost Now Act, H.R. 3, to limit drug prices. The act, introduced Oct. 19, includes a requirement for the Department of Health and Human Services to negotiate Medicare prices for the most expensive drugs. Commercial health plans also have the option of adopting those prices. Specifically, the Centers for Medicare and Medicaid Services (CMS) must negotiate maximum prices for insulin products and at least 25 single source, brand name drugs that do not have generic competition and that are among the 125 drugs that account for the greatest national spending or the 125 drugs that account for the greatest spending under the Medicare prescription drug benefit and Medicare Advantage (MA). The negotiated prices must be offered under Medicare and MA and may also be offered under private health insurance unless the insurer opts out.

The negotiated maximum price may not exceed 120% of the average price in Australia, Canada, France, Germany, Japan, and the United Kingdom; if such information is not available, the maximum price may not exceed 85% of the U.S. average manufacturer price. Drug manufacturers that fail to comply with the bill’s negotiation requirements are subject to civil and tax penalties.

Lawmakers Introduce Legislation to Fund IDEA

Reps. Jared Huffman (D-Calif.) and Mark DeSaulnier (D-Calif.) introduced the IDEA High Cost Pool Funding Act, H.R. 4673, Oct. 15 to support states that establish pools to reimburse schools with expenses beyond the threshold. The bill would establish and make disbursements from high-cost funds. Since the special education law, known as the Individuals with Disabilities Education Act, was first passed in 1975, the federal government has yet to provide sufficient funding for the mandate. According to the bill sponsors, Congress provides just 15% of the costs for special education and related services mandated by law.

Four Congressional Seats Are Vacant

With the passing of Rep. Elijah Cummings (D-Md.) last week, three seats are now vacant in the U.S. House of Representatives and one in the U.S. Senate that will be vacant by the end of the year. Rep. Sean Duffy (R-Wis.) resigned effective Sept. 23; Rep. Chris Collins (R-N.Y.) also resigned in September, and Sen. Johnny Isakson (R-Ga.) will be resigning at the end of this year due to his health.

Federal Courts Block Final Rule on Public Charge for Immigrants 

Five federal courts temporarily blocked the administration’s new “public charge” policy with regard to low-income individuals with green cards and visa applications. The rule, which was set to become effective Oct. 15, called for rejecting individuals who the government believed would become a burden on U.S. taxpayers.

GAO is Conducting Interviews to Learn About Domestic Violence and TBI

The General Accountability Office (GAO) is interviewing state government employees and brain injury associations involved in educating, training, and screening victims of domestic violence who may also have sustained a traumatic brain injury (TBI). This work is the result of a bipartisan amendment to the Departments of Defense and Health and Human Services 2018 “minibus III” funding bill to require the GAO to report on federal efforts to study the prevalence of TBI among victims of domestic violence. U.S. Sens. Catherine Cortez Masto (D-Nev.) and Joni Ernst (R-Iowa) introduced the amendment. Much of the work conducted in the states is due to federal funding. The Brain Injury Association of America (BIAA) participated in a meeting with GAO regarding this upcoming report. BIAA also met with both offices regarding this issue.

World Stroke Day is Next Week

The World Stroke Organization is celebrating World Stroke Day Oct. 29 by continuing efforts to increase awareness and education for strokes in babies, children, and teens with its “Think Stroke… At Any Age” campaign. Studies have indicated that there are many challenges and delays in the diagnosis of childhood stroke. One of the organization’s findings reports that the time range from onset of symptoms to parents seeking medical help was 1.7 to 21 hours, which is understandable given the lack of awareness that strokes can happen in children. Once at the hospital, the major causes of delay include delayed consideration of stroke among front-line providers and delays in accessing MRIs, often related to the need for sedation or anesthesia. Delays were found to be greater in evenings and weekends. Click here for the organization’s campaign information.

NCSL Publishes Brief on State Responses to Juvenile Justice and TBI

As part of work with the Mount Sinai Injury Control Research Center on juvenile justice and TBI, the National Conference on State Legislatures (NCSL) issued a brief. This report examines the issue and prevalence of TBI among justice-involved juveniles and highlights steps that policymakers, researchers, and public officials in Colorado, Minnesota, Pennsylvania, and Virginia can take. Work in these four states was supported by the Administration for Community Living Federal TBI State Partnership Grant Program. This brief and associated work is in keeping with Grant No. 6 R49CE002092-05-05 from the Centers for Disease Control and Prevention to Mount Sinai. NCSL mailed the report to state legislators and their staff who are focused on health and criminal justice issues.