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Key committee could advance stalled health policy overhaul

The House Energy and Commerce Committee is giving a significant platform to revived, bipartisan talks on legislation to lower prescription drug costs, according to a staff memo reviewed by POLITICO.

The committee’s health subcommittee, led by Rep. Buddy Carter (R-Ga.), will hold a hearing on so-called “PBM reform” for Feb. 26, although that date could change.

Democrats and Republicans struck a deal late in the last Congress to place new regulations on pharmacy intermediaries, known as pharmacy benefit managers, in a bid to lower costs for patients and employers. These benefit managers, or PBMs, negotiate drug costs for insurers and employers. Carter and his counterpart on the health subcommittee, Rep. Diana DeGette (D-Colo.), held craft the legislative compromise.

The agreement was part of a larger, bipartisan package of health care policy provisions slated to be passed alongside a sweeping government funding bill — until Donald Trump and Elon Musk railed against the spending measure for being too broad and had to be shelved.

Still, the president has supported reining in PBMs, as has much of Congress on both sides of the aisle. It’s among the few areas ripe for bipartisan policy-making with full Republican control of Washington.

The prospects for moving this overhaul through Congress this year, however, will depend on how Republicans choose to proceed. Republicans have acknowledged they might like to use new regulations on PBMs to achieve cost savings necessary to finance their party-line legislation necessary for enacting Trump’s domestic policy agenda — the Energy and Commerce Committee could be instructed to identify as much as $880 billion in savings, a far larger number than many House Republicans had originally anticipated.

It’s still not clear whether the reforms would qualify for inclusion in a budget reconciliation bill under the strict procedural rules governing the process, and how much savings could even be achieved through it. But Democrats have warned not to use new regulations on PBMs as pay-fors in reconciliation package, warning it could poison further opportunities for bipartisanship on the panel.

There’s also disagreement about whether further regulations on pharmaceutical benefit managers are a good idea. The pharmaceutical industry has traditionally argued PBMs drive up drug costs to pad their profits, while the PBMs themselves argue new regulations would only raise drug costs.

A spokesperson for Committee Chair Brett Guthrie (R-Ky.) didn’t respond to a request for comment.

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