Hart Health Strategies provides a comprehensive policy briefing on a weekly basis. This in-depth health policy briefing is sent out at the beginning of each week. The health policy briefing recaps the previous week and previews the week ahead. It alerts clients to upcoming congressional hearings, newly introduced bills, regulatory announcements, and implementation activity related to the Patient Protection and Affordable Care Act (PPACA) and other health laws.


Senate to Consider Tax Bill This Week

Sources in the White House have indicated that the President will not insist that repeal of the Affordable Care Act’s (ACA) individual mandate be included in the GOP’s tax reform legislation should it become an impediment to passage. The version of the bill being considered in the Senate would eliminate the penalty for Americans who decline to purchase health insurance, while the House-passed version of the bill includes no such provision. It remains unclear how inclusion of the provision would impact the bill’s chances of passing. Sen. Susan Collins (R-Maine) has expressed opposition to its inclusion, and believes that the Alexander-Murray legislation to stabilize the individual market should be passed prior to the tax bill. Sen. Lisa Murkowski (R-Alaska), who voted against earlier efforts on health care reform, has announced that she supports repeal of the individual mandate. Republicans can only afford to lose two members of their caucus in order to secure Senate passage. The full text of the Senate legislation was released last week, and is expected to be voted on by the full chamber as early as November 30.

Experts Estimate Economic Burden of the Opioid Crisis

The economic burden of the opioid crisis reached $95 billion in 2016, according to a new analysis released by Altarum. The loss of life – 53,054 deaths in 2016 alone – resulting from the opioid epidemic accounts for $43.2 billion in economic loss. The report estimates than an additional $12.4 billion results from the loss of productivity from non-fatal drug use. Health care services for those suffering opioid dependencies accounts for $24.6 billion. These costs are largely borne by the criminal justice system, child and family assistance services, and the education system. The federal government assumes $29.2 billion of the total costs associated with opioid misuse and abuse, indicating that the private sector bears most of the burden of this crisis. Furthermore, Altarum states that preliminary data indicates that costs associated with the epidemic in 2017 are likely to rise beyond 2016 levels, while only a small fraction of the total cost burden is currently spent on opioid prevention and treatment efforts.

The White House Council of Economic Advisers (CEA) released its own analysis placing the cost of the opioid crisis at $504 billion. The higher figure is a result of CEA’s inclusion of the “value of a statistical life,” which places a cost on the intangible value of life itself, beyond the concrete estimates of lost earnings included in Altarum’s report. The number of overdose deaths have doubled during the past decade; the total number of life-years lost in 2016 due to opioid overdoses reached 1.84 million years in 2016. The CEA calls for a better understanding of the economic causes contributing to the crisis. The White House also said that it plans to offer a follow-up analysis of recent actions aimed at solving the crisis.

President Signs Several Health Care Bills into Law

President Trump has signed the “Protecting Patient Access to Emergency Medications Act” into law. The bill aims to assist first responders through clarifying how registered agencies can administer controlled substances. It will improve the Drug Enforcement Administration (DEA) registration process for emergency medical services (EMS) agencies, and codify EMS professionals’ ability to administer controlled substances pursuant to standing or verbal orders under certain conditions. The President also signed into law H.R. 1545, which will explicitly require the Veterans Health Administration to disclose information to prescription drug monitoring programs (PDMPs) for anyone – veteran or non-veteran – who is prescribed a controlled substance medication through the VA.

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