Drug Pricing Bill: Goes Too Far For Some, Falls Short For Others

One of the few areas where Republicans and Democrats can agree during this contentious year is that greater transparency in our health care system is a good thing.

But that consensus wasn’t strong enough to help a House Democrat who wanted to bring greater transparency to drug prices. Rep. Joann Ginal (D) sponsored House Bill 1102, which would have required drug manufacturers to submit reports on treatments that cost more than $50,000 annually or over the course of treatment.

But the bill died Thursday in the House Health, Insurance and Environment Committee. A key amendment failed to gain the support of all of the committee’s Democrats, and members ultimately voted 12-1 to kill the bill, with Ginal the lone vote opposing its death.

Ginal had hoped to change several components of the legislation, including moving responsibility for analyzing drug prices from the Colorado Commission on Affordable Health Care to an independent research organization, and extending a timeline that some thought was too short. But the bill was caught between the pharmaceutical industry on one side and advocates on the other side who believed it did not go far enough.

Rep. Su Ryden (D) said she thought the bill would provide false hope for reforming high health care costs. Her fellow Democrat, Rep. Dianne Primavera, was not convinced that the bill did enough to help consumers. Both voted no.

On the other side of the aisle, Rep. Lois Landgraf (R) said the bill missed a key opportunity for analysis of insurance companies in addition to drug companies. Rep. Gordon Klingenschmitt (R) said he feared that it would put pharmaceutical companies at a competitive disadvantage in Colorado and discourage them from offering life-saving drugs here.

As Ed Sealover notes in the Denver Business Journal, several committee members who voted against HB 1102 are in the midst of offering other bills designed to improve transparency this session. For Ginal, it’s back to the drawing board after a drawn-out fight to pass this bill.

Since our last blog, several other bills we’re watching came up for votes on the House floor:

• Senate Bill 90, which would give the state the choice to collect marijuana data at the regional level rather than the county level, passed its third and final reading 57-8 with no amendments, so it is on to Governor Hickenlooper for a signature.
• HB 1103, which hopes to clarify rules about licensing for mental health professionals, including social workers, passed its third reading unanimously and moves next to the Senate.
• HB 1164, which would move the authority to review student immunization exemptions from individual schools to the state Department of Public Health and Environment (CDPHE), passed its second reading yesterday after extensive debate on the House floor. It is up for final approval in that chamber this morning. Supporters say the state is better equipped to handle such decisions and that the change would generate better data about vaccination rates; opponents see it, as The Denver Post described, as “an attempt to have the state bully parents who don't want their children vaccinated.” The bill faces stiff opposition and an uncertain future if it advances to the Senate.

Across the Capitol, SB 135, which would allow insurance plans to cover services provided by qualified pharmacists, passed its third reading in the Senate unanimously and moves now to the House.

Other bills advanced out of committees:

• The House Health, Insurance, and Environment Committee approved two bills of note. SB 27, which would give Medicaid enrollees the choice to receive prescription drugs by mail, passed 13-0 and goes next to House Appropriations. SB 127, which aims to repeal a 2010 law that established the Medical Clean Claims Task Force, also passed unanimously and will be heard next on the House floor.
• The Public Health Care and Human Services Committee supported three bills. SB 94, a bill to give rural counties greater flexibility in decision-making and funding allocation for their district public health agencies, continued its perfect track record when it was approved by all 13 committee members. It goes now to the full House. HB 1112, which would establish a program to have military veterans with referrals from mental health professionals train dogs as service animals, passed 11-2 and is on to House Appropriations. On Twitter, the bill’s sponsor, Rep. Lois Landgraf (R), called it “my favorite bill in three years.” And HB 1210, which proposed a ban on psychiatrists and other mental health providers from engaging in conversion therapy with patients under the age of 18, advanced on a 7-6 party-line vote, with Democrats prevailing. That earns it a trip to the House floor.
• The House Finance Committee gave the nod to HB 1266, which would give the state power to confiscate and destroy marijuana containing unauthorized pesticides. It moves next to the Appropriations Committee.

There’s plenty to keep an eye on in the House:

• Today (Friday), the House Public Health Care and Human Services Committee will hear two bills we’re tracking. HB 1277 would extend the required notice period that the Department of Health Care Policy and Financing (HCPF) must give Medicaid enrollees about changes to their benefits, and give enrollees more time to appeal such changes. HB 1321 would direct HCPF to acquire federal permission to implement a Medicaid “buy-in” program, which allows qualified adults to pay to receive benefits through Medicaid when their income is above the eligibility threshold. The program would be available to Coloradans who qualify for home- and community-based services.
• Next week, the House Health, Insurance, and Environment Committee will consider HB 1294, which would require health plans to cover all 40 forms of contraception approved by the Food and Drug Administration. The Affordable Care Act only requires coverage of 18 forms.
• The House Finance Committee will vote on HB 1142, which seeks to create a new tax credit for preceptors who train students to become rural primary care providers. There has been recent discussion to make sure existing preceptors (not just new ones) would be eligible for the tax credit under the bill.
• The House Judiciary Committee will hear HB 1278, which would allow courts to require anyone on probation to participate in a residential drug treatment program, not just those who were sentenced for drug-related offenses.
• The House State, Veterans, and Military Affairs Committee will hear HB 1221, which would require the state government to cut its costs for lobbying and membership in professional organizations and then re-direct the savings to boost Medicaid provider rates. It seems that no legislators want to see these provider rates fall, but Democrats and Republicans don’t agree on how to accomplish it.

Of note: HB 1101 was scheduled for its first House floor vote earlier this week, but has been delayed until at least March 16. The bill, which has proven controversial, proposes to allow doctors to make decisions for a patient without fear of criminal liability if none of the patient’s family or friends can be found. And HB 1203, which would require all abortion clinics to be inspected by the attorney general and relicensed each year, had been on calendar for this week but now is delayed until early April.

We’ll be keeping tabs on three new Senate bills, two of which are up in committees next week:

• SB 139 has bipartisan Senate sponsors in Sen. Ellen Roberts (R) and Sen. Mary Hodge (D). The bill would require the Colorado Commission on Affordable Health Care to draft a proposal to allow the state to change from reimbursing rural hospitals with a fee-for-service model to a total-cost-of-care model. The change would apply to reimbursement for Medicare and privately insured patients. “Total-cost-of-care” refers to a comprehensive payment model that includes all services and administrative charges for an episode of care. Some believe it better incentivizes effective care and better outcomes in hospitals. The bill is up for its first hearing next week in the Senate Health and Human Services Committee.
• SB 147 also has bipartisan support: Sen. Linda Newell (D) and Sen. Beth Martinez Humenik (R) are Senate sponsors. It would establish a “zero suicide model” under CDPHE – which would commit the state to treating as preventable all suicide deaths for people under care by health professionals. Proponents call it a “bold and aspirational goal.”
• SB 152, sponsored by Sen. Irene Aguilar (D), deals with out-of-network services. This bill seeks to require clinics and hospitals to provide written notice to people about upcoming services that will not be covered in-network under their insurance plan. Under the bill, insurers would also have to provide clear lists of in-network options for covered health care services. It is headed to the Senate State, Veterans and Military Affairs Committee, where it will face a tough crowd.

Other bills we’re tracking, such as HB 1097,  which would create a new carrier category for those who provide nonemergency transportation to Medicaid clients, seem to be stuck in the legislative quicksand: This bill had its most recent hearing on February 4 and, although it advanced, has not been scheduled for its next committee.

With fewer than 50 work days to go in the session and the budget still to come, the legislature may be in for a busy final two months.