MTM, pharmacy measures in final HCR bill
Cost analysis, text of bill released as clock ticks toward House vote on Sunday.
With a nonpartisan cost estimate showing that the final health care reform (HCR) bill will reduce the federal deficit in each of the next two decades, the House of Representatives is set for a vote on the legislation this weekend.
The House can vote on the bill 72 hours after the language was made public, making a vote possible after noon Eastern time on Sunday.
The cost analysis, conducted by the Congressional Budget Office (CBO), shows a deficit reduction of $138 billion in 2010–19. The CBO generally estimates costs for only 10 years. But Congress had asked for projections of the bill’s long-term impact. Looking at the subsequent 2020 decade, CBO predicted the bill would lower the deficit by around 0.5% of the Gross Domestic Product. Democrats pegged that at $1.2 trillion, according to reports in lay media.
The CBO analysis is considered conservative since it only includes numbers for which reliable estimates are available. Thus, innovations such as medication therapy management (MTM) are generally scored as neutral or negative, since the only sure thing is that providers would have to be paid for the services. An article in today’s Washington Post questions the accuracy of the forecast, noting that this estimate contains more uncertainty than most because of the bill’s comprehensive nature.
Included in the legislation are numerous pharmacy-related provisions, including a grants program for medication therapy management sought by APhA and other members of the pharmacy coalition. An adjustment for pharmaceutical pricing based on average manufacturer price, or AMP, is also in the bill.
In the reconciliation package that will go to the Senate for certain “fixes” to the big bill, the AMP formula is tweaked further. Language closing the Medicare Part D prescription drug doughnut hole in increments over the next decade is also in the reconciliation bill. This year, Part D beneficiaries would receive a $250 rebate after they reach the gap in coverage.
If the HCR package is passed by the House, the bill would go to President Obama for his signature. Once that happens, the reconciliation would go to the Senate for its consideration. Some observers think that the public signing for HCR would be of the reconciliation package rather than the main document now before the House.
In addition to the Democrats’ full-court press on the HCR bill that is evident on cable news channels, President Obama held a campaign-style rally in support of HCR this morning at George Mason University, just outside Washington. The House Rules Committee posted a section-by-section analysis of the bill, now titled H.R. 4872, The Health Care & Education Affordability Reconciliation Act of 2010, and the reconciliation language. The House Committee on Energy and Commerce posted an analysis showing the benefits of the bill for each county in the United States.