Cicilline to Reintroduce Resolution to Reestablish House Aging Committee

Published in the Woonsocket Call on November 18, 2018

In October 1992, the House eliminated the House Permanent Select Committee on Aging charged with investigating and putting a spotlight on aging policy. The Committee was instrumental in conducting research and publishing a number of reports on elder abuse, leading to the passage of reform legislation intended to improve nursing home operations and reduce abuse against patients. The Committee’s work also led to increased home care benefits for the aging, establishing research and care centers for Alzheimer’s Disease, and many other accomplishments on a broad array of aging issues.

Over 26 years later, on March 1, 2016, Congressman David Cicilline (D-RI) introduced his House resolution 160 to reestablish the Committee. He would attract Rhode Island Congressman James R. Langevin (D-RI) and 23 other cosigners (no Republicans) out of 435 lawmakers, but would ultimately see no legislative action taken. “I discussed this proposal with Speaker Paul Ryan (R- WI) and followed up with a letter asking him to move forward with this idea, but he declined to do so.”

“I think many of my Democratic colleagues didn’t think this resolution would get much traction with a Republican controlled House, but we did get Seniors Task Force Co-Chairs, Reps. Doris Matsui (D-CA) and Jan Schakowsky (D-IL), which was important,” says the Rhode Island Congressman.

A New Opportunity with a House Democratic Majority

With a Republican-controlled Congress successfully blocking Cicilline’s simple resolution from reaching the floor for a vote, the Democratic lawmaker says he will reintroduce House resolution 160 in the new Congress with the Democrats controlling the chamber’s legislative agenda. “With Democrats in the majority, I think there will be more interest from other members in this resolution,” he says, noting, “We will try to make this a bipartisan effort and hope to find Republicans who would be supportive.

“I will first reintroduce the resolution [in the new Congress] and build support from members and then present the proposal to my House leadership. We will try to make this a bipartisan effort and hope to find Republicans who would be supportive,” says Cicilline, noting that he will reach out to aging groups for support, including the Leadership Council on Aging Organizations, whose leadership includes Alliance for Retired Americans, the National Committee to Preserve Social Security and Medicare, and AARP.

“Of course, I would be honored to lead the reestablished House Permanent Select Committee on Aging, but that decision will be made by the incoming Speaker,” says Cicilline.

According to Cicilline, the House can readily create an ad hoc (temporary) select committee by approving a simple resolution that contains language establishing the committee—giving a purpose, defining membership, and detailing other aspects. Funding would be up to the Appropriations Committee. Salaries and expenses of standing committees, special and select, are authorized through the Legislative Branch Appropriations bill.

Cicilline says that a newly established House Permanent Select Committee on Aging would be charged to conduct comprehensive studies on aging policy issues, funding priorities and trends. As its predecessor, its efforts would not be limited by narrow jurisdictional boundaries of the standing committee but broadly at targeted aging policy issues.

“Our nation’s seniors deserve dedicated attention by lawmakers to consider the legislative priorities that affect them, including strengthening Social Security and Medicare, reducing the costs of prescription drugs, and the particular challenges of poverty, housing, long-term care, and other important issues,” adds Cicilline.

Aging Advocates Call for Reestablishing the House Select Committee on Aging

When Max Richtman, CEO and President of the Washington, D.C-based National Committee to Preserve Social Security and Medicare (NCPSSM), and former Staff Director of the Senate Special Committee on Aging, heard of Cicilline’s efforts to bring back the House Select Committee on Aging almost three years ago, he remarked, “It’s long overdue.” The Select Committee will once again provide serious oversight and lay the ground work for House legislative proposals impacting Social Security, Medicare and Medicaid, he said.

Richtman says that NCPSSM has just joined a working group to push for the reestablishment of the House Permanent Select Committee on Aging spearheaded by Howard Bedlin of the National Council on Aging. This group will devise strategies to resurrect the Committee, adds Richtman.

Richard Fiesta, Executive Director at the Alliance for Retired Americans, whose organization chairs the LCAO, representing over 70 aging groups, says that its membership voted this month to support and push for the reestablishment of the House Select Committee on Aging. “Members during the discussion expressed views that the Committee can be a focal point on aging issues such as such as Medicare, Social Security, Medicaid, long term care, and prescription drug prices,” says Fiesta, noting that it could provide important oversight on the U.S. Administration of Aging programs and be a forum for emerging issues such as home care needs.

“With 10,000 American turning age 65 each day, a Select Committee on Aging would be an important step in addressing the needs of older Americans,” says Fiesta.

Bill Benson, a former staff director of the Subcommittee on Housing and Consumer Interests, one of the four subcommittees of the House Select Committee on Aging, concurs with Richtman that the establishing the Committee is “long overdue.”

“During the 26 years we’ve been without the House counterpart to the Senate Special Committee on Aging,” which Benson also served on, “the House has not had an equivalent powerful voice for advancing critical issues for an aging society as we’ve had in the Senate. To successfully improve national policy requires both chambers of the Congress to be fully engaged. Restoring the House Select Committee on Aging would be important to do that.”

Howard Bedlin, National Council on Aging Vice President of Public Policy and Advocacy, adds: “A House Select Committee on Aging will raise visibility of the challenges older Americans are facing every day and support the work of authorizing committees to craft bipartisan policy solutions. Aging is an issue for all Americans. Discussion about the systemic strains that come with longevity and a growing aging population, or highlighting the many intergenerational needs of families across the country can only lead to better understanding and ultimately better support for all Americans as we age.”

Taking an Important Step to Protecting Seniors

As Cicilline gears up to put together the bipartisan support to pass his reintroduced to reestablish the House Permanent Select Committee on Aging, he says, “Overall, this resolution represents an important step towards protecting our seniors and the benefits they have earned, like Social Security and Medicare.”

“The reestablishment of this Select Committee on Aging would emphasize Congress’ commitment to our current and future seniors and would allow us to focus our energy to ensure that they are able to live with dignity and enjoy a high quality of life,” he adds.

A Washington insider tells me that some Democratic House lawmakers and aging groups are now pushing to reestablish the House Select Committee on Aging through new rules enacted by the incoming House Democratic leadership. The Washington, DC-based LCAO can now play a pivotal role in reestablishing the House Select Committee by advocating for and supporting Cicilline’s resolution that will be introduced in the next Congress or backing the attempt to change House rules. As the House takes up in the new Congress its debates on Social Security, Medicare and Medicaid, the Older Americans Act, and other issues of importance to older adults, it will be important to have a House Select Committee that once again puts the spotlight and attention on America’s aging issues.

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Ahead of Midterms, Trump Unveils His Proposal to Slash Prescription Drug Costs

Published in Woonsocket Call on October 28, 2018

With mid-term elections looming, President Trump moves to block Democrats tying the high cost of prescription drugs to an unresponsive Republican-controlled Congress and to GOP efforts to undo health care protections for people with preexisting medical conditions, one of the most popular provisions of the Affordable Care Act, referred to as Obamacare.

According to recent Roll Call poll, health care is a top issue for Democratic and Independent voters in key battle ground states while the GOP tout’s immigration and the economy and jobs as its priority.

Last Thursday, afternoon, at the Department of Health and Human Services (HHS) with Secretary Alex Aza, FDA Commissioner Scott Gottlieb and CMS Administrator Seem Verman standing by President Trump, he announced major changes as to how Medicare pays for prescription drug to bring down costs by making prescribed medications more affordable to seniors, making pricing of U.S. drugs fairer relative to costs paid by other countries.

Bringing Down Medicare’s Skyrocketing Drug Costs

“We’re taking aim at the global freeloading that forces American consumers to subsidize lower prices in foreign countries through higher prices in our country,” said Trump at the Oct. 25 press conference in his 14-minute speech. He noted that the costs for the same pharmaceutical drug in some countries are 20 percent less than those purchased in the United States even though it was made by the same manufacturing company.

“At long last, the drug companies and foreign countries will be held accountable for how they rigged the system against American consumers,” says Trump.

Trump rattled off specific examples of how Medicare pays higher prices for the same pharmaceutical drugs that are cheaper in other developed countries. For instance, one eye medication that prevents blindness would annually cost about $187 million rather than $1 billion dollars if Medicare paid the same prices other countries pay, he said.

Another example, a highly used and very effective cancer drug is nearly seven times as expensive for Medicare as it is for other countries, said Trump, noting that “this happens because the government pays whatever price the drug companies set without any negotiation whatsoever.”

Under Trump’s unveiled proposal, a new Medicare model, the International Pricing Index (IPI), is created to bring down Medicare drug costs to ensure seniors get a “more fair deal on the discounts drug companies voluntarily give to other countries.”

Currently, Medicare sets payments for physician-administered drugs at the average sales price in the U.S. market—plus a price-based add-on fee. Trump’s proposal would allow Medicare to set the payment of these drugs at a Target Price, based on the discounts drug companies give other countries. With the model fully implemented, it is estimated that total payment for these drugs would drop by 30 percent.

Under the IPI model, described in an Advance Notice of Proposed Rulemaking, Medicare’s payments for select physician-administered drugs would shift to a level more closely aligned with prices in other countries. Overall savings for American taxpayers and patients is projected to total $17.2 billion, with out-of-pocket savings potentially totaling $3.4 billion over five years.

Medicare beneficiaries not covered by the IPI model could also see their drug costs lowered, because the average price used to calculate traditional Medicare reimbursement will drop.

Trump’s drug pricing proposal still needs to be refined and put though a federal rule-making process and its impact may not be seen for years.

Is Trump’s Efforts to Lower Drug Costs Just Election Year Posturing?

“It’s hard to take the Trump administration and Republicans seriously about reducing health care costs for seniors two weeks before the election when they have repeatedly advocated for and implemented policies that strip away protections for people with pre-existing conditions and lead to increased health care costs for millions of Americans,” says U.S. Senate Minority Leader Chuck E. Schumer in a statement.

“Once again, the President’s plan doesn’t go far enough to bring down the costs of prescription drugs. Democrats have proposed letting the HHS Secretary negotiate the prices of all drugs covered under Medicare, as well as new tools to ensure transparency and accountability when companies try to raise their prices. Without these critical steps, the President’s plan is just more words with little substance,” says Rhode Island Congressman David N. Cicilline.

Pharmaceutical Research and Manufacturers of America (PhRMA) president and CEO Stephen J. Ubl, opposes Trump’s proposal to lower Medicare’s drug costs, warning that it would “jeopardize access to medicines for seniors and patients with disabilities living with devastating conditions such as cancer, rheumatoid arthritis and other autoimmune diseases.” Trump’s proposal severely alters the Medicare Part B program by reducing physician reimbursement and inserting middlemen between patients and their physicians,” charges Ubl.

Adds, Frederick Isasi, executive director of Families USA, in his statement: “The data is clear. The way we currently pay providers and pharmaceutical companies for drugs administered in doctors’ offices and hospitals creates perverse financial incentives for providers to select extraordinarily expensive drugs that may not be best for their patients. “

“Medicare Part B is the perfect example of misaligned incentives, and the proposed rule, if implemented, could pilot significant new ways to pay for drugs that align incentives so that patients get the highest value care, they have the best outcomes possible, and costs come down, says Isasi.

Like many, Isasi hopes that Trump’s proposal of using the power of the federal government to reduce Medicare drug costs is “not just election year posturing” but truly reflects a policy shift to using federal negotiating power to get unstainable prescription drug prices under control.

Next year, after the dust settles after the mid-term elections, Congress must work together to hammer out a comprehensive legislative strategy to lower pharmaceutical drug costs and to provide health care to all Americans. Listen to the polls.