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Weekly Column: Examining President's Health Department Budget On Behalf Of Idahoans

Guest column submitted by U.S. Senator Mike Crapo

Following the annual release of the President’s budget request to Congress, the Senate Finance Committee invites members of the President’s Cabinet to discuss aspects of the budget request under the Committee’s jurisdiction.  As Ranking Member of the Committee, I use these opportunities to advocate for policies to help Idahoans and push back on recommendations in the budget requests that are truly setbacks.  Because the Finance Committee’s expansive jurisdiction includes oversight of federal health care programs, the Committee recently held a hearing to discuss President Biden’s fiscal year 2025 budget request for the U.S. Department of Health and Human Services (HHS) with HHS Secretary Xavier Becerra.  At the hearing, I secured commitments from the Secretary to support congressional efforts to expeditiously enact much-needed pharmacy benefit manager (PBM) reform; work on a bipartisan basis to improve Medicare Part D; and expand telehealth flexibility for seniors and working families, despite the President’s proposed budget failing to deliver on these and other key promises for Americans. 

The Finance Committee has taken bipartisan action to tackle a range of health care challenges, leveraging collaboration and consensus to advance solutions for seniors and working families.  Our PBM reforms would modernize Medicare’s prescription drug benefits, driving down costs at the pharmacy counter and netting billions in savings for taxpayers.  The Committee’s mental health proposals would build on previous efforts to shore up patient access to critical services, especially in rural communities.

These policies have received nearly unanimous bipartisan support among Committee members.  HHS has helped align our legislation with its intended goals, and I am urging further action on these overdue improvements to deliver outcomes for patients, community pharmacies and frontline health care providers. 

The President’s budget request, unfortunately, falls severely short of that aim.  On prescription drug affordability, the budget request makes virtually no mention of the robust bipartisan, bicameral efforts to reform PBM practices.  Other bipartisan bills would address unintended consequences spurred by the Inflation Reduction Act’s pricing provisions, particularly for patients with rare diseases, who will likely see fewer treatment options under the law.  Rather than embrace these avenues for viable reform, however, the budget seeks to expand the program’s scope, with no attempt at improved transparency, certainty or mitigation. 

Further, the President’s budget request affirms an overreaching mandate that will force more nursing homes to close their doors and result in less access to home and community-based services for Medicaid beneficiaries.  This budget highlights divisions and misses vital opportunities for productive, patient-driven partnerships with Congress.

I will continue engaging with HHS on a host of health care hurdles that demand policymakers’ attention.  This includes the ongoing surge in medication shortages, including for life-saving therapies, an issue for which Finance Committee Chair Ron Wyden (D-Oregon) and I have proposed potential solutions

We also stand ready to partner on proposals aligned with the President’s Cancer Moonshot, including by ensuring that seniors can access innovations like multi-cancer early detection screening tests.  Senator Michael Bennet (D-Colorado) and I have a bill that would grant Medicare coverage for these technologies and bipartisan majorities in both chambers have joined as cosponsors.  More broadly, while the Administration erred in rescinding regulations aimed at expediting access to medical breakthroughs, HHS could take a range of steps to restore patients’ trust in reliable coverage for medical devices, including by expanding and enhancing the proposed pathway that CMS published last year.

Congress and the Administration have an obligation to build on longstanding legacies of bipartisanship to bolster the clinician workforce, drive value-based care, improve broken payment systems and ensure long-term access to telehealth.  In the weeks ahead, I will continue to use opportunities such as this to advance policies beneficial to Idahoans. 

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