TRANSPARENCY PACKAGE SAILS THROUGH — The House advanced on Monday one of the bipartisan bright spots in Congress this year: health care legislation called the Lower Costs, More Transparency Act, which passed in a 320-71 vote. The measure would increase reporting requirements for insurers, hospitals and pharmacy benefit managers. PBMs have been a bipartisan target in both chambers, and the passage is the most significant action lawmakers have made against them this year — now prompting the Senate to act. The bill renews a number of federal health programs and changes Medicare payment policy so that drugs administered in a hospital outpatient department are reimbursed at the same rate as a doctor's office, a policy known as site-neutral payments. Hospitals and PBMs oppose the bill and vow to continue pushing against the policies. The bill was slated to receive a vote in September but was pulled from the calendar amid questions over its support and House chaos over government spending. It passed Monday with the support of 166 Republicans and 154 Democrats, a total that could bolster House lawmakers’ negotiating leverage with the Senate. Rep. Brett Guthrie (R-Ky.), chair of the Energy and Commerce health subcommittee, told Pulse that the House is “getting back to normal” following the passage of a government funding package and the election of a new speaker. Rep. Bobby Scott (D-Va.), ranking member of the Committee on Education and the Workforce, had flipped to support the bill. A House Democratic aide told Pulse that adding more robust privacy protections was key to getting Scott on board. However, some key players opposed the bill. Rep. Richard Neal (D-Mass.), ranking member of the Ways and Means Committee, cited a lack of ownership transparency requirements that would reveal when private equity firms purchase health facilities, including nursing homes. Other Ways and Means Democrats — including Reps. Lloyd Doggett (D-Texas) and Bill Pascrell (D-N.J.) — also voted no. Democratic leadership was split, with House Minority Leader Hakeem Jeffries (D-N.Y.) and Minority Whip Katherine Clark (D-Mass.) supporting and Rep. Pete Aguilar (D-Calif.), chair of the House Democratic Caucus, opposing. The bill also authorizes increased funding for community health centers, Daniel reports. But the increase that passed Monday night — an annual 10 percent boost through calendar year 2025 — is far less than a Senate proposal. Some community health advocates hope Monday’s vote will jump-start negotiations with the Senate, where leaders have signaled they’re looking for more than what’s in the House bill, Amanda Pears Kelly, CEO of Advocates for Community Health, told Pulse. Funding expires in mid-January. WELCOME TO TUESDAY PULSE. Are you going to work on reconciling Senate and House packages? We want to hear from you. Reach us at bleonard@politico.com or ccirruzzo@politico.com. We can keep you anonymous. Follow along @_BenLeonard_ and @ChelseaCirruzzo. TODAY ON OUR PULSE CHECK PODCAST, your host Ben talks with POLITICO health care reporter Megan Messerly about her report on a coming mining boom that brings with it industry jobs that have good health care benefits — and how that can counterintuitively damage health care access, boosting it for some while hampering it for others.
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