HHS Faces Hard Questions from Congress Over Step Therapy

This post originally appeared in STAT News' "DC Diagnosis" Newsletter on Tuesday, March 19 2019. 

HHS Secretary Alex Azar trudged up to Capitol Hill three separate times last week, and he got some tough but expected questions about Obamacare, the agency’s family separation policy, and myriad other hot-button health policy issues. But one line of questioning was striking — and surprisingly bipartisan: It concerned the agency’s idea of allowing private Medicare plans to not cover certain drugs that treat conditions like depression and HIV — drugs known as the so-called protected classes.

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The idea has inflamed the groups representing patients who will be most affected by the change — particularly those dealing with HIV (more than 140 wrote to CMS in January opposing the policy). And lawmakers increasingly are raising concerns, too.
 
During last Tuesday's Energy and Commerce hearing, no fewer than four lawmakers, including Rep. Greg Walden (R-Ore.), used their five minutes of questioning to press the secretary on how allowing the policy would impact patients. More than 70 House lawmakers and 14 senators also sent letters to HHS last week opposing the change.
 
“While we all agree that high drug pricing must be addressed, we do not believe that these provisions in the proposed rule would result in significant cost savings and would result in pushing access to critical medication out of reach for patients in need,” the House letter states, which was signed by everyone from progressive celebs like Ocasio-Cortez to Rep. Billy Long, the Missouri Republican who is such a big fan of Trump that he asked the president to sign his tie during this year’s State of the Union.