Alexander, Murray Release Bill to End Surprise Bills, Lower Healthcare Costs

A day after holding a hearing about their proposed bipartisan legislation that aims to lower some healthcare costs, Senators Lamar Alexander, R-Tennessee, and Patty Murray, D-Washington, introduced the bill and said it will be voted on next week.

Alexander, the chair of the Committee On Health, Education, Labor, and Pensions, and Murray, the ranking member, said the vote on S 1895, the Lower Health Care Costs Act of 2019, will take place June 26.

“This legislation will reduce what Americans pay out of their pockets for health care in three major ways: First, it ends surprise billing; second, it creates more transparency—you can’t lower your health care costs until you know what your health care actually costs. And third, it increases prescription drug competition to help bring more lower cost generic and biosimilar drugs to patients,” said Alexander in a statement.

Alexander’s committee has held 5 hearings on ways to reduce healthcare costs and 4 hearings on the cost of prescription drugs. The bill, released in May, is made up of nearly 3 dozen discrete provisions from at least 16 Republican senators and 14 Democrat senators.

Murray said she was “glad my Republican colleagues decided to listen to families and join Democrats at the negotiating table to work on these bipartisan steps to help lower health care costs, end surprise billing, respond to issues like the maternal mortality crisis, vaccine hesitancy, and obesity, and more.”

The bill does not address any issues with the Affordable Care Act, which Murray referenced in her statement, adding, “I hope Republicans will build on this momentum by joining us at the table on bigger health care issues too—like repairing the damage from President Trump’s health care sabotage and protecting people with pre-existing conditions.”

The 5 sections of the bill are:

Ending surprise medical bills

This seeks to protect patients by requiring charges for emergency care to count toward their deductible, requiring only the in-network cost-sharing amount, setting a regional benchmark, and holding people harmless from surprise air ambulance bills, among other things.

Reducing prescription drug prices

This updates and expands the amount of information about biologics and biosimilars that the FDA must include in the Purple Book; modernizes the Orange Book, the FDA reference for generic drugs; improves access to generic drugs; clarifies that transition products cannot receive new marketing exclusivities; and prevents first-to-file generic applicants from blocking subsequent entrants beyond a 180-day exclusivity period.

Improving transparency in healthcare

This would, among other provisions, ban gag clauses between providers and health plans regarding quality and price information; ban anticompetitive terms in facility and insurance contacts; create a nonprofit entity to improve transparency of healthcare costs; require healthcare facilities to engage in timely billing; prohibit pharmacy benefit managers (PBMs) from engaging in spread pricing; and require PBMs to pass on all of their rebates to plan sponsors.

Improving public health

This includes such provisions as raising awareness of vaccines and combatting vaccine-related misinformation; requires HHS to disseminate a guide on obesity prevention; and sets a grant program for improving maternal healthcare quality, including training to reduce implicit bias.

Improving the exchange of health information

This part includes provisions that would require the Government Accountability Office to investigate gaps in privacy and security protections for patients’ health information and incentivize strong cybersecurity practices.