STALEMATE ON PEPFAR — The top Republican working to extend the United States’ global HIV/AIDS relief program admitted negotiations are deadlocked, jeopardizing one of the most successful U.S. foreign interventions of this century, POLITICO’s Alice Miranda Ollstein and Carmen Paun report. “I'm disappointed,” Rep. Michael McCaul (R-Texas) told POLITICO. “Honestly, I was looking forward to marking up a five-year reauthorization, and now I’m in this abortion debate.” McCaul, chair of the House Foreign Affairs Committee, which oversees the President’s Emergency Plan for AIDS Relief, which then-President George W. Bush started 20 years ago, was cautiously optimistic that he could broker a deal to re-up a program that is credited with saving 25 million lives and has long enjoyed bipartisan support. Discussions about a compromise that would extend the program for more than one year but fewer than five, with language stressing the existing ban on federal money directly paying for abortions, have collapsed. Talks have also run aground in the Senate. Sen. Ben Cardin (D-Md.) — the top negotiator in the upper chamber — said he has no plans to introduce a reauthorization bill this year. “We’re still negotiating,” he told POLITICO. “We were ready to move a long time ago. But we were not able to secure the necessary support on the Republican side. Why it matters: A lack of reauthorization for PEPFAR would signal to the countries that have long benefited from it that America doesn’t see the fight against HIV/AIDS as a priority, less than a decade before a 2030 target to end HIV as a public health threat. Program supporters say it would also mark the end of bipartisanship on a program that’s been the U.S. signature foreign aid program for two decades. WE WATCHED A LOT OF BILLS SO YOU DON’T HAVE TO — The House Energy and Commerce Committee advanced a slew of health care bills in overwhelming bipartisan fashion, including many aimed at reining in pharmacy benefit managers, which negotiate drug costs for insurers, by requiring them to be more transparent, Ben reports. But Reps. Buddy Carter (R-Ga.) and Larry Bucshon (R-Ind.) expressed concern that provisions banning so-called spread pricing in Medicare and reimbursement differences between vertically integrated pharmacies and independent in-network pharmacies were left out of Carter’s bill. “I’m disappointed with how this process played out,” Carter said at the markup. Committee Chair Cathy McMorris Rodgers (R-Wash.) said she’s working to address the PBM reimbursement differences and to ban spread pricing in Medicare as the House reconciles PBM legislation. A spread-pricing ban would prohibit PBMs from reimbursing a pharmacy less for a drug than what it charged the insurer. The House is set to vote next week on sweeping legislation that would ban spread pricing in Medicaid and add transparency requirements for PBMs, insurers and hospitals. The committee also advanced legislation that would make CMS’ national coverage determination process more transparent and address doctor pay under Medicare. Other bills advanced included legislation facilitating midyear formulary changes for new biosimilars and another bill requiring CMS to review drugs individually in coverage decisions. Going forward: The House and Senate will also ultimately have to reconcile PBM legislation, a top focus for lawmakers in this Congress.
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