Orrin Hatch's Long And Complicated Legacy Of American Health Care | KUER 90.1

Orrin Hatch's Long And Complicated Legacy Of American Health Care

Dec 20, 2018

Sen. Orrin Hatch will retire next month, winding down a political career spanning four decades ... longer than any elected official in Utah's history. The 84-year-old will likely be remembered for his role in bruising Supreme Court nomination battles, passing the Children's Health Insurance Program and funneling millions of dollars back to Utah.

But this week, KUER is remembering lesser known parts of Hatch's legacy. 

In his 42 years in the Senate, Orrin Hatch authored or co-sponsored over 700 bills — more than any other living lawmaker — making him one of the health care industry’s biggest champions.

Sens. Orrin Hatch and Ted Kennedy were sometimes called “the odd couple.” The two worked on opposite sides of the aisle but managed to work together on a number of bills over the years, including CHIP in 1997.
Credit Gerald Silver / Deseret News

As prolific as he may have been, Hatch can’t claim sole credit for his influence over the industry as his most significant legislation came by working with Democrats, a bipartisanship that is almost unheard of in today’s fractious politics.

His bipartisan achievements include the 1983 Orphan Drug Act which promoted drug development for rare diseases. The 1984 National Organ Transplant Act helped create a national transplant registry. And the 1990 Ryan White CARE Act increased access to medical care for uninsured people with HIV.

Hatch, now 84, also co-sponsored a number of bills with the late Sen. Ted Kennedy of Massachusetts. Sometimes called “the odd couple,” Hatch and Kennedy in 1997 proposed the landmark Children’s Health Insurance Program, also known as CHIP.

“This is an area the country has made enormous progress on and it’s something we should all feel proud of, and Senator Hatch should too,” says Joan Alker, executive director of Georgetown University’s Center for Children and Families.

When the bill that created the program was proposed, the number of kids without health insurance in America was around 10 million. Now, with the help of CHIP, that number has been cut in half.

But Hatch’s influence also grew from his chairmanships of several powerful Senate committees.

“History was on his side because the Republicans were in charge,” said Dr. David Sundwall, an emeritus professor in public health at the University of Utah and Hatch’s health director in the 1980s.

When Ronald Reagan was elected president in 1981, the Senate became Republican-controlled for the first time in decades. Hatch was appointed chairman of the what is now known as the Health, Education, Labor and Pensions Committee. With that role came oversight of the Food and Drug Administration, Centers for Disease Control and Prevention and National Institutes of Health. It was a powerful position for a junior senator.

“He was virtually catapulted into this chairmanship role. This is astonishing that he had chairmanship of an umbrella committee in his first term in the senate,” Sundwall says.

He was virtually catapulted into this chairmanship role. This is astonishing that he had chairmanship of an umbrella committee in his first term in the senate. — Dr. David Sundwall

His work on that committee led to an interest in bigger health programs. In 2011, Hatch was appointed to the more influential Senate Finance Committee where he later became chairman. There he helped oversee national health programs such as Medicare, Medicaid and CHIP.

Hatch’s growing influence in Congress did not go unnoticed by the lobbying influence of the pharmaceutical industry. According to the watchdog organization Center for Responsive Politics, in over 25 years of campaigns, Hatch ranks third of all members of Congress for contributions from the pharmaceutical and health sector, behind Democratic senators who ran for higher office, President Barack Obama and nominee Hillary Clinton.

“Clearly, he was pharma’s man on the Hill,” said Dr. Jeremy Greene, a professor of the history of medicine at Johns Hopkins University School of Medicine.

Hatch did work to lower drug prices, Greene said, but his overall record on the pharmaceutical industry was mixed.

An important piece of Hatch’s legislative legacy is the 1984 Hatch-Waxman Act, drafted with Democratic Rep. Henry Waxman. The law promoted the development of cheaper, generic drugs. At the same time, it rewarded brand-name drug companies by extending their patents on valuable medicines.

The law did spur sales of cheaper generics, Greene said. But soon, drugmakers learned how to exploit the law’s weaknesses.

“The makers of brand name drugs began to craft larger and larger webs of multiple patents around their drugs to try to help find ways of preserving monopolies after the initial patent expired,” he said.

Sens. Orrin Hatch and Ted Kennedy worked together on health legislation throughout their careers.
Credit Courtesy Office of Sen. Orrin Hatch

Another workaround for brand name drugmakers was to simply pay generic manufacturers not to compete, in order to preserve their own monopoly power.

“These pay-for-delay deals effectively hinged on a part of the Hatch-Waxman Act,” Greene said.

Hatch also received mixed reviews for his work with the dietary supplement industry. The multi-billion dollar industry specializing in vitamins, minerals, herbs and other ‘natural’ health products, is concentrated in Utah.

“There was really no place for these natural health products,” said Loren Israelsen, president of the United Natural Products Alliance and a Hatch staffer in the late 1970s.

As the industry grew, there was a debate over how to regulate it. In 1994 Hatch sponsored the Dietary Supplement Health and Education Act, known as DSHEA, and cosponsored with Iowa Democrat Tom Harkin

While bipartisanship framed much of Hatch’s career, it faded in recent years. He opposed the Affordable Care Act, once calling supporters of the health law the ‘stupidest, dumb-ass people’ he ever met.

In his farewell speech on the senate floor, Hatch lamented the polarization that has overtaken Congress, even if he had come to contribute to it

“Gridlock is the new norm,” he said. “Like the humidity here, partisanship permeates everything we do.”