State lawmakers are considering a number of plans to reduce prescription drug costs this session, including a bill that would cap insulin copays and another that would allow the state to import drugs from other countries.
But most laws they pass would only affect a fraction of the state’s insured. According to Kelly Atkinson with the Utah Health Insurance Association, the state Legislature only has jurisdiction over those under fully-insured employers and the state public health plan, PEHP. In 2018, they accounted for about 28% of the state’s population.
That means comprehensive reform will have to come from the federal government.
“This is a priority for people [but] it's really something that's got to be dealt with here in Washington,” said Utah Republican Congressman Chris Stewart. “The president, Republicans and Democrats, we all really do agree this is a federal issue.”
And while there have been a few federal bills introduced over the last year targeting prescription drug pricing, none seem to be gaining much traction.
One of the most comprehensive plans, according to the journal Health Affairs, was proposed by House Democrats last September — H.R. 3, the Lower Drug Costs Now Act of 2019. It would have given Medicare the ability to negotiate the price of up to 250 commonly used drugs and extend those deals to private insurers — one of the keys to lowering drug costs in the U.S., according to Paul Ginsburg, director of the USC-Brookings Schaeffer Initiative for Health Policy.
But Democratic Rep. Ben McAdams was the only Utah congressman to vote in favor of the bill, which passed the House along party lines before stalling in the Senate.
Stewart said he couldn’t support it.
“What it came down to, for me, perhaps more than anything was my fear that the price controls were just so punitive,” Stewart said. “It's just going to stifle the innovation of new therapies.”
Stewart said he saw more promise in H.R. 3’s alternative, H.R. 19, Lower Costs, More Cures Act, introduced by House Republicans in December. That bill’s primary cost control measure would be to cap out-of-pocket costs at $3,100, but it does little to tackle high prices set by drug makers in the first place.
Stewart said, though, it would help protect funding for research and development.
Despite party divisions, Stewart said lowering prescription costs is a priority for lawmakers on both sides of the aisle. And while there are disagreements as to how to achieve that, he said the most likely path forward would be to combine aspects of both bills.
“You have to be extraordinarily patient in this business. I think we're at the end of the process of prescription drug pricing, not [the] beginning,” Stewart said. “There's enough overlap between [Democrat and Republican-supported bills] that I think we can move that through the committee and maybe get a vote as early as summer.”
Jon Reed is a reporter for KUER. Follow him on Twitter @reedathonjon
