“Health Care Policy in Congress: More Charlie Brown’s Tree than Rockefeller Center’s”

The end-of-year government spending bill passed by the House of Representatives has left many health care policy goals unaccomplished, resembling Charlie Brown’s Christmas tree rather than a grand display. The bill, which funds the government for three months, includes funding for under-the-radar public health programs and a short-term extension of telehealth services for older adults.

However, despite two years of effort, Congress failed to pass any legislation to regulate pharmacy benefit managers (PBMs), which act as middlemen in the prescription drug industry. The biggest PBMs, including UnitedHealth Group’s Optum Rx, CVS Health’s Caremark, and Cigna’s Express Scripts, have remained untouched despite years of scrutiny.

The bill also includes over $100 billion in disaster relief and $10 billion in emergency farm aid. However, doctors will see a 2.8% decrease in Medicare pay starting on January 1, as lawmakers did not continue bonus payments initiated during the Covid-19 pandemic.

Efforts to address legal tactics used by pharmaceutical companies to delay competition for expensive medicines also failed after five years of debate. Provisions of a law aimed at preventing pandemics expired, and legislation to address the opioid crisis lapsed.

Despite the setbacks, hospitals fared relatively well in the bill, with subsidy programs extended and a hospital billing transparency measure removed. Some provisions may be revived in the future, as both President-elect Trump and Senator Johnson have expressed interest in regulating PBMs.

Overall, the challenges faced in passing the government funding bill highlight the difficulty of achieving consensus in Congress, particularly within the House Republican caucus. The failure to address key health care issues underscores the ongoing struggles in the U.S. health care system.