Douglas Huynh, JD, Director, Congressional Affairs, APhA
As we approach the August recess, we find ourselves looking at fewer and fewer legislative days left on the congressional calendar. With the midterm elections also coming up, what has always historically been a race for time ramps up even more. At the time of writing, Congress has 41 days left in session to pass any meaningful health care legislation. Complicating this are the unexpected primary election losses of several key figures in both the House and Senate and the passing of Sen. Lindsey Graham (R-SC). Although none of these figures were direct champions of our legislative priorities, the domino effect of their losses may still have a profound impact on pharmacists. As we have mentioned before, “politics often gets in the way of policy.” This could not be more true than the scenarios we face today.
With so little time left on the calendar, members in both the House and Senate must prioritize the policies and legislation they want to move forward. This is why we often talk of going through “regular order.” At this point in time, barring an unforeseen event, no policy will be considered unless it has been fully vetted first. Any legislation that is introduced between now and December is merely a placeholder and will evaporate into thin air once the new year rolls around. This is why it is crucial to continue beating the drum for the issues we have spent time and focus on.
While we are certainly encouraged by what has developed so far with pharmacist reimbursement issues, such as with the Main Street Pharmacy Access Act (formerly known as ECAPS) passing through committee, we are also hopeful that Congress will continue to consider other APhA-backed priorities, such as the HIV PEP/PREP bill and TRICARE. Without being able to predict the future, the Main Street Pharmacy Access Act likely has the best chance of becoming law. When we speak of things such as regular order, the process by which this bill has moved through Congress is a classic example of how members like to see things move forward. Members don’t like surprises. Members also don’t like to be embarrassed, which is why you will seldom see a floor vote on any piece of legislation unless the majority is all but certain it will pass.
In the case of the Main Street Pharmacy Access Act, we continue to check boxes as we go along, making it primed for inclusion into a larger health care package.
While we have built momentum with the HIV PEP/PREP bill and the TRICARE bill, these bills may need a little more seasoning before they are considered for inclusion. That is not to say, however, that the effort would have been wasted. At the very least, it lays the groundwork for future conversations and serves as a primary placeholder in 2027 and beyond.
With all that said, the question begs: What do we expect next? The short answer to that is it depends. What we do know is that there are still several health care issues that Congress needs to resolve, such as passing legislation to extend Medicaid funding. There may also be some telehealth provisions that are addressed before the consideration of any other issues. These, of course, include issues such as pharmacist reimbursement, drug pricing, and perhaps even more legislation on PBM reforms.
While we may still face some opposition from groups such as AMA, the real opponent would be time. With many lame-duck members wrapping up their terms, several may have “legacy” items to consider, which might take up space that otherwise would have been free. That factor, on top of the limited number of legislative days left in the session, may complicate things. But hope springs eternal, and given the amount of support we have received on many of the issues we have been pushing, it would not be a surprise to see some of these issues, such as the Main Street Pharmacy Access Act, make it to the finish line.