Late Sunday evening the House Energy and Commerce Committee released the legislative text and summaries of the budget reconciliation plans the panel is scheduled to mark up, beginning today, May 13, at 2 p.m. ET. Currently, the text includes one of NCPA's top policy priorities on PBM reform as well as the elimination of spread pricing and institution of reasonable dispensing fees in Medicaid managed care. NCPA will be in close contact with Congress as this legislative process continues.
Budget reconciliation is a very intricate legislative process. Earlier this year, the House of Representatives and the Senate each passed their own budget resolutions, which instructed committees on the levels they need to meet when cutting spending. With that authority given, the budget reconciliation can be drafted, starting with each part of the bill going before their respective committee for markup and debate. Once each committee finalizes its recommendations for inclusion, the final bill goes up for a vote on the floor of the House of Representatives.
After it passes that vote, the budget reconciliation is put before the Senate, where it undergoes a strict scrutiny process called a "Byrd Bath," where all provisions, if challenged, must prove that they are not extraneous (meaning the contents only apply to spending or revenue laws) and that they are germane, otherwise that section may be taken out of the budget reconciliation package. After passing in the Senate, any changes to the House bill will either then be adopted by a vote in the House or by the two chambers coming together for a conference committee to iron out details. There are many steps and moving pieces, and as this continues, NCPA will continue to work closely with Congress if PBM reform is to be included.
