‘Throwing mud up against the wall’: E&C Republicans plot health care cost savings

Energy and Commerce Committee Republicans met Tuesday to discuss where they might find billions of dollars in potential cuts to existing health care programs — including by making changes to the safety-net program Medicaid.

Finding such cost savings will be a key to financing incoming President Donald Trump's domestic policy agenda, which Congressional Republicans want to advance as quickly as possible through the budget reconciliation process.

“We're still in the process of just throwing mud up against the wall to see what sticks,” Rep. Buddy Carter (R-Ga.), chair of the Energy and Commerce Health Subcommittee, told reporters after the meeting. “Today we got down to some specifics, but we don't have a consensus on what we're going to do yet.”

Committee Republicans on Tuesday discussed making changes to pharmacy benefit managers, which negotiate drug prices on behalf of insurers. There has been a major bipartisan push to regulate their business practices to lower drug costs for consumers.

They also talked about how to recapture savings from enhanced premium subsidies for Affordable Care Act plans as well as whether they could enact so-called "site-neutral payment policy" — another bipartisan proposal which would stop hospitals from getting paid more by Medicare for the same care received at a doctor’s office.

Bipartisan solutions aren't going to make the Republican reconciliation process a cross-the-aisle affair, however, as GOP lawmakers also continue to go after cuts to Medicaid, which would prompt significant backlash from Democrats and from many Republicans, too.

“It’s really hard. We have to find ways to make savings without harming health care for recipients,” said Rep. Morgan Griffith (R-Va.), who chairs the panel’s environment subcommittee. “We’re trying to help the program by making it more affordable … We’ve got to try and thread the needle.”

Ultimately, the ideas presented at the closed-door meeting have been floated previously by committee leaders, and the full committee chair, Rep. Brett Guthrie (R-Ky.), presented similar proposals to House Republicans earlier this month.

Guthrie, who plans to convene another meeting Thursday of Energy and Commerce Republicans to discuss reconciliation bill savings in the energy and environment arena, said the Tuesday health care meeting had an “informational” tone laying out what options are available.

“We looked at all the options,” Guthrie said.