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CMS Chief Defends Innovation Center

By Kerry Young and Erin Mershon, CQ Roll Call

October 7, 2016 -- A top federal official defended the Center for Medicare and Medicaid Innovation, which tests new approaches to health care, as a "national treasure." Andy Slavitt, the Centers for Medicare and Medicaid Services (CMS) acting administrator, says the Congressional Budget Office (CBO) signaled its confidence in the center's work while examining a bill to stop one of its major projects.

Slavitt was referring to CBO's estimate that blocking a five-year test of alternative Medicare payments for drugs—as a bill (HR 5122) by Rep. Larry Bucshon, R-Ind., proposes—would cost about $1.15 billion in lost savings over a decade. 

"To me, it's the ultimate compliment," Slavitt told reporters at a Thursday evening gathering of the Association of Health Care Journalists (AHCJ).

The center's planned test of drug payments, which has angered drugmakers and many doctors. CBO said blocking the drug payment test would free up the center to pursue other projects. The budget office projected $750 million in savings over a decade from these potential projects, resulting in a net $395 million cost to the bill.

The center, a part of CMS that is also called the Innovation Center, was created by the 2010 health law, which is likely to be revisited in the next session of Congress. House Republicans want to kill the center, while many Democrats defend its work as a key part of overhauling the practice of medicine.

Legislative Agenda

At a separate panel at the AHCJ event, policy experts delved into changes that Congress might make in the 2010 law in the next few years. Neera Tanden, president of the left-leaning Center for American Progress, and G. William Hoagland, senior vice president of the Bipartisan Policy Center and a former Republican congressional staffer, both expressed optimism that the next Congress might move past efforts to repeal the 2010 health law and consider fixes to the law.

"Now, you can be a Republican and face your constituents and actually think about fixing something because it has not been in live debate either in the primary or the general election," Tanden said. 

Hoagland agreed on this point, and the duo also predicted lawmakers will consider ways to rein in rising drug costs. Tanden credited Republicans in both chambers for holding hearings on the issue this year.

"It is a testament of the bipartisan nature of this that you see a number of Republicans who are concerned," she said. "It's a test of Democrats, whether they will truly take action on this. It's a quintessential issue in which people see special interests controlling Washington, and it's up to Democrats to show that they can be different."

Hoagland said that while there were some fixes to the health care law Republicans might be able to stomach, any proposal to add a federally run public option would "blow the whole thing up."

But in cases where only one insurer is participating in a state exchange—which for 2017, will be true in at least five states—Hoagland said he would "soften his opposition to the public option."

"I do think competition is good," he said.

Others in his party might have a harder time with the idea, however.

"It's the nose of the camel under the tent for moving to just universal health care. And there will be some on my side of the aisle who will say, 'This is what they wanted all along. They wanted the ACA to fail so that they could say, 'The only way to do this now is to come in with the public option.'' There is that cynicism out there," he said.

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