Capitol Perspectives

The Capitol Perspectives column is written by John McManus, president and founder of The McManus Group, a consulting firm specializing in strategic policy and political counsel and advocacy for healthcare clients with issues before Congress and the administration. Prior to founding his firm, McManus served Chairman Bill Thomas as the staff director of the Ways and Means Health Subcommittee, where he led the policy development, negotiations, and drafting of the Medicare Prescription Drug, Improvement and Modernization Act of 2003. Before working for Chairman Thomas, McManus worked for Eli Lilly & Company as a senior associate and for the Maryland House of Delegates as a research analyst.
  • Trump Surprises: 340B Reform And Pharmaceutical Exec For HHS
    Trump Surprises: 340B Reform And Pharmaceutical Exec For HHS

    Policymakers recently have focused on the 340B program as its size increased. Whole cottage industries have been created that instruct how hospitals and contract pharmacies can profit from the loose regulations, to the point that the drug industry can no longer overlook the market inefficiencies Yet despite several oversight hearings by the House Energy & Commerce Committee, Congress could not come to a consensus on how to reform it.

  • Republican Dysfunction Could Result In Radical Democratic Health Agenda

    Many analysts believe the Republican base’s frustration with the inability of the party to repeal Obamacare makes a Democrat takeover of Congress in 2018 a real possibility. An examination of Democratic health priorities is therefore in order.

  • What Does The Trump Pivot Mean For Healthcare?

    Frustrated with congressional Republican inaction on major pieces of his agenda, President Trump cut deals with Democrats on a short-term increase in the debt ceiling and funding the government. Then to the surprise and consternation of his base, Trump agreed to work on a deal to extend DACA, a Democratic priority. But what does Trump’s new interest in working with Democrats mean for healthcare policy-making? That is not yet clear.

  • Part D Is Due For A Tune-Up

    Lost in the hubbub over drug pricing has been the flat and declining spending recently in Part D. The Congressional Budget Office’s (CBO) June 2017 Baseline projections show that Part D spending stabilized at $95 billion annually for 2016 and 2017 and will decline to $92 billion in 2018.

  • 340B Reform Gets A Kick Start

    This month, our Washington D.C. insider discusses the 340B drug discount program and the 340B Hospital Outpatient proposed rule. “Notwithstanding the hoopla over the CMS proposal, a proposed rule does not necessarily mean it will become finalized policy.”

  • Path Forward On Obamacare Replacement?

    After the House of Representatives passed The American Health Care Act — the bill that would replace Obamacare — by a razor-thin margin, consideration moved to the Senate, where Republicans have only two votes to spare to secure passage.

  • Drug Costs Moderating, But Growing Copays Fuel Ire

    At a Stanford University conference last week, Office of Management and Budget (OMB) Director Mick Mulvaney said President Trump keeps asking him what he is doing to address the high cost of pharmaceuticals.

  • Provider Consolidation Raising Costs And Undermining Competition

    As Republicans attempt to recover from their face-plant on repealing and replacing Obamacare, policymakers are grappling with how to address the growing problem of healthcare provider consolidation, which appears to be raising costs and undermining competition.

  • Repeal & Replace Confronts Trump’s Base

    To understand the political peril Republicans confront in their effort to repeal and replace Obamacare, it is worth noting that many of the areas that gained the most coverage from Obamacare are the working-class districts carried by President Trump with the largest margins.

  • Pharmaceuticals Escape The Knife As GOP Mulls Medicaid Reform

    After bracing for the worst, pharmaceutical executives emerged from a White House meeting with newly installed President Donald J. Trump relatively unscathed. But they soon concluded that his ever-roving spotlight would be back on them in a matter of time.

  • Trump Targets The Pharmaceutical Industry

    Our new President seemed to criticize recent inversions, but more importantly vowed to go after the industry: “Our drug industry has been disastrous.

  • Risks And Rewards Of Repeal And Replace

    The Republican sweep in the 2016 elections hands the enormous power of the Center for Medicare and Medicaid Innovation (CMMI) to the Trump administration. What to do with this power?

  • Washington Outlook For 2017: Trump Takes The Helm

    The stunning Trump victory and the Republican hold in the Senate, giving the GOP full control over the executive and legislative branches, provides some breathing space for a pharmaceutical industry that increasingly felt under siege.

  • Leaked Emails, Physician Reg Signal Risks For Rx Industry

    As the most bizarre and unpredictable election season draws to a close, scrutiny is turning to wikileaked emails among senior officials in the Clinton campaign licking their chops to take on the pharmaceutical industry, and healthcare policymaking by the executive branch.

  • Congress’ Abdication Of Authority Of Medicare To The Executive

    Six years after the enactment of the Affordable Care Act (ACA), policymakers are just beginning to appreciate a little-known provision that essentially outsources Congress’ authority over Medicare to the executive branch.

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