Bipartisan lawmakers can rebuild trust by passing infusion therapy bill

When U.S. lawmakers return home in mid-December for the holidays, they will face constituents asking, “What have you achieved in Washington?” Republicans controlling both the Senate and House of Representatives will be especially grilled on healthcare, after failing to repeal and replace the Affordable Care Act.

However, there is one thing lawmakers can do before the holidays that will improve the lives of some of the sickest patients in America — pass a law helping people in line for heart transplants to endure their wait at home rather than in a hospital.

{mosads}Over the holidays, it will be important for lawmakers to be able to point to ways that they have helped real people solve their everyday problems, because voters don’t trust government. In 1958, about three-quarters of Americans trusted the federal government to do the right thing almost always or most of the time, but since 2007 that number has not surpassed 30 percent, according to the Pew Research Center’s National Election Study.

U.S. senators can start rebuilding that trust by passing the Medicare Home Infusion Therapy Access Act of 2017, to restore home infusion therapy payments for patients on Medicare. The U.S. House of Representatives has already passed legislation to address this issue. Now, the U.S. Senate must approve its version.

Democrat Mark Warner (Va.), who introduced the bill with Republican Johnny Isakson (Ga.), calls the law a “commonsense fix” for an unintended consequence of another law passed last year.  

Last December, Congress passed the 21st Century Cures Act (CURES,) winning bipartisan support for its laudable goals of promoting medical research and curing cancer.

The law unfortunately also cut reimbursement by more than 95 percent for many infusion drugs, cutting monthly Medicare payments from about $11,000 per infusion patient to $500. In its place, it created a new benefit to reimburse home-infusion providers, but that provision does not take effect until 2021. That funding gap is hurting patients, but Warner-Isakson would bring the new benefit forward to the start of 2019.

This is not a budgetary issue: The Congressional Budget Office says home infusion is the most cost-effective way to treat patients. Private insurance, Medicaid, Tricare (for veterans) and Medicare Advantage, all still pay for home infusion, but it is not covered by traditional Medicare after the passage of CURES.

Warner-Isakson is truly bipartisan — a rarity in Washington these days. It is co-sponsored by Sens. Tammy Baldwin (D-Wis.), Michael Bennet (D-Colo.), Richard Blumenthal (D-Conn.), Sherrod Brown (D-Ohio), Ben Cardin (D-Md.), Chris Coons (D-Del.), Kirsten Gillibrand (D-N.Y.), Chuck Grassley (R-Iowa), Angus King (I-Maine), Amy Klobuchar (D-Minn.), David Perdue (R-Ga.), Rob Portman (R-Ohio), Pat Roberts (R-Kan.), Jeanne Shaheen (D-N.H.), and Roger Wicker (R-Miss.).

History teaches us that when our leaders work on bipartisan issues that we can all agree on, trust in government rises. For example, trust rose sharply after Republican President Ronald Reagan in 1982 began collaborating with Democratic Speaker of the House Tip O’Neill, doing deals to increase tax revenues and reform Social Security.

Arizona Sen. John McCain (R-Ariz.)said in July that as a result of Washington’s hyper-partisanship, “We’re getting nothing done.” The senator urged Republicans and Democrats, “Let’s trust each other. Let’s return to regular order. We’ve been spinning our wheels on too many important issues because we keep trying to find a way to win without help from across the aisle.” Voting for Warner-Isakson is one small way that lawmakers can display bipartisanship and get something meaningful done together.

While this legislation is small in the general scheme of things, it’s a big deal to the patients that it impacts. About 4,000 patients in the United States are waiting for a heart transplant at any time, a wait that can last up to one year or more. They would typically receive their drugs via home infusion therapy, but now many Medicare patients have to endure their wait from a hospital, which costs significantly more and leaves them with a diminished quality of life.

Making matters worse, some of these patients are considered too sick and prone to infection to endure a long wait in a hospital, so they are undergoing invasive surgery to implant a left ventricular assist device, or LVAD — implantation of a mechanical pump inside the patient’s chest to help their weakened heart to pump blood. That expensive surgery could be avoided for many patients if they could receive home infusion while waiting for their transplant.

The Centers for Medicare and Medicaid Services (CMS) says it can implement the home infusion benefit in 2019, but only if the Senate acts. No one wants to force hundreds of vulnerable patients to live in hospital beds rather than enjoying life in their own homes with their loved ones. And yet, there is a risk that amid all the rancor and distractions in Washington that this sensible law could fall through the cracks. Senators who want to share some good news with constituents over the holidays won’t let that happen.

R. Carter Pate is chairman of the board of Bioscrip and the former U.S. Managing Partner of Health Care at PwC.