Protecting Health Care for All Patients Act of 2023

Floor Speech

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Ms. ESHOO. Mr. Chair, I rise, sadly, in opposition to this bill, H.R. 485.

I support, and everyone here supports, banning quality-adjusted life years, also known as QALYs. It is a discriminatory metric that should not be used, and Democrats are the ones who recognized this in 2010 when we banned Medicare's use of QALYs in the Affordable Care Act.

If this bill simply banned QALYs, it would pass the House, the Senate, and become law. It would become law quickly. However, the problem is that the legislation bans QALYs and ``similar measures.'' I have repeatedly said that this vague ``similar measures'' phrase is a problem, including during the hearing and the markup of the bill.

This overly broad ``similar measures'' phrase weakens the Federal Government's ability to negotiate drug prices by ruling out any type of comparative effectiveness. Without this analysis, CBO found that States and the Federal Government would have less leverage for drug discounts.

The CBO estimates that this ``similar measures'' phrase will raise Federal costs in Medicaid by nearly half a billion dollars--that is with a b--and by nearly a quarter of a billion dollars in TRICARE and the VA. It also means out-of-pocket costs will rise for veterans and Federal workers, and State budgets will be hit by higher Medicaid spending.

Mr. Chair, I have tried everything I could to fix this legislation. I voted ``present'' in the markup to continue bipartisan negotiations and met with the chairwoman about changing the language, but the bill before us today is the same bill that passed out of committee. It adds insult to injury because the Republicans are using the Affordable Care Act Public Health Prevention Fund to pay for it. Over 170 patient and public health groups oppose using this fund as an offset.

My Republican colleagues have said they wish the legislation could be bipartisan, but their actions say otherwise. This bill has only five cosponsors, all Republicans, no Democrats. It has a poisonous pay-for, and the Veterans' Affairs and Armed Services Committees never heard the bill despite its major impact on the VA and TRICARE.

This is, in my view, a partisan bill that needlessly cuts public health to increase drug spending, and that is why I urge my colleagues to vote against it.

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