Alex Hendrie

Coalition Urges Withdrawal of International Pricing Index

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Posted by Alex Hendrie on Thursday, January 30th, 2020, 5:00 AM PERMALINK

In a letter to HHS Secretary Alex Azar, ATR and a coalition of 52 organizations urged the administration to withdraw, not finalize, the proposed International Pricing Index.

Click here to read the full letter. 

Recent media reports indicate that the administration is planning to move forward with the IPI and could release an updated proposal in the coming weeks.

This would be a mistake. The IPI would import socialist style price controls that will harm patients and innovation.

The United States is a world leader in research and development because our system of healthcare rejects price controls and encourages innovation. As a result, a majority of new medicines are developed and launched in America.

America’s innovative environment for medicines is enormously beneficial to the U.S. healthcare system. Investment in the research and development of medicines is critical to the growth of high-paying jobs and a stronger economy.

In sharp contrast, socialized foreign healthcare systems put price controls on their medicine, eschewing America’s free market approach. Time and time again, price controls have been proven to suppress innovation. Price controls utilize government power to forcefully lower costs in a way that distorts free-market incentives to lower costs through efficiency and innovation.

The Trump administration has repeatedly identified price controls as being harmful to innovation. Instead of fighting these price controls, the proposed International Pricing Index adopts them. This will suppress competition and innovation and harm American competitiveness and investment.

Click here to read the full letter or see below: 

The Honorable Alex Azar
Department of Health and Human Services
200 Independence Avenue SW
Washington, DC 20201

Dear Secretary Azar:

We urge you to withdraw, not finalize, the administration’s proposed International Pricing Index (IPI) for drugs administered under Medicare Part B.

The proposed payment model imports foreign price controls into the U.S. by modifying the Part B reimbursement rate so that it is calculated based off the prices set by 14 countries.

Instead of relying on government price setting, Medicare Part B is currently calculated based on market prices. The formula, which is based on the “Average Sales Price” (ASP) in the U.S. market, includes the discounts negotiated between payers, hospitals and health plans. Recently this system led to a 0.8 percent decrease in the cost of the top 50 Part B drugs.

In contrast, foreign countries frequently utilize a range of arbitrary and market-distorting policies to determine the cost of medicines – by definition such approaches are price controls.

There is no negotiation and foreign governments often force innovators to accept lower prices in a “take-it-or-leave it” proposition. This results in reduced or restricted access to new medicines and higher prices for those medicines that enter the market.

Conservatives have long opposed price controls because they utilize government power to forcefully lower costs in a way that distorts the economically-efficient behavior and natural incentives created by the free market.

When imposed on medicines, price controls suppress innovation and access to new medicines. This deters the development and supply of new life saving and life improving medicines to the detriment of consumers, patients, and doctors.

The U.S. is a world leader in research & development because our healthcare system rejects price controls and encourages innovation. As a result, a majority of new medicines are developed and launched in America.

This innovative environment is enormously beneficial to the long-term well-being of Americans and the efficiency of the U.S. healthcare system. In addition, the investment required for research and development of medicines leads to more high-paying jobs and a stronger economy.

Importing price controls will undermine this system by basing U.S. prices on the prices of socialized foreign healthcare systems. This will inevitably suppress innovation and harm American competitiveness.

Ironically, the administration recognized the damage that adopting foreign pricing would have on American innovation in a report released in February 2018 by the president’s Council of Economic Advisors:

“If the United States had adopted the centralized drug pricing policy in other developed nations twenty years ago, then the world may not have highly valuable treatments for diseases that required significant investment.”

We are also concerned that the IPI is being proposed through the Obamacare Center for Medicare and Medicaid Innovation (CMMI). There is long standing conservative opposition to CMMI based on the concern that it bypasses Congress’ power over the purse as enshrined in Article I of the Constitution.

CMMI is completely exempt from the Congressional appropriations process and is prone to being misused in ways that result in the executive branch of government usurping Congress’ role in setting policy.

The administration has repeatedly acknowledged that foreign price controls have damaged medical innovation.

Instead of fighting these price controls, we are concerned that the proposed International Pricing Index adopts them. This proposal will suppress competition and innovation and harm American competitiveness and investment.

We respectfully request that your department withdraw this proposal.


Grover Norquist
President, Americans for Tax Reform

James L. Martin
Founder/Chairman, 60 Plus Association

Saulius “Saul” Anuzis
President, 60 Plus Association

Dick Patten
President, American Business Defense Council

Phil Kerpen
President, American Commitment

Dan Schneider
Executive Director, American Conservative Union

Steve Pociask
President, American Consumer Institute

Lisa B. Nelson
CEO, American Legislative Exchange Council

Dee Stewart
President, Americans for a Balanced Budget

Rick Manning
President, Americans for Limited Government

Bob Carlstrom
President, AMAC Action

Andrew F. Quinlan
President, Center for Freedom and Prosperity

Ryan Ellis
President, Center for a Free Economy

Jeffrey Mazzella
President, Center for Individual Freedom

Ginevra Joyce-Myers
Executive Director, Center for Innovation and Free Enterprise

Peter J. Pitts
President and Co-founder, Center for Medicine in the Public Interest

Thomas Schatz
President, Citizens Against Government Waste

Gregory Conko, Senior Fellow
Competitive Enterprise Institute

Matthew Kandrach​​​​​​​
President, Consumer Action for a Strong Economy (CASE)

Fred Roder​​​​​​​
Health Economist/Managing Director, Consumer Choice Center

Yaël Ossowski​​​​​​​
Deputy Director, Consumer Choice Center

James Edwards
Executive Director, Conservatives for Property Rights

Joel White
President, Council for Affordable Health Coverage

Katie McAuliffe​​​​​​​
Executive Director, Digital Liberty

Robert Roper
President, Ethan Allen Institute

Palmer Schoening​​​​​​​
President, Family Business Coalition

Richard Watson
Co-Chair, Florida Center-right Coalition

Adam Brandon
President, FreedomWorks

George Landrith​​​​​​​
President, Frontiers of Freedom

Naomi Lopez Bauman
Director of Healthcare Policy, Goldwater Institute

Tim Chapman
Executive Director, Heritage Action for America

Mario H. Lopez
President, Hispanic Leadership Fund

Linda Gorman
Health Care Policy Center Director, Independence Institute

Carrie Lukas
President, Independent Women’s Forum

Heather R Higgins
CEO, Independent Women’s Voice

Tom Giovanetti​​​​​​​
President, Institute for Policy Innovation

Colin Hanna
President, Let Freedom Ring

Seton Motley
President, Less Government

Mary Adams
Chair, Maine Center-right Coalition

Charles Sauer​​​​​​​
Founder/President, Market Institute

Tim Jones
Chair, Missouri Center-right Coalition
Former Speaker, Missouri House of Representatives

Pete Sepp​​​​​​​
President, National Taxpayers Union

Stephen Stepanek​​​​​​​
Co-Chair, New Hampshire Center-right Coalition

Doug Kellogg
Executive Director, Ohioans for Tax Reform

Jeff Kropf​​​​​​​
President, Oregon Capitol Watch Foundation

Sally Pipes
President, Pacific Research Institute

Ed Martin
President, Phyllis Schlafly Eagles

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KEY VOTE: ATR Urges No Vote on H.R. 5377, a Pledge Violation

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Posted by Alex Hendrie on Wednesday, December 18th, 2019, 3:00 PM PERMALINK

The House of Representatives is set to vote on H.R. 5377, the “Restoring Tax Fairness for States and Localities Act.”

ATR urges a “NO” vote. 

This legislation is a violation of the Taxpayer Protection Pledge, a commitment made by 218 members in the House and Senate to oppose any and all net tax increases.

[Click here for a list of pledge signers in the 116th Congress ]

If passed into law, it will raise taxes on individuals and small businesses that file through the individual income tax system. This bill trades a temporary rollback of the SALT cap for a permanent rate hike. 

This legislation is a net tax increase of $2.4 billion over the ten-year budget window, according to the Congressional Budget Office.

H.R. 5377 also rolls back the Tax Cuts and Jobs Act, passed by Republicans and signed into law by President Trump. 

“The Trump tax cuts reduced taxes across the board. This legislation is step one toward abolishing the entire Trump tax cuts and increasing taxes on the middle class, a key goal of every Democrat presidential candidate," said Grover Norquist, President of Americans for Tax Reform.

The legislation raises the cap on the state and local tax deduction from $10,000 to $20,000 for 2019 and removes the cap entirely for 2020 and 2021.

The legislation also raises the top rate from 37% to 39.6% and lowers the threshold that this top rate kicks in for all filing statuses.

Under current law, the 37 percent bracket kicks in for a single filer at $518,400 in income. Under the legislation, the new top rate is increased to 39.6 percent and the threshold is lowered to $441,475 of income.

Similarly, a family taking the married filing jointly status currently hits the 37 percent bracket at $622,050 in income. Under the legislation, this family will hit the 39.6 bracket at $496,000 in income.

Repealing or rolling back the SALT cap is regressive.

  • 94 percent of the benefits from repealing the SALT cap would go to taxpayers making more than $200,000 a year. 
  • The left leaning Center for Budget and Policy Priorities has stated that this proposal would be “regressive and costly.”
  • The Center for American Progress has stated that repeal of the SALT cap “should not be a top priority” as it would “overwhelmingly benefit the wealthy, not the middle class.”
  • Senator Michael Bennet (D-CO) recently criticized efforts to repeal the SALT cap noting that it runs counter to Democrat ideals: “We can say we’re for a progressive tax bill and for fighting inequality, or we can support the SALT deduction, but it’s really hard to do both of those things.”

Repealing or rolling back the SALT cap is also unnecessary. 

While Democrats claim the SALT cap raised taxes, this is overstated and misleading.

 The TCJA reduced taxes for roughly 90 percent of Americans and for taxpayers at every income level through lower rates, the expanded standard deduction, and the doubling of the child tax credit.

Furthermore, repeal of the Alternative Minimum Tax meant that 4.5 million families were able to claim $10,000 in SALT deductions, as the AMT disallowed this deduction.

The SALT deduction subsidizes high tax, big government states. This deduction is rarely used by middle class families as they take the standard deduction instead of itemizing. Capping this deduction has meant that the federal government is no longer providing a benefit to upper income earners in blue states.

ATR urges a NO vote on this regressive legislation that violates the Taxpayer Protection Pledge.

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ATR Expresses Disappointment with Tax Extenders Deal

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Posted by Alex Hendrie on Tuesday, December 17th, 2019, 11:54 AM PERMALINK

Congress announced a tax extenders deal late Monday that extends numerous tax provisions as part of the budget agreement.

While there is some important tax reduction included in this package, in net, this legislation marks a return to Congress’ bad habit of routinely extending specific, temporary tax cuts for one or two years at a time instead of focusing on broad based tax reduction. Not only did this promote uncertainty, but it distorted the revenue baseline and obscured the true cost of these provisions.

This pattern in 2015 was broken in 2015 when Congress passed the Protecting Americans from Tax Hikes (PATH) Act, which made many conservative tax priorities permanent and phased out distortionary credits.

While some lawmakers, like Ways and Means Republican Leader Kevin Brady (R-Texas), continue to advocate for making all remaining extenders permanent or repealing them, others have pushed for targeted tax breaks to receive short term extensions again and again.

Unfortunately, this tax extenders package does the latter. This legislation extends dozens of provisions for one, two, or in some cases, five years while doing nothing to address them in the long-term.

Worse still, this legislation retroactively revives many credits that expired at the end of 2017. Under this, agreement these credits and deductions can be claimed for 2018, which could result in a windfall for these taxpayers.

This is not the only retroactive tax change – the proposal also retroactively increases taxes through the disallowance of the Alternative Fuels Mixture Credit.

The fact is, retroactivity is terrible policy – any extenders should be dealt with prospectively, rather than retroactively. Taxpayers that have followed the law based upon reasonable statutory interpretations should be afforded certainty and fairness. Retroactivity undermines confidence in the tax system by affecting activity (in this case taxes paid, and credits claimed) that has already occurred.

In the past, when Congress has determined the statute of a law is inconsistent with Congressional intent, they have disallowed the provision on a prospective basis. For instance, when paper manufacturers claimed a credit for mixing diesel with alternative biomass fuels, or “black liquor,” Congress disagreed with this outcome and repealed the credit prospectively.

The retroactive repeal of the AFMC interferes with ongoing litigation, denies taxpayers due process, and creates potentially arbitrary and unfair outcomes. If Congress wants to make changes to the AFMC, it should be done on a prospective basis.

The deal extends several important tax cuts including the Craft Beverage Modernization and Tax Reform Act (CBMTRA) and the CFC-look thru rule. However, it disappointingly only extends these provisions for one year, even as numerous other provisions received multi-year extensions. 

Moving forward, Congress should make these provisions permanent:

  • CMBTRA enacted excise tax relief for local craft breweries, wineries, and distilleries. Because of this tax reduction, local breweries, distilleries, and wineries across America are hiring more employees, purchasing new equipment, and expanding production. A list of examples of breweries, wineries, and distilleries that have expanded because of this tax reduction can be found here.
  • The CFC look-thru rule is a key component of a modern, globally competitive U.S tax system. This provision was first enacted in 2006 and protects American businesses from double taxation when they redeploy business earnings from one CFC to another.  The majority of America’s foreign competitors do not face additional taxation when redeploying capital, so this provision is key to ensuring U.S. businesses are on a level playing field.

More broadly, lawmakers should ensure this extenders package does not become the norm and should return to scrutinizing outstanding provisions toward the goal of making these permanent or repealing them as part of broad-based tax reform.

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Budget Deal Expands Retirement Savings

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Posted by Alex Hendrie on Tuesday, December 17th, 2019, 10:22 AM PERMALINK

The budget deal released by Congress and set to be voted on by the House and Senate later this week includes the Setting Every Community Up for Retirement Enhancement (SECURE) Act.

This is a positive development -- the legislation contains numerous reforms that will assist small businesses in helping their employees save for retirement. In addition, it gives workers greater flexibility to save and older workers and retirees more control over their savings.

The law will make it easier to set up multiple-employer plans, which are commonly used by small businesses and independent workers as a pathway for retirement savings. These plans help employers offer workplace savings plans to their employees by removing many administrative hassles that have prevented small employers from offering their own independent plans.

The SECURE Act further encourages small employers to set up retirement plans by increasing the employer tax credit for starting a new retirement plan from $500 to $5,000. And that’s not all.

The bill would require employers to include long-time, part-time workers in 401(k) plans, and new parents would be able to withdraw from an Individual Retirement Account or 401(k) penalty-free. It also helps older workers by repealing the maximum age for contributions to an IRA and increasing the age when you are required to take a distribution from a retirement account.

To be clear, the SECURE Act is not perfect.

Despite unanimously passing the House Ways and Means Committee, Speaker of the House Nancy Pelosi removed a provision to expand 529 Education Savings Accounts in order to appease teachers' unions and liberals who oppose homeschooling.

Lawmakers could have also made other improvements to retirement savings like the reforms found in Sen. Rob Portman’s Retirement Security and Savings Act. 

However, none of these are reasons not to pass the SECURE Act.

Passage of this legislation will strengthen retirement savings and offers an opportunity for lawmakers to help workers, families, and small businesses.

See also: Congress Set To Repeal Three Obamacare Taxes 

Photo Credit: 401(K) 2012

Congress Set to Repeal Three Obamacare Taxes

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Posted by Alex Hendrie on Monday, December 16th, 2019, 5:34 PM PERMALINK

The budget deal released by Congress and set to be voted on by the House and Senate later this week repeals three Obamacare taxes – the health insurance tax, medical device tax and Cadillac tax.

Repeal of these taxes will result in hundreds of billions of dollars in tax reduction over the next decade and represents significant progress toward repealing all trillion dollars in Obamacare taxes.

Health Insurance Tax

Repeal of this tax is a win for the middle class, seniors, and small businesses that would have seen higher healthcare costs.

The tax is imposed on 11 million households that purchase through the individual insurance market and 23 million households covered through their jobs.

The tax is responsible for a 2.2 percent increase in premiums per year and by almost $6,000 over a next decade for a typical family of four with small or large group insurance. This tax is also highly regressive – half of the HIT is paid by those earning less than $50,000 a year.

The HIT also directly impacts approximately 1.7 million small businesses, and would have cost small businesses 286,000 jobs and $33 billion in lost sales by over a decade.

Cadillac Tax

The 40 percent excise tax on employer-provided plans, known as the Cadillac tax, was passed into law under Obamacare but has never taken effect. If Congress had not acted, the tax would have gone into effect in 2022 on plans exceeding $10,200 for individuals and $27,500 for families.

The Cadillac tax is broadly unpopular with the American people – a 2018 poll had 81 percent of respondents in opposition to the tax.

In order to avoid the Cadillac tax threshold, employers would be forced to raise deductibles and copays in the plans they offer their employees. 

According to research by the Kaiser Family Foundation, nearly half of all companies which offer health insurance to their employees would have faced the tax by 2030. This could have cost families with high quality insurance plans as much as $3,400 per year.

The left-leaning Tax Policy Center reported that, “70 percent of the revenue raised by the Cadillac tax will be through the indirect channel of higher income and payroll taxes, rather than through excise taxes collected from insurers.”

Medical Device Tax

Obamacare imposed a 2.3 percent excise tax on the sale of medical devices by manufacturers and small businesses. This tax covers common hospital equipment like X-Ray machines, MRI machines, and hospital beds.

The medical device tax was in effect from 2013 and 2015 but Congress has suspended the tax since 2016. When it was in effect, research indicates that the tax reduced research and development by $34 million in 2013 and disproportionately harmed companies with lower profit margins. This resulted in a loss of approximately 28,000 jobs.

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Congress Should Pass the USMCA

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Posted by Alex Hendrie on Monday, December 16th, 2019, 11:04 AM PERMALINK

After over a year of negotiations, Congress and the White House have reached a deal on the United States – Mexico – Canada Trade Agreement (USMCA). The House is expected to vote on H.R. 5430, legislation that will implement the USMCA, this week. The Senate will take up the agreement after the new year.  

While the Democrat Congress has stripped the USMCA of several provisions that would have made it a better deal, the agreement updates the North American Free Trade Agreement to reflect the realities of the 21st century economy. Prior to USMCA, NAFTA had not been updated since it went into effect in 1994.

The USMCA will build on the success of Trump’s economic agenda. Since Trump took office, entrepreneurs and small businesses have created 7 million jobs. In November, the U.S. economy added 266,000 jobs. Unemployment has once again hit its record low of 3.5 percent, wages are growing, and the labor force participation rate remains robust at 63.2 percent.

The USMCA is projected to grow the economy by $68 billion and create 176,000 new jobs for Americans, according to the International Trade Commission. These positive economic effects are estimated to have the equivalent impact as a 4 percent corporate tax cut. 

America’s largest trading partners are Canada and Mexico, 12 million American jobs rely on trade with Mexico and Canada, and this number will only grow with USMCA’s ratification. Nearly 2/3 of American exports are purchased by Mexico and Canada, accounting for $500 billion every year. If implemented, the USMCA would increase exports to Canada by $19 billion and to Mexico by $14 billion.

USMCA ratification will also benefit American farmers, as the deal is projected to increase agriculture exports by more than $314 million. Through USMCA negotiations, Canada agreed to open market access to American farmers who wish to sell dairy, poultry, and eggs in Canada. In return, Canada will have access to American dairy and peanut products.

The Trump trade deal brings trade into the 21st century with numerous provisions on e-commerce, cross-border data flows, and encryption. This is the first trade agreement in U.S. history to include these protections.

However, the USMCA is not perfect, and its problems have grown during negotiations. Negotiators ultimately failed to include a crucial provision that would have provided 10 years of data protection for lifesaving biologic medicines. Biologics are the next generation of medicines and are more costly and complex to produce than other cures. Data protection recognizes the extraordinary time, resources, and opportunity cost that innovators must devote to go through the regulatory approval process.

If implemented, the USMCA’s 10-year period would have allowed innovators to earn a positive rate of return on the immense costs associated with research, development, and the FDA approval process. Without this provision, we have lost an opportunity to bring IP in Mexico and Canada up to U.S. standards that have existed for a decade.

Despite these disappointments, the USMCA is a good trade deal that will benefit American workers, businesses, and innovators. Now that an agreement has finally been reached, Congress should ratify USMCA.

Photo Credit: Gage Skidmore

President Trump Scores Another Win With China Trade Deal

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Posted by Alex Hendrie on Monday, December 16th, 2019, 11:01 AM PERMALINK

The United States and China have reached a Phase One trade deal that will begin to hold China accountable, establishes enforceable reforms to intellectual property, and will reduce tariffs and trade barriers. 

This deal is a huge accomplishment for President Trump and is further proof that he has followed through on his campaign promise to renegotiate better trade deals for Americans workers and families.

The Phase One deal protects intellectual property and ends forced technology transfers.  China’s intellectual property theft has been harming American workers and businesses for years and has been at the forefront of tensions between the two countries since the Trump administration began investigations in 2017. 

Practically every sector of the economy has accused China of stealing trade secrets and software including automobile manufacturers, consumer electronics, and biotech and pharmaceuticals.  The protections included in the Phase One deal are a monumental win for American innovators and companies.

The agreement will also begin to roll back tariffs with Both China and the U.S. agreeing to not impose planned tariffs that would have gone into effect on December 15. However, the 25 percent tariffs on about $250 billion of Chinese imports will remain, as well as 7.5 percent tariffs on about $120 billion.  

The deal also reduces the trade imbalance with China, who has agreed to purchase more U.S. exports of agriculture, energy, and manufactured goods, among many others.

This trade agreement further builds upon the success of the Trump administration in ensuring free trade that benefits Americans across the country.

The administration has also negotiated a trade agreement with Japan that will ensure that 90 percent of U.S. products are tariff free or will receive preferential tariff access. Trump has also replaced the 25-year old NAFTA with the modern United States-Canada-Mexico Trade Agreement (USMCA) which, if passed by Congress, will raise GDP by $68.2 billion and create approximately 176,000 American jobs.

While this China-US agreement is a win, more needs to be done to ensure robust and fair trade with China. Fortunately, President Trump has stated Phase Two negotiations will begin “immediately.”  Among the outstanding items remaining, both countries should ensure that existing tariffs are removed.

Regardless, the Phase One China trade deal is a further win for President Trump in ensuring American businesses and workers can compete overseas and that the U.S. economy continues to thrive.

Photo Credit: Gage Skidmore

ATR Opposes Benchmark Rate-Setting in the "Lower Health Care Costs Act"

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Posted by Alex Hendrie on Friday, December 13th, 2019, 2:24 PM PERMALINK

Americans for Tax Reform President Grover Norquist has released a letter in opposition to the benchmark rate-setting provision of the "Lower Health Care Costs Act."

Government rate-setting would allow government bureaucrats to interfere in private negotiations between insurers and providers. As the end of the year rapidly approaches, lawmakers need to take a serious approach in addressing the problem of surprise billing instead of rushing to pass a flawed proposal that would impose price controls on our healthcare system. 

You can read the full letter here or below. 

Dear Member of Congress:

I write in opposition to price-fixing mechanisms in the “Lower Health Care Costs Act,” legislation released earlier this month by the Senate Health, Education, Labor, and Pensions (HELP) Committee and the House Energy and Commerce (E&C) Committee. As Congress looks to its final legislative days of 2019, lawmakers should not attach this proposal to a must-pass government funding vehicle. 

This legislation proposes addressing payment disputes related to surprise medical billing through the creation of a new price fixing mechanism in the form of a rate-setting for any payments made to out-of-network providers.

Americans for Tax Reform has long expressed concerns with proposals that directly or indirectly impose price controls on the US healthcare system. Price controls are bad policy because they utilize government power to forcefully lower costs in a way that distorts the economically efficient behavior and natural incentives created by the free market.

In this case, the government would set a benchmark rate to resolve out-of-network payment disputes between insurers and providers. The government would set this rate at 100 percent of the in-network rate.

Benchmark rate-setting would allow government bureaucrats to interfere in private negotiations between insurers and providers.

Conservative lawmakers have expressed significant opposition to price fixing mechanisms within healthcare. For instance, 192 Republicans opposed H.R. 3, legislation that would impose price controls on pharmaceutical innovation under threat of a 95 percent excise tax.

Given this opposition, any approach to surprise billing should include market-based provisions rather than distortionary price fixing mechanisms.

As the end of the year rapidly approaches, lawmakers need to take a serious, deliberative approach in addressing the problem of surprise billing instead of rushing to pass a flawed proposal that would impose price controls on our health care system.


Grover Norquist
President, Americans for Tax Reform

Photo Credit: 401(K) 2012

ATR Opposes Section 206 of the "Lower Healthcare Costs Act"

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Posted by Alex Hendrie on Thursday, December 12th, 2019, 10:00 AM PERMALINK

Americans for Tax Reform President Grover Norquist has released a letter to Senate Majority Leader Mitch McConnell and House Minority Leader Kevin McCarthy in opposition to Section 206 of the "Lower Healthcare Costs Act."

If implemented, this provision would ban pharmacy benefit managers from offering guaranteed-level pricing contract arrangements, also known as spread pricing, in any contract with employers. This is yet another government mandate on private business that would raise costs on the U.S. healthcare system 

You can read the full letter here or below: 

Dear Leader McConnell and Leader McCarthy: 

I write to express concerns with Section 206 of the "Lower Healthcare Costs Act" as currently negotiated by the Senate HELP and House Energy and Commerce Committees. 

This section contains a provision that expressly prohibits pharmacy benefit managers (PBMs) from offering guaranteed level pricing contract arrangements, also known as spread pricing, in any contract with employers. 

Under any existing employer plan, a PBM will agree to reimburse an employer for prescription drug purchases in one of two ways –– exactly what was paid to the pharmacy or through spread pricing, which sets the price at a predetermined sliding scale. This is beneficial to the employer because it offers a more predictable, standardized amount, and aligns the employer and PBM's incentives to drive down pharmacy reimbursement costs. 

Because of this flexibility, many employer plans negotiate spread pricing contracts with PBMs, including many small employers. The federal government should not be in the business of dictating the terms of contracts between two private entities. Lawmakers should not intervene or impose restrictions on the ability of employers and PBMs to negotiate contracts designed to best fit the needs of the individual employer. 

Functionally, this proposal is just another imposed government mandate on private businesses that directly or indirectly will increase costs on the US healthcare system and distorts the economically efficient behavior and natural incentives created by the free market. 

Although this proposal is not as harmful as direct price controls proposed by Democrats in Congress and running for President, it should still be rejected as it interferes in private contracts by imposing restrictions on the contracts agreed to by PBMs and employers. 


Grover Norquist
President, Americans for Tax Reform

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ATR Urges No Vote on HR 5363, the FUTURE Act

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Posted by Alex Hendrie on Tuesday, December 10th, 2019, 10:37 AM PERMALINK

House Democrats will today bring up H.R. 5363 to the House floor, legislation that strengthens Historically Black Colleges and Universities (HBCUs) and Minority Serving Institutions. As a standalone provision, this legislation should be taken up and passed into law. 

However, Democrats are amending the legislation to include a $2.5 billion tax pay-for that will threaten taxpayer privacy and create a new precedent to misuse taxpayer information. While H.R. 5363 contains these provisions, it should be rejected by the House.

The FUTURE Act adds H.R. 5368, legislation that could subject 31.2 million individual disclosures to large-scale sharing of taxpayer information without taxpayer consent. Thousands of bureaucrats, government contractors, and educational institutions could have access to this taxpayer information. 

This would be the third largest disclosure of taxpayer information for non-tax purposes – second only to the Census and Obamacare.

While H.R. 5363 contains this poison pill, Congress should reject the bill to uphold taxpayer privacy and protect millions of taxpayers from new pathways of misuse of taxpayer data.

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