Colorado Western Slope congressional race likely to focus on health care costs
State Rep. Diane Mitsch Bush, a Steamboat Springs Democrat, announced last week she’s trying to become the latest challenger to take on seemingly entrenched Republican U.S. Rep. Scott Tipton in the sprawling 3rd Congressional District that includes a big chunk of Eagle County.
State Rep. Diane Mitsch Bush, D-Steamboat Springs
The first question that comes to mind is why Mitsch Bush thinks she realistically has any better shot at unseating Tipton than the last three Democratic challengers, who lost by 20, 12 and 14 percentage points respectively. At some point in the near future I hope to ask her that question directly, but, in the meantime, I suspect I know at least one of her reasons: health care.
Specifically, the astronomically skyrocketing costs of both health care and health insurance on Colorado’s Western Slope – an area entirely encompassed by Tipton’s 3rd CD. In fact, it’s right there in Mitsch Bush’s email announcement to supporters last week:
“Too often in recent years, folks in our communities have struggled to get by due to limited economic and educational opportunities, as well as soaring health care costs,” Mitsch Bush wrote. “Working together, we can strengthen public education, create good paying jobs, protect our air, water, wildlife and public lands, build and maintain 21st century infrastructure, and make high-quality health care available and affordable so that we can all thrive together.”
Sure, there are a few other campaign planks in there – the three E’s of the environment, economy and education – but it all comes back to health care and health insurance. Costs for both are some of the highest in the nation in the two largely rural and resort counties that Mitsch Bush currently represents in the Colorado House: Eagle and Routt.
And rural Coloradans would suffer the most, according to a wide range of studies and reports, under Republican plans to dramatically slow the growth of Medicaid that now covers health care for one in five residents of the state.
Why does Mitsch Bush potentially have a better shot at defeating Tipton than former state Sen. Gail Schwartz, a Crested Butte Democrat who last November unsuccessfully championed renewable energy and the state’s outdoor recreation economy over boom-and-bust coal mining and natural gas drilling?
U.S. Rep. Scott Tipton, R-Cortez
The U.S. Senate version – the Better Care Reconciliation Act – is only slightly better at 22 million fewer Americans with health insurance. And both bills would rein in federal spending on Medicaid, which expanded under the Affordable Care Act and now significantly props up rural hospitals across Colorado’s Western Slope and the entire state.
Even conservative political groups such as Americans for Prosperity, funded by the Koch brothers, have backed off on supporting a Senate bill that appears to have little chance of passing before the August recess. Increasingly, Senate Majority Leader Mitch McConnell seems resigned to working with Democrats to prop up distressed insurance markets under the ACA.
Colorado Democratic Sen. Michael Bennet, a vocal critic of both the House and Senate bills to repeal and replace, earlier this month warned against underestimating McConnell’s ability to get something passed in the Senate. And Republican Colorado Sen. Cory Gardner spent the July Fourth break dodging protesters angered at the possibility Congress will gut the ACA.
Mitsch Bush told the Steamboat Pilot her biggest advantage over previous Democratic candidates in CD3 is she’s getting into the race early, but for many beleaguered Western Slope residents, cheaper health care is the only campaign issue that matters. Democrats will have to drive home the message that they have answers to have any shot at retaking the House.
So, while Tipton voted for the AHCA, Mitsch Bush has spent her last four years in the State Legislature trying unsuccessfully to figure out how to bring down health care and health insurance costs, sponsoring or co-sponsoring a number of bills in the Democrat-controlled House that have then died in the Republican-controlled state Senate.
Just this past legislative session, Mitsch Bush ran a bill to “provide emergency financial assistance to rural, middle-income Coloradans who pay over 15 percent of their incomes for health insurance premiums.” A bill aimed squarely at CD3 voters who largely backed President Donald Trump and Tipton last November.
“This is short-term fiscal relief for people who are suffering from pretty extreme inequities between rural and urban Colorado,” Rep. Mitsch Bush said at the time. “We will continue to work with all on a longer-term solution. In the meantime, this relief is critical for people in my district who are having to choose between rent and health care.”
The bill failed, and massive health insurance increases no doubt loom again for Western Slope private-market consumers in 2018. Meanwhile, “longer-term solutions” remains elusive and underreported.
Also not getting much attention during the repeal-replace ACA debate is the key campaign promise by Trump to overhaul runaway drug pricing – something many experts say is contributing significantly to price hikes in health insurance.
I collaborated recently with former Colorado Springs Independent and Colorado Public News editor Cara DeGette on a story about how the drug-pricing debate and possible legislative solutions have been put on hold during the stalled overall health care fight. It’s another area Mitsch Bush and other Democrats worked on in the State Legislature – with no success.
Here’s a version of that story, which first posted on both the Park Hill News (Denver) and Colorado Springs Independent websites. It should be noted that Tipton’s office, which has remained relatively quiet on the overall health care debate, did not respond to an email request for comment on this story:
Battle over health care reform stalls efforts to lower runaway drug prices
As lawmakers and the White House continue to wrangle over the Affordable Care Act and its Republican replacement, the American Health Care Act, efforts to corral one of the most talked-about components of health care – the rising cost of prescription drugs – has largely stalled both in Washington and Colorado.
Meanwhile, many prescription drug prices are continuing to spiral upwards. In early May, for example, the Indianapolis-based drug giant Eli Lilly raised the prices of nine of its medicines between 6 and 10 percent, according to data obtained by CNBC. The increases included a 9.9 percent hike for the blood thinner Effient; 7.8 percent increases for the insulin medications Humalog and Humulin; and a 6.9 percent increase for the psoriasis drug Taltz.
According to the Washington-based Campaign for Sustainable Rx Pricing, in 2015 the prices of prescription drugs saw the largest increases in 24 years. Overall, prescription drug prices have risen more than 7 percent since last year, the largest one-year hike since 1992.
The increases have been across the board. The prices for insulin, used to treat diabetes, have skyrocketed in the past few years. Last year the price of the EpiPen drug, used to treat life-threatening food allergies, made headlines when it jumped from about $100 for a two-pack dosage to as high as $600.
Lawmakers in Washington and in Colorado have vowed to crack down, and President Donald Trump made the rising costs of prescription drugs one of his signature campaign issues. However, observers often cite the pharmaceutical industry and its powerful lobbying network for thwarting any real progress.
“The market for prescription drugs in this country is out of control and fundamentally broken,” said Will Holley, spokesman for the Campaign for Sustainable Rx Pricing. The nonpartisan coalition includes organizations ranging from AARP to the American Hospital Association to Walmart to Kaiser Permanente, and seeks to find market-based solutions to lower drug prices in the U.S.
Campaign for Sustainable Rx Pricing is currently engaged in a public information campaign to highlight drug-pricing practices across the country, including Colorado.
“We want to make sure everyone understands what’s happening, and what they can do,” Holley said. Whether the drug is being sold in a pharmacy or being dispensed in a hospital, clinic or nursing home, patients, he said, should have access to what is being charged for prescriptions, and notified when a price hike occurs.
Federal fixes
In the last Congress, two bipartisan bills were introduced that were, Holley said, designed to fast-track generic drugs into the marketplace.
The Fair Access for Safe and Timely (“FAST”) Generics Act would have, according to the Campaign for Sustainable Rx Pricing and a number of partner groups, “provided a clear solution to abusive, anticompetitive business practices that increase costs to the American health care system by impeding patient access to generic and biosimilar medicines.”
The Senate version of that bill was called the CREATES Act: Creating and Restoring Equal Access to Equivalent Samples. However, in recent months, neither of those bills has advanced. Holley cited the distraction of the refocus on the larger issue of GOP efforts to repeal the Affordable Care Act and replace it with the Affordable Health Care Act.
Rep. Diana DeGette, a Democrat from Denver and a co-sponsor of last year’s FAST Generics Act, said she plans to add her name again to the bill when it is reintroduced this year.
“Rep. DeGette believes Congress should devote much more time to the issue of high drug prices, and she would strongly support efforts to reduce the cost burden on consumers where possible,” said her spokeswoman, Lynne Weil. “If this could be done in the context of a bipartisan effort to improve the Affordable Care Act, she would be supportive – but because Republican House members this year have not been good partners on health care reform, much less the issue of rising drug prices, it’s difficult to say how this can be achieved on a bipartisan basis.”
The House narrowly passed its unpopular American Health Care Act in May – with most Coloradans and many health care groups opposed to the bill – and the Senate delayed voting on its companion Better Care Reconciliation Act before heading home for the Fourth of July break. However, prescription drug prices were not a central part of the debate.
Rep. Doug Lamborn, a Republican who represents Colorado Springs and the surrounding 5th Congressional District, voted along with two other Colorado Republicans in favor of the AHCA, which was opposed by all three Colorado House Democrats. Lamborn would not make any predictions about the Senate version of the bill, which would then have to be reconciled with the House bill if it ever passes.
“When it comes to the pace of work of the Senate and any conference committees, it is difficult to predict specific timelines,” Lamborn told The Independent, adding he does not support the FAST Generics Act to reduce prescription drug prices.
“The Risk Evaluation and Mitigation Strategies [REMS] system is set up by the [Food and Drug Administration] in order to ensure that access, innovation and patient safety are all considered with regard to FDA user fees for prescription drugs and medical devices,” Lamborn said in an email statement.
“Bills like the FAST Generics Act run a real risk of increasing frivolous litigation, gutting intellectual property protection and endangering the safety of both researchers and patients,” Lamborn added.
Rep. Jared Polis, a Boulder Democrat who is running for governor in 2018, said in a phone interview that he supports state and federal efforts to allow for re-importing prescription drugs.
“The state passed a Right to Try Bill and we need to clarify the federal statutes to ensure that there’s not additional liability when people re-import for their own use prescription drugs, which allows them to save considerable amounts of money on prescription drugs from Canada, Mexico and other countries,” Polis said.
“At the federal level as well, we need to look at reducing the costs of the FDA approval process,” he continued. “It costs over a billion dollars to bring a drug to market, particularly for a targeted drug. If there’s only 10,000 or 20,000 people who would benefit from it, that billion dollars in costs plus the profit margin for the drug company has to be spread among a very small number of people, so you wind up with ridiculously expensive drugs.”
Kyle Huwa, spokesman for Republican Rep. Ken Buck, said the congressman from northern Colorado believes “there’s no reason why a conversation about drug costs shouldn’t be part of the broader conversation of health care reform.”
“Congressman Buck will assess the Fast Generics Act after he can read the committee report from the Energy and Commerce Committee,” Huwa said. “He is supportive of finding ways to make prescription drugs more affordable and finding ways to positively reform the FDA approval process. He believes that the cost of care is a key element in health care reform.”
Colorado solutions
In Colorado, efforts to target runaway drug prices have failed in the last two legislative sessions.
In 2016, several Colorado lawmakers introduced HB1102, which would have required pharmaceutical companies to detail the costs to research, develop and produce drugs that are priced at more than $50,000 per year or per course of treatment. Nearly 100 drugs would have qualified, including a 12-week drug treatment for Hepatitis C, most treatments for multiple sclerosis, and many cancer therapies.
However, the bill died in the state House of Representatives.
This year, HB 1318 would have created a database for pharmaceutical costs, requiring health insurers to submit costs to the Colorado Division of Insurance. The bill was supported by the governor’s office, but ultimately died in the state Senate.
Tim Gaudette, Colorado outreach manager for Small Business Majority, highlighted a recent poll that was conducted by his organization, showing the rising cost of prescription drugs are becoming “a major concern … and many feel that drug costs are impacting their bottom line.”
The poll, released in December, included 504 owners of business of up to 100 employees. The vast majority supported a range of policy proposals to address the rising cost of prescription drugs.
For example, 88 percent of them agreed that, “it should be illegal for a drug company to pay another company that makes generic drugs to delay the release of a generic drug.”
Fully 90 percent of those polled agreed that prescription drugs that are developed with taxpayer dollars should be made affordable to every American. And, 85 percent agreed that Americans should be able to purchase prescription drugs from Canada and that the federal government should be allowed to negotiate lower Medicare drug prices.
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