August 19,2019

ICYMI: Grassley Puts Teeth Back Into Finance Committee

ICYMI: Grassley Puts Teeth Back Into Finance Committee
By Dan Diamond and Adam Cancryn
Powerful health care interests are starting to once again fear the Senate Finance Committee under its chairman, Sen. Chuck Grassley, who since taking the gavel in January has led investigations into high-profile targets such as drugmakers, major hospital systems, pharmacy benefit managers and nursing homes.
The 85-year-old Iowa Republican has fewer than 18 months left as Finance chief; he already chaired the panel between 2003 and 2007 and faces a six-year term limit. But Grassley said that's only emboldened him to use the platform to renew his aggressive industry oversight, which has marked his nearly four-decade long career in the Senate.
"It's one of those things you only need one vote to do," Grassley told POLITICO in an interview last month, pointing to investigations that he launched into the defense industry as a freshman senator in 1981. "It's something I advise every senator to do."
…Grassley's committee has made a point of grilling pharma executives over pricing and other business practices, as well as senior agency regulators and other officials, in much-watched hearings. His probes of HHS' inner workings also have repeatedly unsettled Trump administration leaders, who have courted his support.
No lawmaker has consistently devoted more resources to oversight than Grassley. His seven-person oversight team shifted over from the Judiciary Committee when Grassley gave up the chairmanship of that panel for Finance, and now has more than two-dozen open investigations. Five other staffers regularly review watchdog reports and identify policy proposals.
"We have the bandwidth to do policy writing and oversight at the same time," said one Grassley staffer.
Grassley's top focus is a sweeping drug-price bill unveiled in July that still faces an uncertain path to a full Senate vote. Yet in the meantime, his team is working on nursing home legislation that would increase CMS transparency requirements and background checks of workers. Grassley also is ramping up probes into alleged conflicts of interest between opioid manufacturers and nonprofits, research integrity efforts to prevent conflicts at federal health agencies and FDA overseas inspections, telling POLITICO that whistleblowers drive "80 percent" of his investigations.
Wall Street analysts have said that Grassley represents a material risk to the health care industry's bottom line.
The shift in focus has been striking, if well-telegraphed, given Grassley's longstanding skepticism of the business practices of nonprofit hospitals and long-term care facilities.
"Grassley views oversight as something that can be accomplished regardless of the season, regardless of who's in the White House," said Dean Zerbe, a former top aide to Grassley. "He has themes that stay constant."
Grassley has since returned to those same targets, and the Trump administration agencies charged with keeping a close eye on them. CMS scrambled to respond to his inquiries into nursing home oversight, after a series of high-profile industry problems — including one incapicitated patient becoming pregnant — and HHS and FDA have faced Grassley's scrutiny over drug safety.
Grassley's biggest current target: drug makers. In his seven months atop the Finance Committee, Grassley has launched a flurry of probes into rising drug costs and potential kickback schemes and — perhaps most controversially — leading a bipartisan effort that would impose sweeping new limits on drug manufacturers' profitability.
That aggressive agenda has upended Washington's traditional alliances, winning praise from some Democrats and consumer groups and pitting Grassley against the deep-pocketed pharma lobby, as well as major elements within his own party.
Grassley told POLITICO that legislation to overhaul drug prices is essential for lasting change. But he also argued that in the short run, his oversight approach — with hearings featuring prominent pharma executives getting grilled — can help intensify lawmakers' appetite for change.
"I think it'd be a stretch for me to say that I might be able to embarrass Big Pharma into reducing prices or leveling off their increases," Grassley said. "But I think that shaming is not impossible to make them do some of that."
Grassley has vowed to press ahead, warning colleagues that whatever action the Senate takes will be far more moderate than anything likely to come out of the Democratic House. Congress has a responsibility to keep close tabs on the sprawling health industry, he told POLITICO, and it's a job he remains more than willing to do on his own.
"Transparency brings accountability," Grassley said. "And when you have accountability, the marketplace will work. And then the consumer ought to benefit."