On Wednesday, the House passed the 21st Century Cures Act (HR 34) by a vote of 392-26. Its next step is a Senate vote expected next week.
On the drawing board since April 2014, the Cures Act provides $1 billion over two years to states through existing grant programs for addiction treatment and prevention, prescription drug monitoring programs, opioid treatment programs and workforce development. It also creates federal drug courts and encourages integration of care for substance use disorders with primary care.
Industry observers note that behavioral health issues are decidedly bipartisan and will continue to be on the radar for lawmakers. Advocates for the Cures Act say the bill will help fight the opioid crisis and better coordinate mental healthcare by reducing duplicate services.
Those opposed argue that it weakens regulations on pharmaceutical companies, allowing them to press forward on new drug approvals more quickly and cheaply, with less oversight by the Food and Drug Administration. In essence, opponents say, the only way to get the “big pharma” lobbyists on board with the bill was to make concessions.
Sen. Elizabeth Warren (D-Mass.) and Sen. Bernie Sanders (I-Vt.) are among those opposed to the bill, calling it a giveaway to pharmaceutical manufacturers. In a statement, Sanders said, “The greed of the pharmaceutical industry has no limit, and this bill includes numerous corporate giveaways that will make drug companies even richer.”
In all, six Democrats and 20 Republicans voted against the Cures Act.
The bill also includes mental health reforms from Rep. Tim Murphy's (R-Pa.) Helping Families in Mental Health Crisis Act (HR 2646). One controversial provision establishes an Assistant Secretary for Mental Health and Substance Use to head SAMHSA, providing more oversight of administration’s investments. It also calls for actions to clarify—but not to change—HIPAA rules around sharing patient information.
Additionally, the $6.3 billion total Cures Act package includes significant investment for President Obama’s precision medicine initiative and Vice President Joe Biden’s “cancer moonshot.” However, the authorized funding is discretionary and subject to annual appropriation. Obama is expected to sign the final bill.