The administration faces increasing pressure to release a concrete healthcare plan as Democratic presidential candidates are eager to keep the national conversation focused on healthcare heading into 2020.

And, as the administration backs a lawsuit seeking to declare the Affordable Care Act unconstitutional, the president faces renewed skepticism any potential plan would protect patients with pre-existing conditions. The outcome of the ACA litigation may not be clear until sometime next year, which would place an outcome in the middle of presidential campaigning.

The healthcare industry and politicians alike are eager for details of the promised plan, which was first reported by The Wall Street Journal earlier this month. The White House has released nothing concrete — the plan could be as simple as a renewal of 2016’s “repeal and replace” effort or a comprehensive plan including protection for pre-existing conditions, incentivizing the sale of insurance across state lines or other efforts to spur competition in the system.

“It won’t be like the Affordable Care Act because the Affordable Care Act is not working,” Verma told reporters Thursday in Washington, D.C. 

Although Verma declined to comment on the timing and details of any potential healthcare plan, CMS is “implementing the president’s agenda on healthcare in all the work CMS does around quality, drug pricing, transparency,” she said. 

“I think we’ve been very clear that some of the changes that need to be made are outside our scope,” Verma added. “I think to some degree we’ve taken things as far as we can in terms of the regulatory changes that we’ve made.”

Some are skeptical Trump has a fleshed-out healthcare plan, with Republican lawmakers saying they weren’t briefed on any potential legislation before departing for the August recess. But the CMS head pushed back against those claims, noting the agency is in talks with lawmakers and the White House.

Verma also reiterated Thursday the agency is bullish on a proposed rule for the International Pricing Index, calling it a “top priority.”

HHS released a notice of proposed rulemaking last October announcing the IPI. Although the healthcare agency originally planned to release a proposed rule by this spring and start the program next year, it was delayed following opposition from the pharmaceutical industry.

The Trump administration has faced a series of setbacks in its efforts to lower drug prices. It had to withdraw a proposed rule to eliminate the safe harbor for drug rebates in Medicare Part D following concerns it would raise premiums.

Additionally, a federal judge blocked an HHS rule requiring drug manufacturers to publish list prices in direct-to-consumer TV advertisements last month.

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