A Conversation With Veteran Healthcare Lobbyist Paul Kelly | DC Roundtable


A limited pharmacy benefit manager (PBM) reform bill may be used as a "pay for" to offset the costs of extending Medicare telehealth flexibilities, shares Kelly, of Capitol Advocacy & Government Affairs.

Welcome to another episode of our DC Roundtable podcast!

Our guest this time is Paul Kelly, of Capitol Advocacy & Government Affairs. Kelly is a second-generation lobbyist — his father, Harold V. Kelly, who was head of the Washington office for Republic Steel Corporation in the mid-70s and 80s. Kelly got his K Street start working for the American Chiropractic Association and advocating for the inclusion of chiropractic services in Medicare coverage.

“I learned some really important lessons about being persistent, about being creative, about how important local issues and the opinions of local voters are to members of Congress and policymakers,” Kelly says.

Kelly has also lobbied for the American Dietetic Association and the National Association of Chain Drugstores. His current clients include the American College of Clinical Pharmacy. He is a consultant to The Livingston Group, a prominent lobbying firm that has healthcare clients.



In his conversation with Peter Wehrwein, managing editor of Managed Healthcare Executive, Kelly talks about the prospects of the pharmacy benefit manager (PBM) legislation that Congress is considering. The House passed the Lower Costs, More Transparency Act by a wide, bipartisan margin last year and various Senate committees have voted for PBM legislation. But Kelly sees obstacles looming for a comprehensive PBM reform bill in the Senate and the notes that the powerful House Ways and Means Committee voted for a bill that extends more liberal coverage of telehealth services by Medicare and uses limited PBM reform as a “pay for” to offset the costs associated with greater use of telehealth.

Kelly also discusses how healthcare might figure into the presidential election in November. The Affordable Care Act (ACA) has many popular provisions, and Kelly doesn’t see any Republican appetite for getting rid of the law. He sees drug prices and the politics of wooing voters with promises to lower them as a “jump ball” between President Joe Biden and former President Donald Trump with both making claims about achievements and intentions.

If Biden is re-elected, Kelly sees his administration continuing to take steps to bolster the ACA and to lower drug costs for patients.

To pivot, Kelly shared his father, Harold V. Kelly (still going strong at 93!) was the head of the Washington office for Republic Steel Corporation in the mid-to-late 1970s and 80s. (Republic was later acquired by the conglomerate LTV in 1984, when it became LTV Steel.) It was the 3rd largest domestic steel company at the time. He was pretty well-know in the Carter, Reagan and H.W. Bush Administrations and in various congressional delegations where steel was an important manufacturer.

Kelly also discussed the Ways and Means telehealth bill. In Section 302, it's an “off set” that uses savings from a PBM reform. This is the same language that the Senate Finance Committee approved in its big healthcare/PBM package (aka, the MEPA) back in November.

The House Energy & Commerce Committee also passed a two-year telehealth extension this week. "I haven’t seen it yet, but late last year, the committee approved H.R. 2880, by Rep. Buddy Carter (R-GA) that included PBM reform language similar to the “offset” sections of the Ways and Means telehealth bill and the Senate Finance “MEWA” bill. I expect E&C is also looking at this language as a potential "pay for" for anything they do in the healthcare space this year, including telehealth," he said.

As usual, until legislation becomes law, any savings it produces (as determined by CBO) is fair game! It can, and will, be used multiple times until it becomes law.

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