Sen. Orrin Hatch Hatch, now 84,co-sponsored a number of bills with Democrats over theyears, including the 1997 Children's HealthInsurance Program. (Photo: Photo: Diego M. Radzinschi/ALM)

|

Sen. Orrin Hatch, the Utah Republican retiring from42 years in the Senate as a new generation is swornin, leaves a long list of achievements in healthcare. Some were more controversial than others.

|

Hatch played key roles in shepherding the1983 OrphanDrug Act to promote drug development for rarediseases, and the 1984 National OrganTransplant Act, which helped create a national transplantregistry. And in 1995, when many people with AIDS werestill feeling marginalized by society and elected leaders, hetestified before the Senate about reauthorizing funding forhis RyanWhite CARE Act to treat uninsured people who have HIV.

|

Related: John McCain's health care legacy

|

“AIDS does not play favorites,” Hatch told othersenators. “It affects rich and poor, adults and children, men andwomen, rural communities and the inner cities. We know much, butthe fear remains.”

|

Hatch, now 84, co-sponsored a number of bills withDemocrats over the years, often with Sen. TedKennedy of Massachusetts. The two men were sometimes called “theodd couple,” for their politically mismatchedfriendship.

|

In 1997, the two proposed a broad newhealth safety net for kids — the Children'sHealth Insurance Program.

|

“This is an area the country has made enormous progress on, andit's something we should all feel proud of — and Senator Hatchshould too,” said Joan Alker,executive director of Georgetown University's Center for Childrenand Families.

|

Before CHIP was enacted, the number of uninsured children inAmerica was around 10 million. Today, it's under half that.

|

Hatch's influence on American health care partly camefrom the sheer number of bills he sponsored — more than anyother living lawmaker — and because he was chairman ofseveral powerful Senate committees.

|

“History was on his side because the Republicans were incharge,” said Dr.David Sundwall, an emeritus professor in public health at theUniversity of Utah and Hatch's health director in the 1980s.

|

When Ronald Reagan was elected president in 1981, the Senatebecame Republican-controlled for the first time in decades. Hatchwas appointed chairman of what is now known as the Health,Education, Labor and Pensions Committee. The powerfullegislative group has oversight of the Food and DrugAdministration, Centers for Disease Control and Prevention and theNational Institutes of Health.

|

“He was virtually catapulted into this chairmanship role,”Sundwall said. “This is astonishing that he had chairmanship of anumbrella committee in his first term in the Senate.”

|

In 2011, Hatch was appointed to the influential Senate FinanceCommittee, where he later became chairman. There he helped overseethe national health programs Medicare, Medicaid and CHIP.

|

Hatch's growing influence in Congress did not go unnoticedby health care lobbyists. According to the watchdogorganization Center for Responsive Politics, in thepast 25 years of political campaignfunding, Hatch ranks thirdof all members of Congress for contributions from thepharmaceutical and health sector. (That's behind Democraticsenators who ran for higher office — President Barack Obamaand presidential nominee Hillary Clinton).

|

“Clearly, he was PhRMA's man on the Hill,”said Dr.Jeremy Greene, referring to the trade group that representspharmaceutical companies. Green is a professor of the history ofmedicine at Johns Hopkins University School of Medicine. ThoughHatch did work to lower drug prices, Greene said, the senator'srecord was mixed on the regulation of drug companies.

|

For example, an important piece of Hatch's legislativelegacy is the 1984 Hatch-WaxmanAct, drafted with then-Rep. HenryWaxman, an influential Democrat fromCalifornia. While the law promoted thedevelopment of cheaper, generic drugs, italso rewarded brand-name drug companies by extending theirpatents on valuable medicines.

|

The law did spur sales of cheaper generics, Greene said. Butdrugmakers soon learned how to exploit the law's weaknesses.

|

“The makers of brand-name drugs began to craft larger and largerwebs of multiple patents around their drugs,” aiming to preservetheir monopolies after the initial patent expired, Greene said.

|

Other brand-name drugmakers preserved theirmonopolies by paying makers of generics not to compete.

|

“These pay-for-delay deals effectively hinged on a part of theHatch-Waxman Act,” Greene said.

|

Hatch also worked closely with the dietary supplement industry.The multibillion-dollar industry specializing in vitamins,minerals, herbs and other “natural” health products, isconcentrated in his home state of Utah.

|

“There was really no place for these natural health products,”said Loren Israelsen,president of the United Natural Products Alliance and a Hatchstaffer in the late 1970s.

|

As the industry grew, there was a debate over how to regulateit: Should it be more like food or like drugs? In 1994, Hatchsponsored the Dietary SupplementHealth and Education Act, known as DSHEA, which treatssupplements more like food.

|

“It was necessary to have someone who was a champion who wouldsay, 'All right, if we need to change the law, what does it looklike,' and 'Let's go,'” Israelsen said.

|

Some legislators and consumer advocacy groups wanted vitaminsand other supplements to go through a tight approval process, akinto the testing the Food and Drug Administration requires of drugs.But DSHEA reined in the FDA, determining that supplements do nothave to meet the same safety andefficacy standards as prescriptiondrugs.

|

That legislative clamp on regulation has ledto ongoing questions about whether dietary supplements actuallywork and concernsabout how they interact with other medicationspatients may be taking.

|

DSHEA was co-sponsored by Democrat Tom Harkin, then asenator from Iowa.

|

While that kind of bipartisanship defined much of Hatch'scareer, it has been less evident in recent years. He was stronglyopposed to the Affordable Care Act, and in 2018 called supportersof the heath law among the “stupidest,dumb-ass people” he had ever met. (Hatch later characterizedthe remark as “a poorly worded joke.”)

|

In his farewellspeech on the Senate floor in December, Hatch lamentedthe polarization that has overtaken Congress.

|

“Gridlock is the new norm,” he said. “Like the humidity here,partisanship permeates everything we do.”

|

This story is part of a partnership that includes KUER, NPR and Kaiser HealthNews.

|

Read more: 

 

Complete your profile to continue reading and get FREE access to BenefitsPRO, part of your ALM digital membership.

  • Critical BenefitsPRO information including cutting edge post-reform success strategies, access to educational webcasts and videos, resources from industry leaders, and informative Newsletters.
  • Exclusive discounts on ALM, BenefitsPRO magazine and BenefitsPRO.com events
  • Access to other award-winning ALM websites including ThinkAdvisor.com and Law.com
NOT FOR REPRINT

© 2024 ALM Global, LLC, All Rights Reserved. Request academic re-use from www.copyright.com. All other uses, submit a request to [email protected]. For more information visit Asset & Logo Licensing.