IV 
117TH CONGRESS 
2D SESSION 
H. RES. 1390 
Expressing support for the protection of Medicare part D’s six protected 
classes. 
IN THE HOUSE OF REPRESENTATIVES 
SEPTEMBER 22, 2022 
Mrs. NAPOLITANO (for herself, Mr. KATKO, Ms. LEE of California, Miss 
GONZA´LEZ-COLO´N, Mr. FITZPATRICK, Ms. ROYBAL-ALLARD, Ms. MAT-
SUI, Mr. SOTO, Mr. TRONE, Mr. SIRES, Mr. GRIJALVA, and Mr. 
CA´RDENAS) submitted the following resolution; which was referred to the 
Committee on Energy and Commerce, and in addition to the Committee 
on Ways and Means, for a period to be subsequently determined by the 
Speaker, in each case for consideration of such provisions as fall within 
the jurisdiction of the committee concerned 
RESOLUTION 
Expressing support for the protection of Medicare part D’s 
six protected classes. 
Whereas Medicare part D was established by Congress in 
2003 to provide much-needed prescription drug coverage 
for seniors and people with disabilities; 
Whereas during implementation, the Centers for Medicare & 
Medicaid Services (CMS) identified six classes and cat-
egories of medicines where patients could face serious 
risks, complications, and negative health outcomes with-
out access to these medicines; 
VerDate Sep 11 2014 
01:46 Sep 23, 2022
Jkt 029200
PO 00000
Frm 00001
Fmt 6652
Sfmt 6300
E:\BILLS\HR1390.IH
HR1390
kjohnson on DSK79L0C42PROD with BILLS
•HRES 1390 IH 
Whereas CMS requires part D plans to cover all or substan-
tially all medication within these six classes, which help 
protect patients needing antidepressants, antipsychotics, 
anticonvulsants, 
immunosuppressants, 
antiretrovirals, 
and antineoplastics; 
Whereas these medications help treat patients with, but not 
limited to, epilepsy, organ transplants, cancer, HIV/ 
AIDS, and mental health conditions; 
Whereas, in the past, CMS has considered changes that im-
pact the accessibility of these medicines; 
Whereas prior proposed changes would have permitted cer-
tain health plans to limit or reduce coverage of drugs in 
the protected classes; 
Whereas prior proposed changes have failed to consider the 
need for Medicare beneficiaries to have access to treat-
ments that are best for their condition(s) or the necessity 
and challenges to determine the best regimen to meet 
those needs; 
Whereas if patients are unable to obtain the medicines they 
need, many will experience costly and avoidable complica-
tions that could increase overall costs to the Medicare 
Program, reduce their quality of life, or even limit life 
itself; 
Whereas such changes would directly target some of our most 
vulnerable citizens; 
Whereas prior proposed changes are particularly worrisome 
given the unique, often complex, medical needs of some 
Medicare beneficiaries; 
Whereas beneficiaries with schizophrenia who are stabilized 
on medication and then forced to utilize a different medi-
cine are at risk of a relapse; 
VerDate Sep 11 2014 
01:46 Sep 23, 2022
Jkt 029200
PO 00000
Frm 00002
Fmt 6652
Sfmt 6300
E:\BILLS\HR1390.IH
HR1390
kjohnson on DSK79L0C42PROD with BILLS
•HRES 1390 IH 
Whereas this would lead to higher medical costs in the form 
of potentially avoidable psychiatric hospitalizations, as 
well as exacerbate patients’ comorbid medical conditions; 
Whereas individuals with depression often need to try several 
medicines before finding one that provides symptom re-
lief; 
Whereas having only one or two drugs to treat the wide-rang-
ing ways someone could present with depression is simply 
inadequate, especially among an older population where 
depression is a significant predictor of suicide; 
Whereas access to medications is essential for those who ex-
perience mental health conditions, which are often co-oc-
curring with other conditions, such as Parkinson’s dis-
ease; 
Whereas for people living with HIV, new drug therapies have 
saved millions of lives and prolonged millions more; 
Whereas the advent of antiretroviral medications shifted the 
prognosis for an individual diagnosed with HIV from a 
near-certain death to a manageable disease, when pa-
tients have access to quality care and medications; 
Whereas not all HIV/AIDS medications are the same, and 
each person may react differently to a particular medica-
tion; 
Whereas disruptions or delays in access to HIV treatment 
can have serious consequences for patients and can in-
crease the risk of HIV transmission to others; 
Whereas for people living with HIV, drug resistance can 
occur, and they must have the ability to switch to an-
other drug without interruption; 
VerDate Sep 11 2014 
01:46 Sep 23, 2022
Jkt 029200
PO 00000
Frm 00003
Fmt 6652
Sfmt 6300
E:\BILLS\HR1390.IH
HR1390
kjohnson on DSK79L0C42PROD with BILLS
•HRES 1390 IH 
Whereas HIV disproportionately affects minority populations, 
and, in 2020, 43 percent of people newly diagnosed with 
HIV were Black, although Black Americans represent 
only 12 percent of the United States population, and in 
2019, Hispanic people represented 29 percent of those 
newly diagnosed with HIV but only 16 percent of the 
United States population; 
Whereas access to oncology drugs (antineoplastics) is crucial 
for cancer patients because drugs in these classes are not 
always interchangeable; 
Whereas oncology patients may respond differently to dif-
ferent treatments, need to access alternative treatments 
based on changes in their condition, or have fewer or 
more tolerable side effects if they use one therapy instead 
of another; 
Whereas at least 1,100,000 Medicare beneficiaries live with 
epilepsy; 
Whereas epilepsy medications, known as anticonvulsants or 
antiseizure medications, are not interchangeable; 
Whereas people with epilepsy who cannot access or are forced 
to switch from the most effective anticonvulsant are at 
increased risk of breakthrough seizures and related com-
plications including injury, disability, and death; 
Whereas seizure-free individuals who are forced to switch 
their medication have nearly a 17-percent rate of seizure 
reoccurrence compared to less than 3 percent among peo-
ple remaining on the most effective medication; 
Whereas eliminating immunosuppressants from the list of 
protected classes would place persons who received any 
transplant at risk for severe medical complications; 
VerDate Sep 11 2014 
01:46 Sep 23, 2022
Jkt 029200
PO 00000
Frm 00004
Fmt 6652
Sfmt 6300
E:\BILLS\HR1390.IH
HR1390
kjohnson on DSK79L0C42PROD with BILLS
•HRES 1390 IH 
Whereas immunosuppressive medications are not interchange-
able; 
Whereas if prescription drugs are filled without regard to 
consistency from one month to the next, the recipient is 
subject to increased risk of organ rejection, along with 
additional clinic visits, lab costs, and potential hos-
pitalization; 
Whereas this includes individuals who take these same medi-
cations to manage their autoimmune disorders, including 
lupus, psoriasis, rheumatoid arthritis, Crohn’s disease, 
and multiple sclerosis; 
Whereas part D plans are already equipped with tools to 
manage spending and encourage the use of generics, 
when possible and appropriate, for the six protected 
classes; 
Whereas, according to an analysis of CMS data by the Pew 
Charitable Trusts, the generic utilization rate in the six 
protected classes is as high as 92 percent; and 
Whereas potential changes to the six protected classes have 
now been rejected during the Obama, Trump, and Biden 
administrations after receiving significant opposition 
from Congress, patient groups, providers, and stake-
holders: Now, therefore, be it 
Resolved, That the House of Representatives— 
(1) supports the six protected classes policy be-
cause it established critical access protection for 
many of our most vulnerable Medicare beneficiaries; 
(2) recognizes that Medicare part D bene-
ficiaries 
currently 
needing 
antidepressants, 
VerDate Sep 11 2014 
01:46 Sep 23, 2022
Jkt 029200
PO 00000
Frm 00005
Fmt 6652
Sfmt 6201
E:\BILLS\HR1390.IH
HR1390
kjohnson on DSK79L0C42PROD with BILLS
•HRES 1390 IH 
antipsychotics, 
anticonvulsants, 
immunosuppressants, 
antiretrovirals, 
and 
antineoplastics depend on the protection of the six 
protected classes to meet their complex medical 
needs and highly personalized treatments; and 
(3) encourages the Centers for Medicare & 
Medicaid Services to continue to work with Con-
gress, patient groups, providers, and stakeholders to 
secure long-term protection of the six protected 
classes policy. 
Æ 
VerDate Sep 11 2014 
01:46 Sep 23, 2022
Jkt 029200
PO 00000
Frm 00006
Fmt 6652
Sfmt 6301
E:\BILLS\HR1390.IH
HR1390
kjohnson on DSK79L0C42PROD with BILLS