美国国家公共电台 NPR How Sen. Orrin Hatch Shaped America's Health Care In Controversial Ways

STEVE INSKEEP, HOST:

The arrival of the new Congress means the retirement 1 of Utah Senator Orrin Hatch.

NOEL KING, HOST:

Hatch was elected 42 years ago in 1976, when Gerald Ford 3 was president. Presidents have come and gone since then - seven presidents from Carter to Trump 4 - but Hatch has always been there.

INSKEEP: In public, Orrin Hatch has always been quotable, often partisan 5, yet noted 6 for working with key Democrats 8.

KING: And behind the scenes, he was deeply influential 9 on health care legislation. His bills affected 10 millions of consumers and many health care companies.

INSKEEP: Erik Neumann of our member station KUER in Salt Lake City has an evaluation 11.

ERIK NEUMANN, BYLINE 12: During his 42 years in the Senate, Orrin Hatch sponsored major pieces of health legislation. There was the 1983 Orphan 13 Drug Act to promote drug development for rare diseases and, in 1990, the Ryan White CARE Act to treat people with HIV who were uninsured.

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ORRIN HATCH: AIDS does not play favorites. It affects rich and poor, adults and children, men and women, rural communities and the inner cities. We know much, but the fear remains 14.

NEUMANN: It was a bold stance at the time. It was also an example of how well Hatch, a Republican, worked with Democrats. Hatch co-sponsored a number of bills with Democrat 7 Ted 2 Kennedy. The two men were sometimes called the odd couple. In 1997, they proposed the Children's Health Insurance Program, or CHIP. It was a major achievement, according to Joan Alker, a health policy analyst 15 at Georgetown.

JOAN ALKER: This is an area the country has made enormous progress on. And it's something we should all feel proud of, and Senator Hatch should, too.

NEUMANN: At the time, the number of uninsured children in America was around 10 million. Today it's less than half that. Hatch's influence on American health care came from the sheer number of bills he sponsored and because he was chairman of several powerful committees.

DAVID SUNDWALL: History was on his side because the Republicans were in charge.

NEUMANN: That's Dr. David Sundwall, a Utah professor who worked as Hatch's health director in the 1980s. When Reagan became president, the Senate also became Republican for the first time in decades. And Hatch nabbed the chairmanship of the committee that oversees 16 the Food and Drug Administration, the CDC and the National Institutes of Health.

SUNDWALL: He was virtually catapulted into this chairmanship role. This is astonishing, that he had chairmanship of an umbrella committee in his first term in the Senate.

NEUMANN: In 2011, Hatch got a seat on the even more powerful Senate Finance Committee and later became chairman. Now he had oversight 17 of Medicare, Medicaid and CHIP. Hatch's growing power did not go unnoticed by health care lobbyists. The watchdog group Center for Responsive Politics ranks Hatch as a top recipient 18 in Congress for health industry contributions. And a lot of Hatch's money came from the pharmaceutical 19 sector 20.

JEREMY GREENE: Clearly he was pharma's man on the Hill.

NEUMANN: That's Dr. Jeremy Greene, a medical historian at Johns Hopkins University. He says Hatch did work on lowering drug prices, but his overall record was mixed. Take a law he sponsored in 1984 with Democrat Henry Waxman. The Hatch-Waxman Act was meant to spur the development of more generic 21 drugs.

And generic sales did increase. Still, companies that sold the more expensive brand-name drugs didn't lose out. The act gave them longer patents on their drugs. And Greene says that soon drugmakers figured out how to exploit the law's weaknesses.

GREENE: The makers 22 of brand-name drugs began to craft larger and larger webs of multiple patents around their drugs to try and help find ways of preserving monopolies after the initial patent expired.

NEUMANN: Hatch has also gotten mixed reviews for his work with another industry, supplements. That's a catch-all term for vitamins, herbs and other natural health products. The multibillion-dollar industry is concentrated in Hatch's home state of Utah. Loren Israelsen is a former Hatch staffer who now leads a supplements trade group.

LOREN ISRAELSEN: There was really no place for these natural health products.

NEUMANN: As the industry grew, a debate began over how to regulate it. In 1994, Hatch responded by sponsoring the Dietary Supplement Health and Education Act.

ISRAELSEN: It was necessary to have someone who would be a champion to say, all right, if we need to change the law, what does it look like, and let's go.

NEUMANN: The act reined 23 in the FDA oversight, saying supplements did not have to go through safety testing like prescription 24 drugs. That's led to ongoing 25 questions about whether supplements work and how they interact with other medications. Hatch co-sponsored the supplements law with Democrat Tom Harkin.

That bipartisanship was how he worked for decades, but in recent years not so much. He strongly opposed the Affordable 27 Care Act. And at one time, he called its supporters the stupidest people he'd ever met. Hatch is now 84. In his farewell speech on the Senate floor, he lamented 28 the polarization that's overtaken Congress.

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HATCH: Gridlock is the new norm. And like the humidity here, partisanship 26 permeates 29 everywhere, everything we do.

NEUMANN: And as Orrin Hatch prepares to leave Washington, there's no sign of relief. For NPR News, I'm Erik Neumann.

INSKEEP: This story is part of a reporting partnership 30 with local member stations and Kaiser Health News.