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Democrats box in Republicans on drug pricing

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Burgess Everett

After months of wrangling, House Democrats finally passed a massive bill aimed at lowering drug prices. And Senate Republicans are flummoxed over how to respond.

The GOP is in a jam that makes action appear somewhere between unlikely and impossible. But if Republicans fail to act, it could easily become a major political liability for the party given the salience of high drug prices in public polling and President Donald Trump’s desire for sweeping reforms.

Yet with an election year cresting and massive divisions among his members, Senate Majority Leader Mitch McConnell is staying put. Associates say the Kentucky Republican is not eager to make a move that splits his caucus and could incur the wrath of the well-financed pharmaceutical industry.

A final decision will wait until after the Senate’s impeachment trial. Many Senate Republicans, however, know they need to do something to satisfy Trump and avoid the awful optics of doing nothing at all.

Senate Finance Chairman Chuck Grassley (R-Iowa) this summer advanced a bill that would fine drugmakers that hike prices above inflation rates, but from the start it had more Democratic support than Republican backing. Even though a significant number of GOP members say it’s a bold stroke with crucial presidential support, many Republicans liken the move to price controls that would kill innovation.

“God, I don’t know. We’re stuck with a price control concept,” said Sen. Lindsey Graham, referring to his opposition to Grassley’s bill. Trump “is nonconventional as a Republican. He would go to price controls … [McConnell] probably wants what I want.”

Summing up the party’s headache, the South Carolina senator said: ‘We’re not divided on if we should do something. We’re divided over what we should do. And I don’t think either of us as a party can walk away and end up doing nothing.”

Fresh off their victorious vote last week on Speaker Nancy Pelosi’s sweeping drug bill allowing the government to negotiate drug costs, House Democrats are trashing Senate inaction — and McConnell specifically. The GOP leader has likened Pelosi’s bill to “socialist price controls” and said in no uncertain terms it has no chance in the Senate. Trump also pledged to veto the measure.

Senate Republicans “keep saying they care about it, but then they do nothing,” said progressive Rep. Pramila Jayapal (D-Wash.), whose battle with House leadership led to last-minute changes that pushed the bill further left.

Republicans across the Capitol have slammed Pelosi’s bill as an even bigger boogeyman to biomedical innovation than the Senate option, and even Grassley has used it as evidence that the GOP needs to get behind his legislation or face a world with fewer new life-saving medicines.

“Thank goodness Republicans control the Senate. That said, we still need something to make medicines affordable,” said Bill Cassidy (R-La.), who voted for Grassley’s effort in committee and still backs it.

Yet without a clear path forward, senators say they feel stuck. And publicly, the White House is waffling on potential compromises. Joe Grogan, the director of the Domestic Policy Council who has worked closely with the senators on their package, first told POLITICO that the controversial inflation cap wasn’t a hill to die on — then later said it was a necessary compromise to keep Democrats on board.

When it comes to the Senate floor, McConnell is not eager to put anything up that doesn’t at a minimum have the support of half his members. He’s warned colleagues that the drug-pricing bill could result in a circular firing squad — exposing his Republicans to tough attacks as they run for reelection.

Take Sen. Thom Tillis of North Carolina, whose state is a hotbed for the pharmaceutical industry. He opposes the Grassley bill — but if he voted against it he’d be sure to take flak from Democrats looking to oust him. He said the need to put caps on drug prices is being “driven by a lot of populist pressure.”

This article was originally published on Politico on December 17, 2019. Reprinted with permission.

About the Author: Sarah Owermohle is a health care reporter for POLITICO Pro covering drug policy and the industry. Before joining POLITICO, she covered the business of health care for S&P Global Market Intelligence and spent five years in Dubai and Beirut reporting on business, finance and development in the Middle East and Africa, including a three-year stint as the editor of Banker Africa. She graduated from the College of William and Mary in Williamsburg, Va.
About the Author: John Burgess Everett is a congressional reporter for POLITICO. He previously was a transportation reporter for POLITICO Pro, Web producer, helping run POLITICO’s Twitter and Facebook accounts, and a contributor to the On Media blog.

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Pelosi brokers deal with liberals on drug pricing bill

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Sarah FerrisAdam CancrynHouse Democratic leadership on Tuesday clinched a deal to win progressive leaders’ support for a sweeping drug pricing bill that could clear its path for passage in the full House on Thursday.

The pact between Speaker Nancy Pelosi and progressive leaders includes an agreement to expand the government’s authority to directly negotiate drug prices under the legislation, ultimately requiring federal officials to hammer out the cost of at least 50 medicines a year, from the original 35.

“We’re likely to see the minimum number lifted, probably to 50,” said Michigan Rep. Dan Kildee, a member of Pelosi’s whip team. “My impression is that progressives will be good on this.”

Top Democrats are also restoring a progressive provision previously cut from the bill that would mandate the federal government eventually issue regulations restricting drugmakers’ ability to raise prices above the rate of inflation in workplace health plans, the largest source of coverage in the country.

The House Rules Committee later Tuesday night approved, 8-3, the rule that sets up debate on the bill, putting it on track for floor consideration. The panel also permitted a separate vote on Republicans’ bill, a measure GOP lawmakers have championed this week as a bipartisan alternative.

The chamber’s liberal wing had threatened to stall Pelosi’s bill if she refused to make a series of last-minute changes to the legislation, throwing the fate of Democrats’ top health care priority into doubt.

But the two sides brokered a tentative resolution this afternoon during a closed-door meeting that included Pelosi and Congressional Progressive Caucus co-leaders Pramila Jayapal (D-Wash.) and Mark Pocan (D-Wis.).

Jayapal called the deal a “huge win,” adding in a statement that “it shows what we can do when we stick together and all push hard for the American people.”

The changes represent a major victory for progressive leaders following a rare public showdown with Pelosi. They also come just one day after Pelosi and other senior Democrats warned progressive members against taking a hard-line stance on the bill.

Democratic leaders had long resisted making changes to the legislation that would push it further to the left, in part due to fears it could cost support from the dozens of moderate lawmakers key to keeping control of the House.

Many of those Democrats campaigned on lowering drug prices, and had pressed for weeks for a vote on the drug bill before the end of the year — while also warning against any last-minute efforts to make it more ambitious.

Yet top Democrats enraged progressives last week after eliminating the language authored by Jayapal that would have expanded certain price restrictions into the private sector, sparking talk of a rebellion aimed at tanking a procedural vote needed to put the bill on the floor.

In public, Democratic leaders this week expressed confidence that the bill could pass as originally written, insisting that it already represented “transformational” step toward slashing drug prices and that liberal lawmakers’ opposition would eventually collapse.

But Democratic leadership internally took the prospect of mass defections seriously, discussing it at several closed-door meetings on Tuesday.

Before leadership altered the bill, Rep. Alexandria Ocasio-Cortez told reporters Tuesday she would vote no on the legislation without changes. Rep. Lloyd Doggett, an outspoken critic of the bill as far too timid, had also previously threatened to vote against it. And progressive leaders in recent days warned they had enough votes to stop the key Democratic priority in its tracks with just days left on the congressional calendar this year.

Few if any of the chamber’s Republicans are expected to support the package, and it won’t get any traction in the GOP-controlled Senate. The White House on Tuesday issued an official veto threat against the House bill.

Sarah Owermohle contributed to this report.

This article was originally published by the Politico on December 10, 2019. Reprinted with permission. 

About the Author: Sarah Ferris covers budget and appropriations for POLITICO Pro. She was previously the lead healthcare and budget reporter for The Hill newspaper.

A graduate of the George Washington University, Ferris spent most of her time writing for The GW Hatchet. Her bylines have also appeared at The Washington Post, the Houston Chronicle and the Center for Investigative Reporting.

Raised on a dairy farm in Newtown, Conn., Ferris boasts a strong affinity for homemade ice cream, Dunkin Donuts coffee and the Boston Red Sox.

About the Author: Adam Cancryn is a health care reporter for POLITICO Pro. Prior to joining POLITICO, he was a senior reporter for S&P Global Market Intelligence, covering the intersection of money, politics and regulation across the financial services and insurance industries. He’s also written for The Wall Street Journal and Dow Jones Newswires, and got his start at the Philadelphia Business Journal.

Adam is a graduate of Washington & Lee University and a proud New Jersey native.


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