Congress is pushing forward on legislation to lower prescription drug prices, but it’s still not clear where the various efforts underway will lead.
The impetus is clear: Lawmakers know that this is an area where the American public really, really wants something done. “If I go church and there is a Bernie Sanders supporter and a Donald Trump supporter yanking on different lapels but agreeing on the same thing, it’s the high cost of medications,” Sen. Bill Cassidy (R-LA) told reporters this week, according to The Washington Post. “I think that’s why you see candidates across the spectrum speaking of it.”
Whether all that talk results in legislation that gets passed is the question.
The White House is reportedly discussing drug pricing legislation with House Speaker Nancy Pelosi’s office, while lawmakers continue to propose their own plans — and Democratic leaders will need to address some bubbling unrest on their left flank. “If we don’t address this in a big and bold way, a lot of us should go home and start knitting,” Rep. Mark Pocan (D-WI), a co-chair of the Congressional Progressive Caucus, said this week, according to Politico.
Here’s a look at where things stand.
In the Senate: Two efforts to pull together bipartisan packages intended to lower health care costs and bring transparency to prices are underway with the goal of merging them on the Senate floor this summer, the Post’s Paige Winfield Cunningham reports.
Senate Finance Committee Chairman Chuck Grassley (R-IA) and Sen. Ron Wyden (D-OR) are due to release a drug pricing plan this month, while the Committee on Health, Education, Labor and Pensions is preparing for a hearing on draft legislation put out last month by Chairman Lamar Alexander (R-TN) and Sen. Patty Murray (D-WA) aimed at eliminating surprise medical bills and lowering drug costs, among other things.
“Neither package will include one singular big thing to lower health-care costs for consumers,” Winfield Cunningham writes. “Instead, they’ll be full of smaller proposals that legislators say together could help move the needle on prices.”
Cassidy and a bipartisan group of five other senators last month released a separate proposal on surprise medical bills. It would allow an independent “baseball-style” arbitration process in some cases where there’s a dispute over payment rates. Under that process, the insurer and the provider each present an independent arbitrator their proposal for what a procedure should cost and the arbitrator chooses one. That arbitration provision reportedly might be an obstacle to getting the Cassidy bill adopted.
And on Thursday, a group of eight GOP senators released a letter to the Pharmaceutical Research and Manufacturers of America (PhRMA), the leading industry trade association, asking for cooperation in finding solutions “that would increase transparency and directly lower the list price of drugs for consumers.”
In the House: “[W]hile there’s a lot of momentum in the Republican-led Senate, that chamber isn’t where a deal would need to be struck,” Winfield Cunningham says. “Any new measures would have to be passed by the Democratic-led House, so it’s the conversations between Pelosi and the White House that are most important at this juncture.”
Pelosi, however, reportedly faces pushback from the progressive wing of her own party. “Liberal lawmakers and like-minded advocacy groups say the preliminary drug pricing plan pitched by House Speaker Nancy Pelosi is far too timid a response to spiraling U.S. drug costs, and could fail to leverage the government’s massive purchasing power in demanding cheaper medicines,” Politico’s Adam Cancryn writes.
That preliminary leadership plan would reportedly give government officials the power to negotiate prices for some prescription drugs and would empower the Government Accountability Office to decide drug prices in cases where an agreement can’t be reached. It would require prices to be negotiated for a minimum of 25 drugs a year, and those negotiated prices would apply even to private insurance plans.
“Congress should focus on price negotiations on key drugs for the same reason that bank robbers rob banks: Because that’s where all the money is,” Ben Wakana, executive director for Patients for Affordable Drugs, told Politico. “It is really a handful of two dozen drugs that are driving the majority of the spending in Medicare.”
But progressives say Pelosi’s plan is too weak and complain that they’ve been left out of the legislative process. “We talk about transparency in drug pricing. We need a little transparency on the process,” Ways and Means health subcommittee chair Lloyd Doggett (D-TX) said, according to Politico. Doggett has his own drug price reforms proposal, which would let the government strip drug manufacturers of their patents if they refuse to negotiate prices. That proposal has the support of progressives.
A Pelosi spokesman said this week that party leaders are still collecting input from members, according to The Hill’s Peter Sullivan, who also notes that House Majority Leader Steny Hoyer (D-MD) told reporters this week that the chamber will be tied up with appropriations this month and that “we’ll see whether by July we’re ready to deal with prescription drugs.”
The bottom line: There’s still room for a bipartisan deal to get done, but the path to any agreement that can get support from the Trump White House, Democratic leaders and House progressives likely won’t be smooth.