Rachel Cohrs December 11, 2019
House Democratic leaders amended their signature
government drug price negotiation bill on Tuesday to eventually require
drugmakers to pay back private healthcare plans if they raise drug prices
faster than inflation and to include more drugs in negotiations with the HHS
secretary.
The Congressional Progressive Caucus pushed for
the changes, and some members threatened to vote against the bill if their
demands were not met. The inflationary rebate provision was offered by
Progressive Caucus Co-Chair Pramila Jayapal (D-Wash.) and adopted in the
Education & Labor Committee markup on the Elijah Cummings Lower Drug Costs
Now Act, but leadership had watered it down.
The earlier version of House Democrats' bill
would have required drugmakers to pay back Medicare if they raised drug prices
faster than inflation. The new provisions would require the Labor secretary to
issue rules that would expand the inflationary rebates to private healthcare
plans.
The HHS secretary would also ultimately be
obligated to negotiate the prices of at least 50 high-cost drugs with little or
no competition per year, up from the original 35.
"This is a huge win, and it shows what we
can do when we stick together and all push hard for the American people,"
Jayapal said in a statement.
House leadership's concessions on Tuesday were
only the latest in a series of capitulations to the Progressive Caucus in
earlier stages of drafting the legislation. In response to progressive complaints,
House Democratic leaders previously changed the main cost-saving mechanism in
the bill from arbitration to direct negotiation and expanded
negotiation-eligible drugs to include medications with one generic or
biosimilar competitor.
"The improvements agreed upon this
afternoon, coupled with changes made earlier this year, have made this bill
significantly stronger for the American people. Our goal has always been to
expand the scope of this legislation so more families could benefit from lower drug
prices," the Progressive Caucus said in a statement on Tuesday.
Pelosi's bill is expected to pass the House, but
Senate Majority Leader Mitch McConnell (R-Ky.) said the measure will not get a
vote in the Senate. The White House said in a statement Tuesday that President
Donald Trump would veto Pelosi's bill if Congress passed it, further dimming
the legislation's prospects.
Even after the veto threat, House Energy &
Commerce Chair Frank Pallone (D-N.J.) said Tuesday that Democratic leaders are
still holding out hope that Trump will flip and support House Democrats'
legislation.
Trump expressed support for allowing HHS to
negotiate drug prices on the campaign trail and has outlined his own plan to
use foreign reference pricing to lower drug costs for physician-administered
drugs in Medicare. Both policies are foundational policies in House Democrats'
drug-pricing package.
"We're hopeful that he will eventually come
back to supporting what he said he would support— negotiated prices,"
Pallone said.
A floor vote on House Democrats' bill, dubbed
H.R. 3, is expected on Thursday. House Democratic leadership had previously
delayed a floor vote on their drug-pricing package because they were waiting on
final score from the Congressional
Budget Office, which was issued on Tuesday.
The CBO estimated House Democrats' bill would
save more than $500 billion. Analysts estimated House leaders would have $5
billion left over even after adding dental, vision and hearing benefits to
traditional Medicare and funding a variety of other healthcare
initiatives. Democratic leaders said they would use the leftovers
for deficit reduction.
The CBO's controversial estimate on
pharmaceutical innovation impact is that the bill's passage could lead to eight
fewer drugs being brought to market in the United States over the next 10
years, and 30 fewer drugs over the subsequent decade.
While Pelosi's bill is barreling forward,
Republicans still got a win on Tuesday night when the House Rules Committee
agreed to allow a House floor vote on a drug-pricing bill pushed by House
Republican leaders.
House Rules Committee Ranking Republican Tom
Cole of Oklahoma on Tuesday thanked Rules Committee Chair Jim McGovern
(D-Mass.) for allowing the bill to come to a floor vote as an amendment to
House Democrats' bill.
"That was our number one ask, and that was
a very generous thing for you to do," Cole said.
The House GOP drug-pricing package is composed
of a hodgepodge of provisions that have received bipartisan support, though the
bill currently does not have any Democratic co-sponsors.
The White House said in a statement that the
House GOP legislation is a "far better approach to lowering drug prices
and discovering life-saving and sustaining medicines" than House
Democrats' bill, though the administration also reaffirmed its support for a
drug-pricing package authored by Senate Finance Chair
Chuck Grassley (R-Iowa) and Ranking Democrat Ron Wyden of Oregon.
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