Speaker Pelosi Unveils Bill Authorizing Negotiation of Drug Prices and Capping Out-of-Pocket Costs

On September 19, 2019, Representative Frank Pallone, Jr., Chairman of the U.S. House Committee on Energy & Commerce, introduced the Lower Drug Costs Now Act (H.R. 3). As noted in The New York Times, the bill addresses the problem of skyrocketing prescription drugs costs. In a press release, Speaker Nancy Pelosi stated that “[t]he soaring price of prescription drugs is crushing Americans at the pharmacy counter, driving up health insurance premiums, and creating unaffordable costs for taxpayers who finance Medicare and Medicaid.”

The Lower Drug Costs Now Act gives the Secretary of the Department of Health & Human Services the authority to negotiate the costs of 250 drugs every year. According to a fact sheet on Speaker Pelosi’s website, these drugs will be drawn from a list of the most costly drugs in the U.S. “without competition from at least one generic or biosimilar on the market.” 

The fact sheet notes that “[i]n the first year alone, drugs representing more than half of all Medicare Part D spending, covering tens of millions of patients, would be subject to the negotiation process – including insulin.” The negotiated prices would also be available to all purchasers – not just Medicare beneficiaries.


The Act would also make improvements to beneficiary cost sharing, and cap out-of-pocket costs for beneficiaries at $2,000. In addition, if sufficient savings are generated, the funds could be reinvested in the Medicare program, potentially expanding coverage in areas historically lacking, such as vision, hearing and dental.

The Center for Medicare Advocacy has called for drug price negotiations since the creation of Medicare Part D. Lawmakers should embrace this opportunity for savings, and redirect these dollars back into health care, including additional dental, vision, hearing and home-based benefits, and protections for low-income beneficiaries.

• To learn more about the bill, please visit: https://www.speaker.gov/sites/speaker.house.gov/files/HR3%20Lower%20Drug%20Costs%20Now%20Act%20Backgrounder%209.23.19.pdf.