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Greg Nash
Moderate and
progressive House Democrats are clashing with each other over changes to
Speaker Nancy Pelosi
(D-Calif.) signature plan to lower drug prices.
A group of centrists,
including Rep. Stephanie Murphy
(D-Fla.), co-chairwoman of the moderate Blue Dog Coalition, has warned
leadership that some moderate Democrats might vote against the bill if it moves
any further to the left, sources say.
Meanwhile, House
progressives are pushing for revisions they say are needed to toughen up the
legislation. Rep. Pramila Jayapal
(D-Wash.), co-chairwoman of the Congressional Progressive Caucus, told The
Hill, “I really don’t understand” why moderates are objecting to the changes,
adding that she was undeterred.
Pelosi will have to
thread the needle between these dueling factions as she plans to bring the
measure to the floor as soon as mid-November.
The legislation, a top
priority for Democrats, would allow the secretary of Health and Human Services
to negotiate lower prices for as many as 250 drugs per year.
The measure would have
little chance of advancing in the Senate, where Majority Leader Mitch McConnell (R-Ky.)
has called it “socialist” and vowed to block it. Progressives, however, argue
Democrats should put out a bold marker rather than negotiate with themselves on
something that’s almost certain to die in the Senate anyway.
Pelosi’s office has
held out hope that President Trump
might endorse her bill, given his rhetoric against high drug prices, and some
centrists want to move toward common ground with Republicans to increase those
odds.
“The further left you
go with drug pricing bills, it just means it’s only going to be a House-only
bill and a Democrat-only bill,” said Rep. Anthony Brindisi (D-N.Y.), a
co-chairman of the Blue Dog Coalition who faces a tough reelection race.
“That’s not helping people in my district.”
Brindisi called for a
greater focus on finding common ground with GOP lawmakers on something that
could be signed into law. He said he had communicated that “to leadership and
anyone who will listen around here.”
Progressives, though,
are pushing for a range of changes, such as increasing the minimum number of
drugs that will be subject to negotiation, up from 35, and fully repealing the
ban on Medicare negotiating drug prices. As the bill stands now, it creates an
exception allowing a limited number of drugs to be negotiated, rather than
fully repealing the ban.
Progressives have vowed
to push for floor votes on amendments if leadership does not agree to make
their changes beforehand.
They are also looking
to protect a Jayapal amendment, adopted in committee, to ensure it is not
stripped out of the final bill because of objections by moderates. The
provision would extend protections against drug price increases to people in
private employer-sponsored insurance plans, not just those on Medicare.
Pelosi’s office has
expressed concerns about the feasibility of Jayapal’s amendment and other
proposed changes by progressives, like increasing the number of drugs that will
be negotiated, sources say.
Some progressives argue
the feasibility concerns raised by Pelosi’s office are just an excuse to avoid
moving the bill to the left and alienating moderates.
Jayapal has been
adamant that her amendment needs to be included.
“We’re fine with
strengthening it, but not to the point where we’re going to strip it, that’s
not going to happen,” she said, noting her staff had communicated this message
to leadership. “It’s either this or it’s better, but it’s not gone.”
She declined to say if
she would vote against the bill if her amendment is omitted.
“I’m just going to keep
pushing to get it in,” she said.
More broadly, she said
she did not understand why moderates were objecting to further changes to
strengthen the legislation.
“I really don’t
understand why, because this is not a partisan bill,” she said. “Everybody ran
on prescription drug pricing.”
Rep. Ron Kind (D-Wis.), a
centrist, said leadership and committee chairmen had struck a “sensitive
balance” in the legislation.
“Developing consensus
on something as important as drug pricing is always a challenge around here,”
he said.
Increasing the number
of drugs to be negotiated, a move backed by progressives, could lead to
“capacity” problems at the Department of Health and Human Services, Kind warned.
He said he supports the
bill as it is but wouldn’t say whether that stance would change if it moves
further left. “Let’s see what the final product looks like,” he said.
Lobbyists expect that
the only drug pricing measures that have a chance of being signed into law are
much smaller, bipartisan measures that increase competition from cheaper
generic drugs. Those smaller bills have a greater chance of being attached to a
must-pass government funding package.
Drug company lobbyists
are still fighting Pelosi’s bill, though, and have targeted moderate House
Democrats to try to get some of them to vote against it.
Brindisi, the Blue Dog
co-chairman, said he plans to vote for Pelosi’s bill as it currently stands.
“I’m going to support
it,” he said. “It’s not going to see the light of day in the Senate.”
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