Lobbyists Say Democrats Have New Plan For Passing Drug Pricing Bill

Inside Health Policy

June 11, 2021 3:22 pm

Democrats are considering adding Medicare drug price negotiation to the president’s American Families Plan and using budget reconciliation to pass it separately from the infrastructure bill, if a bipartisan deal is struck on infrastructure, drug and consumer lobbyists said.

Yet key lawmakers are also going through the motions of negotiating a bipartisan drug-pricing bill. Senate Finance Committee Chair Ron Wyden (D-OR) said he has spoken with Republicans about the issue, and Sen. Chuck Grassley (IA), the Republican who wrote a drug pricing bill with Wyden in 2019, told Inside Health Policy he scheduled a meeting next week with a handful of House Democrats who want to work on a bipartisan drug-pricing bill.

Lobbyists say it’s a long shot to attach drug pricing to the American Families Plan, but they say the effort to do so shows Democrats haven’t given up on tackling the issue this year. Lobbyists who back Medicare price negotiation say it’s good news that Senate Majority Leader Chuck Schumer (D-NY) also now is at least somewhat involved in pushing drug-pricing legislation. Pfizer is headquartered in Schumer’s state, but lobbyists say many Senate Democrats believe they need to lower drug prices, and not just talk about it, if they want to hang on to power the second half of Biden’s term.

Early this spring, many assumed President Joe Biden would combine infrastructure with social and health care reforms, and Medicare price negotiation would be used to pay for some or all of the health care reforms. Biden separated infrastructure (American Jobs Plan) from the rest (American Families Plan) and to the dismay of Democrat lawmakers, he left out drug-pricing reforms from the American Families Plan. The sole health care reform in the American Families Plan is a measure to make permanent the higher exchange premium subsidies that Congress provided in the pandemic stimulus package.

Then the Senate parliamentarian issued a ruling that makes it all-but impossible for Democrats to pass more than one more reconciliation bill this calendar year. Reconciliation bills require a mere majority to pass, and Democrats don’t believe it’s possible to convince 60 senators to vote for Medicare drug price negotiation.

On Thursday, a small bipartisan group of senators said they reached a tentative agreement on infrastructure. It’s unclear whether that deal will hold, but if enough senators agree to the deal to avoid a filibuster, Democrats can save reconciliation for the American Families Plan, and if Democrats are going to go it alone on social reforms, some believe that health care should be included.

“We have got to address the crisis of high-cost prescription drugs and the outrage that Medicare does not negotiate drug prices, one way or another that must be in reconciliation,” Senate Budget Committee Chair Bernie Sanders (I-VT) told Inside Health Policy.

Wyden declined to discuss the potential legislative process. He said he insists that drug-pricing legislation charge price inflation rebates, which was included in the bill he and Grassley wrote, as well as some form of Medicare price negotiation, which Grassley and most other Republicans oppose.

Grassley said Senate Democrats are not talking with him about drug pricing, but he will meet next week with some of the 10 House Democrats who recently expressed their uneasiness with House Democrats’ government drug-price negotiation bill. House Democrats’ bill would cap U.S. prices at 120% of the average price among six other rich countries, and international reference pricing does not sit well with some Democrats.

“Senate Democrats aren’t going to talk to me until they realize they’re not going to get 60 votes for what they want to do,” Grassley said.

Medicare price negotiation might be a tough sell to some Democrats, too. A lobbyist who backs Medicare price negotiation said it’s not clear how Schumer plans to thread that needle, but there might be a way to win reluctant senators over with health care measures that benefit their constituents.

There are many health care priorities that drug pricing could pay for, including new Medicare benefits, and one of the challenges for Democrats is determining what to put on that list to win over hesitant Democrats and possibly some of the patient groups that otherwise would take the drug industry’s side.