Following a likely committee approval Thursday, opposition by GOP lawmakers and many Democrats, who aim to force the Bush administration to negotiate lower-priced drugs for seniors, threaten to derail Baucus’s effort when it reaches the Senate floor next week.

The Medicare negotiation bill removes a curb on the Secretary of Health and Human Services’ (HHS) power to negotiate drug prices, but does not mandate that the HHS chief conduct such negotiations. Current Secretary Mike Leavitt has said he will not exercise the right to do so. Although stronger language requiring government negotiation won 54 backers in a March 2006 Senate test vote, the Democratic cosponsor of that effort said he would back Baucus — during Thursday’s markup, at least.  

“It’s important that we prevail tomorrow,” Sen. Ron Wyden (D-Ore.) said. “That’s the first step.”

Wyden added that he and Sen. Olympia Snowe (R-Maine) still are “counting votes” for their stronger negotiation plan, which mandates Leavitt to push for low pricing on targeted drugs, including single-source medicines. Four freshman senators appear to support Wyden and Snowe’s approach, putting them “right on the cusp of 60 votes,” as Wyden put it.

Any attempt by Wyden and Snowe to beef up Baucus’s version of the bill will wait until it comes to the floor, however, when other Democrats are likely to float amendments.

“We will have many people in the caucus, myself included, who feel legislation of this type should mandate negotiation,” the Democratic Policy Committee chairman, Sen. Byron Dorgan (N.D.), said. “There will be amendments on the floor, sure.”

Sen. Sherrod Brown (D-Ohio), who unseated pro-negotiation incumbent Sen. Mike DeWine (R) last year, agreed: “We want to move as far as we can on this ... I think we’ll try [on the floor].”

Baucus’s effort to define negotiation more narrowly may pay off with centrist Republicans, particularly those up for reelection, as they face a public-relations onslaught from AARP and other interest groups. Sen. Norm Coleman (R-Minn.), who missed last year’s Wyden-Snowe vote, said he is open to Baucus’s bill but remains concerned about the House’s stronger version.

“If you support the measured approach in the Senate, [then] you go to conference, then it comes back ... with a non-measured approach,” Coleman said Wednesday. “I’m concerned about political games, but open to looking at it.”

GOP leaders are primed for a fight over Medicare drug prices, believing the 2003 law that created the drug benefit enjoys broad popular support. This week’s Congressional Budget Office (CBO) report, which found that Baucus’s draft would yield negligible savings for taxpayers, provided Republicans with rhetorical ammunition.

Nonetheless, as CBO Director Peter Orszag noted in a letter to Wyden that called his and Snowe’s plan potentially beneficial to taxpayers, the benefit of negotiation ultimately depends on whether the White House embraces it.

“Simply put, it may be difficult through legislation to force a[n HHS] Secretary to pursue negotiations aggressively if he or she is reluctant to do so,” Orszag wrote to Wyden on Tuesday.