Five health-care priorities for Dems in next Congress

Five health-care priorities for Dems in next Congress
© Stefani Reynolds

Democrats won a majority in the House on Election Day, powered largely by their message on health care. Now they are hungry to put their ideas into action, with plans to lower prescription drug prices and expand the Affordable Care Act.

Here are five health-care ideas that House Democrats will be pushing in the next Congress. 

Protecting people with pre-existing conditions

Democrats hammered Republicans during this year’s campaign for voting to weaken the Affordable Care Act’s (ACA) protections for people with pre-existing conditions. Now the party wants to have a quick vote to reinforce those protections, and to put some moderate Republicans in a tough spot.

One leading idea is to vote to have the House formally intervene in a lawsuit brought by GOP-led states seeking to overturn the ACA and its protections for people with pre-existing conditions.


Another possibility is a vote to counteract the Trump administration’s moves to open up cheaper, skimpier “short-term” health insurance plans that do not have to cover pre-existing conditions.

Allowing Medicare to negotiate drug prices

Fighting high drug prices is one priority for Democrats where they think they can get President TrumpDonald John TrumpRosenstein expected to leave DOJ next month: reports Allies wary of Shanahan's assurances with looming presence of Trump States file lawsuit seeking to block Trump's national emergency declaration MORE on board.

Trump has previously supported one of the boldest ideas, allowing Medicare to negotiate drug prices. It's an area where Democrats hope to win the president’s support.

“I've always been an advocate for negotiated prices under Medicare, and as you know, President Trump says that he's for that, so I think that’s an area where we can get agreement with the president,” Rep. Frank Pallone Jr.Frank Joseph PalloneHigh stakes as Trump, Dems open drug price talks Overnight Health Care — Presented by PCMA — Lawmakers pay tribute to John Dingell's legacy on health care | White House denies officials are sabotaging ObamaCare | FDA wants meeting with Juul, Altria execs on youth vaping Hillicon Valley: Dems ready to subpoena Trump Tower meeting phone records | Dems, Whitaker in standoff over testimony | Bezos accuses National Enquirer of 'extortion' | Amazon offers rules for facial recognition | Apple releases FaceTime fix MORE (D-N.J.), the likely incoming chairman of the powerful House Energy and Commerce Committee, told reporters this month.

Frederick Isasi, the executive director of the prominent liberal health care advocacy group Families USA, gave the Trump administration credit earlier this month for its focus on drug prices.

“To the credit of the current administration they're really having the conversation for the first time, which really hasn’t happened before,” he said. He added that drug pricing is a “ripe area for bipartisan work.”

But drug companies remain a powerful force in Washington, and Republicans will still control the Senate, meaning any drug pricing legislation will have an uphill climb. 

Increasing competition through cheaper generic drugs

Democrats can try to go big on drug prices with Medicare negotiation, but that is more likely to be a messaging bill that only makes it through the House.

If they are looking for policy changes that actually have a chance of making it through the Republican Senate and into law, increasing drug competition is a more promising area.

A bill called the Creates Act would crack down on delaying tactics drug companies use to prevent their competition from selling cheaper generic drugs.

The bill has support from lawmakers in both parties, but has been stalled all year as the drug industry lobbies against it.

Pallone also pointed to that bill this month as a potential path for action.

“I think you need the Creates Act and other initiatives that will aggressively bring generics to market,” he said.

Sen. Chuck GrassleyCharles (Chuck) Ernest GrassleySmaller tax refunds put GOP on defensive High stakes as Trump, Dems open drug price talks Senate approves border bill that prevents shutdown MORE (R-Iowa), the incoming chairman of the Senate Finance Committee, is also a strong supporter of the bill, boosting its chances of eventually reaching Trump's desk. 

Strengthening the ACA

After fending off GOP efforts to repeal the Affordable Care Act last year, Democrats now want to go on offense to make the law more generous.

Many Democrats acknowledge that some people still have trouble affording health insurance, particularly those who make too much income to currently qualify for financial assistance under the law.

Earlier this year, the top Democrats on the House’s health-care committees introduced legislation that would expand the ACA’s financial assistance to people who don’t currently qualify and it make it more generous for those already getting help.

Republicans would likely oppose that bill as simply throwing more money at ObamaCare, but the measure could at least be passed out of the House.

Maura Calsyn, managing director for health policy at the Center for American Progress, a major Democratic group, said the organization does not “necessarily have a priority” on whether Democrats move first on drug prices or the ACA, but that they should ultimately do both.

Pushing Medicare for all

The boldest proposal that Democrats have is "Medicare for all," extending government-run health insurance to everyone.

But the issue divides Democrats and is only a priority for progressives, who are pushing for a vote in the House. More centrist members, though, are warning against moving too fast and instead calling for more pragmatic steps.

House Democratic Leader Nancy PelosiNancy Patricia D'Alesandro PelosiDonald Trump proved himself by winning fight for border security Trump should beware the 'clawback' Congress The national emergency will haunt Republicans come election season MORE (Calif.) said earlier this year that ideas like Medicare for all would “have to be evaluated in terms of the access that they give, the affordability of it and how we would pay for it.”

“But again, it’s all on the table,” she added.

One possibility is a vote on a somewhat less dramatic proposal, like allowing people to buy into Medicare once they reach age 50.  

Rep. Brian HigginsBrian HigginsDems offer smaller step toward ‘Medicare for all' Overnight Health Care — Sponsored by America's 340B Hospitals — Powerful House committee turns to drug pricing | Utah governor defies voters on Medicaid expansion | Dems want answers on controversial new opioid Assault weapons ban push tests Dem support MORE (D-N.Y.), who announced he would support Pelosi for Speaker on Wednesday after previously opposing her, said after speaking with her that he is “confident” Pelosi will work with him on the Medicare buy-in proposal.

Calsyn said more work is needed on the details of Medicare for all proposals, but that work can happen on the idea even as Democrats tackle other priorities.

“That can happen at the same time,” she said.