Vulnerable Republicans balk at Trump-backed drug pricing bill

Vulnerable GOP senators up for reelection next year are giving the cold shoulder to a bipartisan bill aimed at lowering drug prices.

Senate Finance Committee Chairman Chuck GrassleyChuck GrassleyFormer Sen. Bob Dole dies at 98 Alarm grows over smash-and-grab robberies amid holiday season GOP blocks bill to expand gun background checks after Michigan school shooting MORE (R-Iowa) is pushing for passage of his measure with Sen. Ron WydenRonald (Ron) Lee WydenSenators turn up the heat on Amazon, data brokers during hearing Minimum tax proposal drives wedge between corporate interests Senate parliamentarian looms over White House spending bill MORE (D-Ore.) to lower drug prices, something seen as a rare area for possible bipartisan agreement this year.

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Grassley is explicitly and publicly making the case to Senate Majority Leader Mitch McConnellAddison (Mitch) Mitchell McConnellSchumer tees up key Thursday vote on debt deal House approves bill to ease passage of debt limit hike Senate rejects attempt to block Biden's Saudi arms sale MORE (R-Ky.) that his bill would help vulnerable Republicans. However, many of those incumbents have declined to support the Grassley-Wyden bill.

GOP Sens. Thom TillisThomas (Thom) Roland TillisGOP blocks bill to expand gun background checks after Michigan school shooting Overnight Defense & National Security — A new plan to treat Marines 'like human beings' Republicans press Milley over perceived progressive military agenda MORE (N.C.), Martha McSallyMartha Elizabeth McSallyBusiness groups, sensing victory, keep up pressure over tax hikes Kelly raises million in third quarter Ruben Gallego is left's favorite to take on Sinema MORE (Ariz.), Cory GardnerCory GardnerThe Hill's Morning Report - Presented by Facebook - Biden to tackle omicron risks with new travel rules Gun control group alleges campaign finance violations in lawsuit against NRA Colorado Supreme Court signs off on new congressional map MORE (Colo.) and Joni ErnstJoni Kay ErnstFive things to know about Russia's troop buildup near Ukraine  As democracy withers, Bob Dole and other American soldiers must be remembered Ernst on Russian buildup on Ukraine border: 'We must prepare for the worst' MORE (Iowa), who all face potentially tough races next year, have either expressed concerns about the legislation or declined to back it. Sen. Susan CollinsSusan Margaret CollinsSenate confirms Biden's nominee to lead Customs and Border Protection Hillicon Valley — Presented by Connected Commerce Council — Incident reporting language left out of package Language requiring companies to report cyberattacks left out of defense bill MORE (Maine) is the lone vulnerable Republican to endorse the measure.

Senators who haven't supported the bill are highlighting the bind they face. On the one hand, the bill has the support of President TrumpDonald TrumpSenate rejects attempt to block Biden's Saudi arms sale Crenshaw slams House Freedom Caucus members as 'grifters,' 'performance artists' Senate confirms Biden's nominee to lead Customs and Border Protection MORE, and lowering drug prices is a popular issue with voters. But on the other hand, supporting the bill breaks with GOP orthodoxy and invites a backlash from both conservatives and the pharmaceutical industry.

The most controversial provision for Republicans requires drug companies to pay money back to Medicare if their prices rise faster than inflation, something some Republicans view as too close to a “price control.”

Tillis told The Hill that he has “concerns” with the bill, saying that he wants to focus on middlemen known as pharmacy benefit managers and other parts of the supply chain, not just pharmaceutical companies themselves to lower drug prices.

“I think we need to make progress on [the bill],” Tillis said, while adding he has not made a final decision on how he would vote if the bill came to the floor.

McSally has also expressed concerns, declining to say if she would support the bill in an interview with The Arizona Republic in August.

"There are a lot of really good things in that legislation and we're making sure there's not any unintended consequences,” she said. “But we appreciate the intent. We definitely support the intent."

A McSally aide said Friday that the senator “has been in close discussions” with Grassley but did not give a firm position on the measure either way.

Gardner’s office did not respond to a request for comment on whether he supports the bill.

Ernst, Grassley’s fellow Iowan, has also so far declined to endorse the bill.

“Senator Grassley and Senator Ernst share the same goal of lowering the cost of prescription drugs for their fellow Iowans, and on this particular bill, Senator Ernst generally supports the intent of the package and is still reviewing the specifics of the proposal,” said Ernst spokeswoman Kelsi Daniell.

The wavering from GOP senators comes despite support from Trump, who frequently rails against high drug prices.

“I like Sen. Grassley’s drug pricing bill very much,” Trump tweeted last month.

Lowering drug prices is also a major issue for voters. A Kaiser Family Foundation poll in September found that 70 percent of the public said lowering drug prices should be a “top priority.”

But conservative groups have attacked the bill for its limits on price increases in Medicare, and FreedomWorks called the idea “price controls” in July.

“We cannot afford to put our nation on the slippery slope towards socialized medicine,” the group’s president, Adam Brandon, said at the time.

The pharmaceutical industry — a powerful force in Washington and a major source of campaign contributions — is also staunchly opposed to the bill.

Some vulnerable Republican senators are pointing to smaller, less controversial bills to show their commitment to lowering drug prices.

Ernst and McSally, for example, point to their support for the Creates Act, a smaller bipartisan measure aimed at lowering drug prices by cracking down on delay tactics that drug companies use to fend off competition from cheaper generic drugs.

The pharmaceutical industry also supports that measure, helping make it less controversial than the Grassley-Wyden bill.

Grassley last month publicly called on McConnell to support his bill, arguing that it would help Republicans keep control of the Senate in next year’s elections.

He's pitched his bill to Republicans as the “moderate” alternative to Speaker Nancy PelosiNancy PelosiHouse approves bill to ease passage of debt limit hike Ocasio-Cortez: 'Embarrassment' that Democratic leaders are delaying Boebert punishment Overnight Health Care — Biden mandate faces Dem resistance MORE’s (D-Calif.) drug pricing measure in the House, which is far more sweeping but has at least some chance of receiving Trump's support given his focus on drug costs.

"There's a great deal of disgust with the rapidly increasing price of drugs, and every Republican up for election's going to have to have a place to land," Grassley told reporters in September.

"And this is the place to land, because they're surely not going to land with what Pelosi's [doing]," he continued. "If McConnell wants to keep the Republican majority, then this drug pricing bill is part of that plan."

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Grassley spokesman Michael Zona said Friday that support is growing and more Republican supporters will be announced “in the coming days.”

Asked about the path forward for Grassley’s bill and whether it would get a vote, McConnell’s office referred back to the majority leader’s comments to Politico last month, when he said the path forward is still “under discussion” and the Senate is still “looking at doing something on drug pricing.”

However, given the bill's ability to divide McConnell's caucus, he could be hesitant to give it a vote.

Many lobbyists expect that Grassley’s bill will not come up for a vote as a standalone measure and that its only chance is to have sections included in a larger package, such as a government funding deal. However, that could be a more likely scenario for smaller measures such as the Creates Act.

With the election ahead, both sides are already throwing jabs over the issue.

“Voters are worried about prescription drugs getting more expensive, but many Republican incumbents on the ballot haven't taken meaningful steps to bring down prices and are now dodging questions about legislation,” said Democratic Senatorial Campaign Committee spokesman Stewart Boss.

Jesse Hunt, a spokesman for the National Republican Senatorial Committee, countered that Republicans “are firmly committed to addressing the rising cost of prescription drugs through a variety of different measures.”

“These attacks from Democrats are nothing more than an effort to distract voters from their party’s embrace of plans that would eliminate employer-based health care coverage,” he added.