Healthcare

House Democrats clash over Pelosi’s drug pricing bill

Greg Nash

Moderate and progressive House Democrats are clashing with each other over changes to Speaker Nancy Pelosi’s (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.

{mosads}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.”

Tags Donald Trump drug pricing Mitch McConnell Nancy Pelosi Pramila Jayapal Ron Kind Stephanie Murphy

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