The defection of three moderate House Democrats on drug pricing legislation highlights the steep challenge the party faces in pushing their $3.5 trillion package through Congress.
With thin margins in both the House and Senate, there are a range of tough issues that Democratic leaders must navigate, from the overall size of the measure to how to raise the taxes needed to pay for it.
Any one of those issues has the potential to take the entire package down in a House where Democrats can afford just three defections given unified GOP opposition.
The vote also shows that the unity Democrats will need to move a final package is elusive and will be hard won.
“We have overwhelming support on the Democratic side, but not unanimous,” said Rep. Peter WelchPeter Francis WelchDemocrats weigh changes to drug pricing measure to win over moderates Schumer feels heat to get Manchin and Sinema on board Failed drug vote points to bigger challenges for Democrats MORE (D-Vt.). “That’s the challenge we're going to face with each element of the Build Back Better [plan].”
Democratic leaders say they are not backing off despite the failed vote on Wednesday and that the final package will still include legislation to allow the government to negotiate with drug companies to lower the prices for prescription medications.
It’s a long-held goal of the party that progressive Democrats are determined to see get to President BidenJoe BidenGrant Woods, longtime friend of McCain and former Arizona AG, dies at 67 Sanders on Medicare expansion in spending package: 'Its not coming out' Glasgow summit raises stakes for Biden deal MORE’s desk at a time when the party has majorities in both chambers of Congress and holds the White House.
“Delivering lower drug costs is a top priority of the American people and will remain a cornerstone of the Build Back Better Act as work continues between the House, Senate and White House on the final bill,” said Henry Connelly, a spokesman for Speaker Nancy PelosiNancy PelosiSunday shows preview: CDC signs off on 'mix and match' vaccine boosters Buttigieg aims to use Tucker Carlson flap to spotlight paternity leave Judge to hear Trump's case against Jan. 6 committee in November MORE (D-Calif.).
Three moderate Democrats, Reps. Scott PetersScott H. PetersWho is afraid of the EU's carbon border adjustment plan? Overnight Health Care — Presented by The National Council on Mental Wellbeing — Merck asks FDA to authorize five-day COVID-19 treatment Democrats weigh changes to drug pricing measure to win over moderates MORE (D-Calif.), Kurt SchraderWalter (Kurt) Kurt SchraderHouse passes bills to secure telecommunications infrastructure Democrats weigh changes to drug pricing measure to win over moderates Internal battles heat up over Biden agenda MORE (D-Ore.) and Kathleen RiceKathleen Maura RiceDemocrats weigh changes to drug pricing measure to win over moderates Internal battles heat up over Biden agenda Moderate Democrat says he can't back House spending plan 'in its current form' MORE (D-N.Y.), voted against their party in Wednesday’s vote on the House Energy and Commerce Committee.
Theoretically, that wouldn’t be enough defections to stop a package on the floor, but Peters, Schrader and Rice are not the only ones with concerns. Reps. Stephanie MurphyStephanie MurphyDemocratic retirements could make a tough midterm year even worse On The Money — Progressives play hard ball on Biden budget plan Overnight Energy & Environment — Presented by ExxonMobil — Climate divides conservative Democrats in reconciliation push MORE (D-Fla.) and Lou CorreaJose (Lou) Luis CorreaTop Latino group endorses Padilla for full Senate term Democrats weigh changes to drug pricing measure to win over moderates Democrats grasping at straws on immigration MORE (D-Calif.) both signed on to a rival, scaled-down drug pricing measure backed by Peters and Schrader.
In the Senate, Sen. Bob MenendezRobert (Bob) MenendezWhy is Trump undermining his administration's historic China policies? Senate GOP signals they'll help bail out Biden's Fed chair Democrats weigh changes to drug pricing measure to win over moderates MORE (D-N.J.) represents a state that is home to many pharmaceutical companies. He has also raised concerns about cracking down too hard on the industry, and Democrats can’t afford to lose a single vote in the 50-50 Senate.
Moderate Democrats in the House and the Senate have problems with the size of the package and are wary of GOP attacks that the legislation will bust the budget and hamper the economy.
Provisions to tackle climate change and reform the immigration system also have details that could pit progressives against moderates.
On taxes, Republicans are going on the attack, arguing the hikes will slow a recovery from the pandemic.
Biden on Thursday sought to take on some of the criticism head-on, casting the overall measure as a matter of fairness that would help restore a U.S. economy that benefits the middle class more than the super-wealthy.
“How’s it possible that the wealthiest billionaires in the country can entirely escape paying income taxes on what they make?” Biden said in remarks from the White House. “For a long time, this economy has worked great for those at the very top. Ordinary, hardworking Americans, the people who built this country, have been basically cut out of the deal.”
This week’s battle over drug pricing is a microcosm of other potential fights and a bit of a canary-in-the-coalmine moment for Democrats that shows the difficult path ahead.
Alex Lawson, executive director of the progressive group Social Security Works, said the showdown could be a sign of fights on other issues too, like raising taxes on the rich.
“This is a huge bill and it challenges all sorts of concentrated power and money,” he said. “I'm sure the other lobbyists for terrible things took note of it and are going to be making their own plays.”
Drug pricing advocates accused the group of moderates, who back a narrower drug pricing measure rejected by progressives, of simply doing the bidding of the pharmaceutical industry.
Peters, for example, has received $88,550 from the pharmaceutical industry so far this campaign cycle, the most of any House member, according to the Center for Responsive Politics.
Asked to respond to critics pointing to campaign contributions, Peters told The Hill, “It's always going to be the attack because it's simple and it's easier than engaging on the merits.”
“It's flat wrong, and I continue to do what I think is right regardless of how nasty people want to be, and they do get pretty nasty,” added Peters, who also noted there are 27,000 employees of pharmaceutical companies in his district, most of them involved with research.
Peters said that Pelosi and Rep. Frank Pallone Jr. (D-N.J.), his panel’s chairman, had tried to win him over before Wednesday’s vote.
“They did try to get my vote, but I just reiterated where I am and really where I've been all year,” Peters said.
Peters pointed to his scaled-down, alternative legislation to lower drug prices, which he said would also protect innovation from drug companies, unlike House leaders' bill.
Pelosi could end up winning over opponents on drug pricing with sweeteners in other parts of the package.
Correa, one of the lawmakers backing the rival, moderate drug pricing measure, said in a statement that “my priority on reconciliation is immigration reform,” when asked if he would vote against the package if it went too far on drug pricing.
As for Peters, asked if he would vote against the overall package if it included H.R. 3, he said: “Well I've been pretty clear about H.R. 3,” but did not give a fully definitive answer.
“You know, obviously I can't answer what you're saying until the final bill,” he said.