The fight between policymakers intent on lowering prescription drug prices and the drugmakers who keep raising them intensified Thursday as a slew of Republican senators threatened to side with manufacturers against legislation supported by their own committee chairman and president.
After months of closed-door meetings and high-profile hearings, the Senate Finance Committee voted 19-9 to advance legislation introduced by Sens. Chuck Grassley, R-Iowa, and Ron Wyden, D-Oregon, to rein in drug costs in the Medicare and Medicaid programs.
But even some Republicans who supported it warned they may not back the sweeping package of proposals in a full Senate vote. They object in particular to a provision that would cap drug prices paid by Medicare based on the rate of inflation.
Other obstacles have piled up. Wyden announced that Democrats, who provided most of the bill’s support in committee, would not allow a Senate vote without the Republicans agreeing to hold votes on cementing insurance protections for people with preexisting conditions. Democrats have complained for months that GOP efforts to kill the Affordable Care Act (ACA) will leave people with these medical problems without any recourse to get affordable healthcare. Democrats also want to empower federal health officials to negotiate drug prices.
Here are the three major problems revealed in Thursday’s hearing.
Many Senate Republicans disagree with President Donald Trump about how to lower drug prices.
Some of Trump’s efforts to reduce Americans’ drug costs took a beating Thursday. They were criticized—by members of his own party—for putting too much power in the hands of government.
Despite urging from White House and federal health officials to support the legislation, 13 of the committee’s 15 Republicans voted to remove its controversial proposal to prevent drug prices from rising faster than inflation under Medicare. Their attempt failed, barely.
Medicaid already uses this strategy, requiring drugmakers to pay the government a rebate if the prices it pays outpace inflation, and Medicaid tends to pay lower prices on drugs than Medicare. The Department of Health and Human Services Office of Inspector General has said (PDF) Medicare could collect billions of dollars from the drug industry if it did the same. But many Republicans strongly oppose any government interference in private markets or price setting.
Sen. Patrick Toomey, R-Pennsylvania, who introduced the amendment to remove the proposal, said it wasn’t necessary because seniors would be protected from paying too much by another proposal in the bill to cap out-of-pocket expenses.
"It’s my view that we should not use this sledgehammer of a universal price control, imported from Medicaid, to deal with that relatively narrow problem and to disrupt a program that’s working very well," Toomey said, mentioning Medicare’s popularity.
Grassley said the inflation caps would help relieve taxpayers from covering Medicare’s skyrocketing drug costs.
And having played a key role in 2003 creating Medicare’s prescription drug program, called Medicare Part D, he took issue with the idea that his latest bill would harm the program: "I wrote it, so you ought to know that I want to protect it," Grassley said.
Most of the Republicans also backed an amendment to block a proposal being considered by the Trump administration to tie drug prices here to those paid in other developed nations, which narrowly failed. While Grassley said he, too, opposes the administration’s proposal, he did not want the issue to hold up his own bill and so voted against the amendment.
Grassley also said he is not comfortable with empowering federal health officials to negotiate drug prices, as Wyden said he would like to see considered. But Grassley noted that the issue isn’t going away: Trump campaigned on the idea, which White House officials have been discussing with House Democratic leaders as part of a plan expected to be released in September.
But that may not be enough, Grassley suggested: "I don’t think that you’re going to get 60 votes in the United States Senate....
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