Senate Democrats are struggling with how to vote on a medical cures bill amid the vocal opposition of two liberal stalwarts: Sens. Elizabeth Warren (D-Mass.) and Bernie Sanders (I-Vt.).
The measure, known as 21st Century Cures, has been the subject of bipartisan negotiations for over a year. It includes a range of Democratic priorities, including new funding for research at the National Institutes of Health and money to fight opioid addiction.
But Warren and Sanders this week came out strongly against the measure, blasting it as a giveaway to pharmaceutical companies.
“At a time when Americans pay, by far, the highest prices in the world for prescription drugs, this bill provides absolutely no relief for soaring drug prices,” Sanders said in a statement.
Democrats in the past have been wary of crossing the two senators, who hold enormous clout with the party’s liberal base.
But some lobbyists and aides say they expect many Senate Democrats would ultimately come around to supporting the bill.
Senate Democratic leaders declined to take a public position Tuesday, stressing that they were waiting for the final language of the bill to be released in the House.
Sen. Dick Durbin (D-Ill.), the No. 2 Democrat, said he had not firmly made up his mind.
“I’ve gone back and forth, and the good news is it’s changing apparently for the better from the Democratic perspective,” he said.
He said Warren and Sanders are having sway in the caucus, but that instead of generating outright opposition, their objections have pushed Sen. Patty Murray (D-Wash.), the lead negotiator on the bill, to make it stronger.
“They already have [had sway] in the debates in our leadership, and I think it’s led Senator Murray to call for changes,” Durbin said. “We think some of those will be reflected [in the latest version.]”
The bill is aimed at speeding up the Food and Drug Administration’s approval process for new drugs. The bill has appeal to Democrats because it contains a significant increase in funding for research at the National Institutes of Health: $4.8 billion over 10 years.
Warren and Sanders argue, though, that the measure is helping pharmaceutical companies by lowering FDA standards without getting much in return. They note that the NIH funding is not mandatory, meaning it is not guaranteed, and the measure does nothing to deal with the hot-button issue of high drug prices.
“It’s time for Congress to stand up to the world’s biggest pharmaceutical companies, not give them more handouts,” Sanders said in his statement.
Defenders of the bill note that the money for NIH is set aside in a separate fund that is not subject to the usual budget limits. The measure also includes $1 billion over two years to fight opioid addiction, long a priority of both parties, and funding for Vice President Biden’s “moonshot” to cure cancer.
Senate Democratic Leader Harry Reid (Nev.) praised the opioid and cancer funding on Tuesday, while noting that he is waiting for the final language to be released.
Reid acknowledged there is “angst” within his caucus on how to vote on the bill.
One consideration for Democrats is the fact that their bargaining leverage will be greatly diminished next year once Donald Trump is sworn in as president. The cures bill up for consideration now, the thinking goes, might be the best deal they’ll ever get.
The package also includes a mental health bill that Sen. Chris Murphy (D-Conn.) and other Democrats have been working on. Murphy has praised the package.
Yet some Democrats expressed their frustration with the bill at the caucus lunch on Tuesday.
“There is growing concern among Democrats that this is not a good bill,” said a Senate Democratic aide.
Consumer groups are sounding the alarm about the legislation, warning that the provisions in the legislation to speed up the FDA’s approval process would lower safety standards and endanger patients.
“They’ve obviously tried to make this package attractive to many members of Congress by adding increased funding for NIH,” said Dr. Michael Carome, director of the health research group at Public Citizen.
But he said the bill’s FDA section “endangers public health.”
The House is set to vote on the bill on Wednesday, and some Democratic support is expected.
Democratic support is more important in the Senate, where at least six votes from their caucus will be needed to overcome a filibuster.