Democrats race to reach deal on prescription drug pricing

Democrats are furiously negotiating a plan to lower prescription drug prices, making significant progress over the weekend but racing to finalize a deal before a House vote on President Biden’s mammoth social spending package as soon as this week. 

The fate of one of the party’s signature issues hangs in the balance after the White House last week left drug pricing out of the framework of Biden’s reconciliation package. Since then, Speaker Nancy Pelosi (D-Calif.) and key progressives have been working around the clock to win over a handful of moderates — including Sen. Kyrsten Sinema (D-Ariz.) and Rep. Scott Peters (D-Calif.) — on a scaled-back compromise measure to revive the issue. 

“We’re making really significant progress,” Rep. Peter Welch (D-Vt.), one of the progressive negotiators, told The Hill on Monday. “Anything can happen, but it looks like stories about the death of prescription drug reform were premature.”

“It’s close,” added another Democratic source familiar with the talks.

Over the weekend, House leaders had been aiming for a Tuesday vote on both the infrastructure and reconciliation packages, but the votes got pushed back after drug pricing negotiators signaled they were on the cusp of a deal to include the issue in Biden’s Build Back Better plan.      

Negotiators may have won even more time to clinch a deal when Sen. Joe Manchin (D-W.Va.), a backer of lowering drug prices, told reporters on Monday he still had concerns about the broader $1.75 trillion framework Biden unveiled last week and isn’t fully on board.  

The compromise drug pricing proposal under discussion would be significantly scaled-back from Democrats’ earlier sweeping measures. For example, the proposal under discussion would allow Medicare to negotiate lower drug prices, but only for older drugs that are no longer under “exclusivity,” meaning the period when they are protected from competition. 

Peters had warned that earlier versions of Democrats’ legislation, which would have allowed Medicare to negotiate prices for newer drugs, would harm innovation from drug companies to develop new treatments.

Still, the measure under discussion would include a number of substantial provisions to lower drug prices. In addition to allowing Medicare to negotiate drug prices for older drugs, the bill would limit price increases on drugs to the rate of inflation and cap out-of-pocket drug costs for seniors on Medicare, sources say.

The pharmaceutical industry, long known as a powerful force in Washington, has been fighting hard against Democrats’ sweeping measures, warning they would hinder investment in research and development, and lawmakers said they were eager not to let the industry win.

The White House got significant pushback from Democratic lawmakers after leaving drug pricing out of the framework.

Welch said there was a “firestorm of reaction” from Democratic lawmakers when the White House left drug pricing out of its framework last week, with the administration saying the votes simply were not there yet. 

“It was premature of the White House to drop it,” Welch said. “I think the reaction reinforced the enormous support we have.”

Rep. Susan Wild (D-Pa.) added that she was “beyond disappointed” and “quite honestly flabbergasted” that drug pricing was left out of the White House framework.

Since then, Sen. Bernie Sanders (I-Vt.) said on CNN on Sunday that he “ spent all of yesterday on the telephone” trying to get drug pricing added in. 

“Look, we are paying the highest prices in the world for prescription drugs,” he added. “The pharmaceutical industry has spent hundreds and hundreds of millions of dollars to make certain that Americans pay 10 times more for some drugs than the Canadians or the Mexicans do. That fight continues.”

Electorally vulnerable House Democrats are leading the charge on drug pricing, putting pressure on their colleagues that they cannot go back to their districts and face voters without action on an extremely popular issue they campaigned on for years. 

“As majority-makers in competitive districts, we promised our constituents that we would come to Washington to fight on their behalf for lower drug prices,” 15 House lawmakers led by Rep. Angie Craig (D-Minn.) wrote to House leadership. “We cannot turn back now on our promise to the American people. We urge you in the strongest terms possible to include legislative language in the Build Back Better Act that will be voted on by the full House to accomplish this.”

Wild said any talk of dealing with the issue next year would not assuage her. 

“This seems to be our best shot at it,” she said. “That’s why I feel so strongly about it happening now.”