“I support many of the proposals being considered this week, but I do not support the progress of policies that are not fiscally responsible and jeopardize the final passage of the bill,” Rice said.
The standoff came when the Energy and Commerce panel marked its part of the gigantic package that was put to passage using the filibuster-safe budget voting process. And the outcome of the clash could determine whether Democrats can spend up to $ 700 billion in expected savings over a decade on other health policy priorities, such as Adding dental, vision and hearing benefits to Medicare, making enhanced Affordable Care Act subsidies permanent and offering Medicaid coverage to 2 million people in red states who have refused to expand the program.
But the Peters-led plan is a non-starter for progressives, claiming it lets the pharmaceutical industry come easily and would generate far fewer savings by applying other health priorities.
While speaker Nancy Pelosis members are struggling, the uncertainty surrounding drug prices complicates her team’s timeline for moving the social spending package through the House this month. Individual committees are expected to report their portions to the House budget committee by Wednesday so the panel can begin gathering legislation for floor actions later in the month.
Should Peters, Rice and Schrader join all panel Republicans in voting against the drug price bill and preventing it from coming out of committee, it would mark an embarrassment for the leadership, after Democrats from President Joe Biden to Senate Budget Chairman Bernie Sanders ( I-Vt.) Spent months lowering out-of-pocket health spending for tens of millions if not hundreds of millions of people. However, the Democrats noted that if all else fails, they could add the provisions later in the process when the whole committee’s package is submitted to the Committee on Budgets.
A spokesman for the Energy and Trade Committee said efforts on the bill were “ongoing” and Pallone “continues to work to positively report on all the committee’s recommendations for reconciliation of legislation.”
Yet many Democrats are concerned.
Schrader has already signaled that he is likely to vote against the committee’s bill. Democrats are still trying to win over Peters and Rice, who have privately threatened to oppose only the part of the law that prices drugs.
“It does not look good,” an aide to a Democrat in the committee told POLITICO, predicting that the entire section on drug prices in the bill will not be able to move on. “As it stands with voices, it looks like the window about it is closing.”
The centers’ revolt also sparked a panic with progressive advocacy groups such as the Center for Democracy, which on Tuesday blew up warnings urging their members to call congressmen and force them to vote for the more aggressive drug pricing legislation.
The dispute over how aggressive the government should be in negotiating drug prices is likely to settle other ongoing democratic battles over how to split funds between Medicare, Medicaid and Obamacare. This is because the savings in drug price effectively add up to how much extra expense legislators have to work with.
“There’s an independent reason to succeed in negotiating drug prices, and that is that we often pay three times what everyone else in the world pays for drugs,” says the rep. Peter Welch (D-Vt.), Who sits on the committee and is among those leading the push for Medicare negotiations. “But only if we succeed can we have a debate on how we can use these savings.”
With pressure on Democrats to raise enough revenue to fund major expansions of other health programs, the bill will save an estimated $ 700 billion over ten years compared to the $ 492 billion saved in the previous version, according to the Joint Committee on Taxation.
The moderate disagreements argue that leadership-backed drug prices are not going anywhere in the Senate — and that Democrats should not be subjected to a harsh political vote for no reason.
Two more moderate Democrats, rep. Lou Correa and Stephanie Murphy, have supported Peter’s alternative drug bill and are signaling potential problems for a future floor vote, as the party can only lose three votes and still pass the overall package.
Meanwhile, Senate moderates are trying to reduce the size of the total bill. The full Democratic assembly took a “temperature check” on the issue at its weekly lunch on Tuesday, but did not reach a final consensus, an aide said in an interview and addressed the issue on condition of anonymity. Senator Ron Wyden (D-Ore.), Who is leading the drug pricing effort in the upper house, told reporters he still looks at “different approaches” that include direct government negotiations “while being sensitive to innovation.”
One point is that the House’s drug price management plan would link drug prices negotiated in the United States to what is paid in countries that use a metric called Quality-Adjusted Life Years to determine the value of a drug. This measurement of health outcomes and quality of life has been criticized for discriminating against people with disabilities.
Many House Democrats have said they do not want to take hard votes on something that will not be able to pass the Senate. But still getting rid of international benchmarking alone would threaten the overall effort, explained a source close to the Energy and Trade Committee, because hundreds of billions in savings come from just one provision.
In addition to their own internal divisions, Democrats will have to overcome fierce opposition from powerful health industry lobbies to get a bill over the finish line. Key groups have spent years arguing over how many drugs should be subject to the government’s bargaining rules, what benchmark prices will be linked to, and whether the lower prices will apply to employer plans and other private insurances and are currently pouring resources into advertising and lobbying. with the aim of blocking the passage of the bill.
Welch and others, who are pushing for a comprehensive bargaining law, attribute the moderates rebellion to the industry’s lobby blitz and strong influence in Washington, while external advocates accused Peters, Schrader and others of legislation to “bid in the back room of Big Pharma” after receiving large donations from pharmaceutical companies.
“There is anxiety,” Welch said of the Democrats’ current fight against drug prices. “But the anxiety is from the pharmaceutical industry that we are actually going to lower the cost of prescription drugs, and that translates into arguments that are supported to stop us from continuing.”
Until the party can find common ground on a drug bill that satisfies the concerns of both moderates and progressives, all of the party’s other health policy struggles remain in the air.
“The general dynamic is that things are still fluid,” a senior Democratic aide said in an interview. “It depends on how much money can be raised.”