“I support many of the proposals that are being considered this week, but I do not support advancing policies that are not fiscally responsible and jeopardize the final passage of the bill,” Rice said.
The confrontation occurred when the Energy and Trade panel marked its share of the giant package set for its passage through the filibuster-proof budget conciliation process. And the outcome of the clash could determine whether Democrats can spend up to $ 700 billion on savings planned over a decade on other health policy priorities, such as adding dental, vision and hearing benefits to Medicare, making improved subsidies the Affordable Care Act is permanent and offers Medicaid coverage. 2 million people in red states who have refused to expand the program.
But the Peters-led plan is not a principle for progressives, who argue it allows the pharmaceutical industry easily and would generate far fewer savings to apply to other health priorities.
As members of President Nancy Pelosi fight, uncertainty over the price of drugs complicates her team’s schedule to move the social spending package to the House this month. Individual committees are expected to report their parts to the House Budget Committee before Wednesday so the group can begin meeting legislation for minimum actions later this month.
If Peters, Rice and Schrader join all the Republicans in the group to vote against the section on drug pricing, which will prevent it from advancing from the committee, it will be a shame for the leadership, after the Democrats of the President Joe Biden to pass to the presidency of the Senate budget Bernie Sanders (I-Vt.) He spent months promising to reduce the health care spending of tens of millions, if not hundreds of millions, of people. Democrats noted, however, that if anything else fails, they could add provisions later in the process, when the entire committee package passes to the Budget Committee.
A spokesman for the Energy and Trade Committee said efforts on the bill are “ongoing” and Pallone “continues to work to report favorably on all the Committee’s conciliation legislative recommendations”.
Still, many Democrats are worried.
Schrader has already noted that he will likely vote against the committee’s bill. Democrats are still trying to win over Peters and Rice, who have privately threatened to oppose only part of the drug price legislation.
“It doesn’t look good,” an aide to a Democrat on the committee told POLITICO, who predicted that the entire drug pricing billing section will not be able to move forward. “As it holds up with the votes, it looks like the window is closing.”
The centrist uprising also caused panic with progressive advocacy groups such as the Center for Popular Democracy, which on Tuesday sparked alerts urging its members to call members of Congress and pressure them to vote on the bill. more aggressive pricing.
The dispute over the government’s aggressiveness in negotiating drug prices is likely to decide other ongoing Democratic fights over how to split funds between Medicare, Medicaid and Obamacare. This is because saving on the price of drugs effectively sets the amount of spending that legislators will have to work on.
“There’s an independent reason to be successful in drug price negotiations, and it’s that we often pay three times what everyone else pays for drugs,” said Rep. Peter Welch (D-Vt.). He sits on the committee and is one of those leading the push for Medicare negotiation. “But only if we get it can we have a debate on how to use those savings.”
With pressure on Democrats to get enough revenue to fund large expansions of other health programs, the law will save about $ 700 billion over ten years, compared to the $ 492 billion saved by the previous version, according to the Joint Committee on Taxation.
Moderate dissidents argue that the language of drug prices backed by the leadership goes nowhere in the Senate and that Democrats should not be subjected to what could be a tough political vote for no reason.
Two more moderate Democrats, Reps Lou Correa and Stephanie Murphy, have co-sponsored Peters’ alternative bill on drugs, which points to possible problems for a future flat vote, as the party can only lose three votes and continue approving the overall package. .
Meanwhile, Senate moderates are trying to reduce the size of the general bill. The Democratic Democrats did a “temperature review” of the issue during Tuesday’s weekly luncheon, but did not reach a final consensus, an aide said in an interview, which addressed the issue on condition of anonymity. . Senator Ron Wyden (D-Ore), who leads the upper house drug pricing effort, told reporters he is still looking at “several approaches” that include direct government negotiation “while it is sensitive to innovation “.
A critical point is that the House’s leading drug pricing plan would set the prices of drugs traded in the U.S. with what is paid to countries that use a metric called Quality-Adjusted Life Years to determine the value of a drug. This measure 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 vote hard on anything the Senate cannot approve. However, getting rid of the international comparison would only threaten the global effort, a source close to the Energy and Trade Committee explained, because hundreds of billions of savings come from this provision alone.
In addition to their own internal divisions, Democrats will have to overcome stiff opposition from the powerful health industry lobbies to get a bill on target. Key groups have spent years discussing how many drugs should be subject to government bargaining rules, what benchmarks prices will be adjusted for, and whether lower prices will apply to business plans and other insurance. private, and are currently pouring resources into ads and lobbying aimed at blocking the passage of the bill.
Welch and others pushing for a broad negotiation bill attribute the revolt of the moderates to the rapid influence of industry pressure and powerful influence in Washington, while outside advocacy groups accused Peters, Schrader and others of opposing it. to the legislation of “making the request of Big Pharma” receiving large donations from pharmaceutical companies.
“There’s anguish,” Welch said of the Democrats ’current fight against drug prices. “But the anxiety comes from the pharmaceutical industry that we will actually reduce the cost of prescription drugs, and that translates into arguments that are proposed to prevent us from continuing.”
Until the party can find common ground on a drug bill that satisfies the concerns of moderates and progressives, all other party 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.”