House passes sweeping Pelosi bill to lower drug prices

The House on Thursday passed a sweeping bill aimed at lowering prescription drug prices, a step toward a long-held Democratic goal that was met with sharp Republican resistance.

The bill passed on a largely party-line vote of 230-192. The measure, which would allow the government to negotiate lower prices for prescription drugs, is one of House Democrats’ top priorities and is expected to be touted by vulnerable Democrats up for reelection next year.

The party is also looking to show that it is focused on kitchen table issues like lowering drug costs even as lawmakers prepare for an impeachment vote against President Trump.

“What I hear most often is not impeachment, it’s not what’s on the front page of The Washington Post, it’s ‘What are you going to do about the cost of our prescription drugs?’ ” said Rep. Kim Schrier (D-Wash.), one of several freshmen facing competitive reelection races who showcased the bill on the Capitol steps Thursday. “And this bill is an answer to my constituents.”

Two Republicans voted in favor of the bill: Reps. Brian Fitzpatrick (Pa.) and Jaime Herrera Beutler (Wash.), both moderates who face competitive reelection races next year. No Democrats voted against the bill.

The measure drew support from progressives following months of negotiations that cleared the way for it to pass this week. The bill is almost certain to die in the GOP-led Senate, though, given that Senate Majority Leader Mitch McConnell (R-Ky.) has called it “socialist” and vowed to block it. Republicans warn the measure would hinder the development of new treatments and impose “price controls.”

It is possible that smaller measures to lower drug prices could become law, given a bipartisan push to do something on the topic, but a path forward remains unclear amid division and multiple competing proposals.

Pelosi had tried for months to win Trump’s support for the bill, given that he broke from Republican orthodoxy and supported government negotiation on drug prices during his 2016 campaign.

After months of talks between Pelosi’s staff and the White House, though, the administration came out against the measure, leading Democrats to say Trump is breaking his promise to support negotiation for lower prices.

“It’s exactly what President Trump promised on the campaign trail,” said Rep. Andy Levin (D-Mich.).

Trump is instead supporting a more modest bipartisan bill in the Senate to lower drug prices, legislation that does not include a provision to negotiate prices.

The House bill, known as the Elijah E. Cummings Lower Drug Costs Now Act, is named for the late Democratic lawmaker who was a champion of lowering drug prices.

The legislation would allow the secretary of Health and Human Services to negotiate lower prices for a minimum of 50 drugs per year, up to a maximum of 250 drugs. The prices for those drugs would also be capped at 120 percent of the prices in certain other wealthy countries. The government would then negotiate to bring prices down even further below that cap.

The lower prices would apply to people on private insurance in addition to those on Medicare.

If a drug company refused to negotiate, the company would be hit with a tax up to 95 percent of the revenue for the drug.

That steep penalty has led Republicans to argue the bill is not really “negotiation” as Democrats claim, but is effectively just mandating the price that drug companies must sell their products at.

The White House said the bill would impose “price controls” in its message threatening to veto the measure.

Progressive House Democrats had resisted the bill from the other direction, arguing that the measure did not go far enough. Reps. Pramila Jayapal (D-Wash.) and Mark Pocan (D-Wis.), along with Rep. Lloyd Doggett (D-Texas), spent months pushing Pelosi to make the bill tougher.

In recent days they threatened to try to block a vote on the bill unless changes were made, but struck a deal with Pelosi after a meeting in the Speaker’s office Tuesday, clearing the way for the bill to pass with minimal drama. One of the changes increased the minimum number of drugs to be negotiated from 35 to 50.

The Congressional Budget Office (CBO) found the bill would lower prices by about 50 percent for drugs subject to negotiation and save $456 billion over 10 years. The bill then invests those savings in expanding Medicare benefits to include hearing, dental and vision care.

On the other hand, the CBO also found the bill would result in eight fewer drugs being developed over a decade, out of about 300 usually introduced in that time period. 

House Republicans put forward a competing proposal that also received a vote Thursday. Their bill is much smaller in scale. Republicans touted it as leading to lower prices without imposing “price controls” or threatening the development of new drugs. 

House Minority Leader Kevin McCarthy (R-Calif.) called the Democratic bill a move to “appease the progressive base and have a partisan bill that denies us more cures,” while calling the GOP alternative a “practical solution” that would still allow new cures to come to market.

Democrats say polling shows the public is behind their bill. The progressive group Data for Progress on Thursday released polling testing different messages about the bill and finding strong support. Opposition never rose above 40 percent even when voters were presented with only negative messages about the bill. 

Pelosi said on the House floor on Thursday that she did not know why the White House stopped working with her on the drug pricing bill.

“We were working with the interests of the White House, the administration, on all of this,” she said. “I don’t where it happened, but somewhere along the way, negotiation and the rest fell by the by. And what that could be attributed to, I don’t know what.”

Updated: 2:30 p.m.