Newly empowered House Democrats plan to move first on smaller, bipartisan legislation to lower drug prices, hoping to notch some early victories before moving on to more sweeping measures.
Democrats have targeted a number of measures that are smaller in scope but have support from some Senate Republicans, according to Democratic sources. They hope taking a strategic approach and passing those measures will build momentum as they prepare to tackle more controversial proposals further down the road, like allowing Medicare to negotiate drug prices.
Lowering drug prices is a top priority for both House Democrats and President Trump, making it a rare area of potential bipartisan agreement. But it also holds possible political pitfalls.
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Democratic lawmakers are facing pressure from progressives to go big on an issue that helped them retake the House in the 2018 midterms.
“Candidates ran on the promise to lower drug prices and eight in 10 voters think lowering drug prices should be Congress’s top priority,” said Ben Wakana, executive director of Patients for Affordable Drugs, an advocacy group.
Leaders, though, will also be wary of moving too quickly and failing to notch any easy wins.
Hovering over their efforts will be Trump, who has said he is willing to work with Democrats on the issue. Both sides see the potential for a major legislative accomplishment but are also wary of handing the other side an important victory in the run-up to 2020.
For now, Democrats intend to move first on smaller measures, such as encouraging competition from cheaper generic drugs, that have the potential to actually be signed into law because they are supported by some Senate Republicans.
One top priority is known as the Creates Act, and cracks down on drug companies gaming the system to delay the introduction of cheaper generic competition. That measure is supported by many Republicans, including Sen. Chuck Grassley (R-Iowa), who will chair the Senate Finance Committee.
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Another option is a bill to crack down on “pay for delay” deals in which drug companies pay generic competitors not to bring their drugs to market, putting off competition.
Democratic aides said it’s not yet clear whether those bills would be packaged together or broken up and used to pay for larger pieces of legislation, given that they generate savings.
House Democrats’ strategy, though, involves putting off bolder bills that have strong support in the party and among progressives but have no shot at making it through the Senate, such as allowing Medicare to negotiate drug prices. That’s long been a Democratic priority, but one opposed by most Republicans.
Both Speaker Nancy Pelosi (D-Calif.) and House Energy and Commerce Committee Chairman Frank Pallone Jr. (D-N.J.) have called for allowing Medicare to negotiate pharmaceutical prices, but under Democrats’ plan, action on that front would not come right away.
A Pallone spokesman said the chairman plans to listen to members of the committee, including new members who have not been named yet, and therefore “no final decisions on strategy or agenda have been finalized.”
It is still an uncertain strategy. It is unclear whether even the smaller measures, like the Creates Act, will make it into law.
While Grassley supports the bill, other Senate Republicans, including Senate Majority Leader Mitch McConnell (R-Ky.), could be less willing to take up a House Democratic bill or other drug pricing measures. McConnell will be wary of taking up a bill that could split his caucus.
And despite bipartisan backing, the measure stalled all of last year amid opposition from the powerful pharmaceutical industry.
Still, lobbyists said they think the pharmaceutical industry’s opposition to the Creates Act has softened, as the measure has been on the table in negotiations over other drug pricing issues. They believe that larger packages moving through Congress, such as a budget deal, could provide a vehicle for measures like the Creates Act.
Starting on the smaller side, though, leaves Democratic leaders open to pressure from the progressive wing of the party, which is demanding faster action on more sweeping drug pricing legislation.
“We don’t need more hearings to study the problem,” Wakana told The Hill.
For now, key Democrats are talking cautiously about taking up larger measures.
Rep. Lloyd Doggett (D-Texas), a fierce opponent of the pharmaceutical industry, is on track to become chairman of the Ways and Means health subcommittee, according to Democratic aides. The Texas lawmaker is likely to put drug pricing in his sights.
Doggett told The Hill last week that he wanted hearings before moving forward with major action.
“I think that we need to proceed with hearings to explore the issue since we’ve been unable to secure hearings on any of these things and beginning to lay the groundwork for action is important,” he said.
Rep. Diana DeGette (D-Colo.), who is set to become chairwoman of the Energy and Commerce oversight subcommittee, said last week she would “probably” call drug company CEOs to testify before her panel.
“Oversight is going to do some in-depth investigations,” she said.
The Trump administration also plans to keep moving forward with its own proposals to lower drug prices without congressional action. That is likely to raise pressure on Democrats not to cede the issue to Trump.
Advocates are urging House Democrats not to lose sight of their larger goals.
Lauren Aronson, executive director of the Campaign for Sustainable Rx Pricing, said her group has “long supported the Creates Act and other bipartisan, market-based solutions that will put an end to Big Pharma’s abusive practices, boost competition and lower drug prices.”
“We’re looking forward to continuing our work with lawmakers to advance these bills and provide relief to millions of Americans,” she said.