High stakes as Trump, Dems open drug price talks

Democrats and the Trump administration are beginning to hold talks on lowering drug prices as they look for a rare area of common ground.

Both President Trump and congressional Democrats say that lowering drug prices is a priority, providing a potential area for bipartisan action in a government that is otherwise bitterly divided after a months-long fight over border security.

But the political risks are high for both sides in a politically polarized atmosphere and with the 2020 elections rapidly approaching.

{mosads}Trump and Speaker Nancy Pelosi (D-Calif.) spoke briefly about working together to lower drug prices during a phone call at the end of January and their staffs have begun preliminary discussions, according to a Democratic aide.

Rep. Peter Welch (D-Vt.), one of the House’s fiercest critics of the pharmaceutical industry, also spoke with acting White House chief of staff Mick Mulvaney during a trip to Camp David last weekend.

And Secretary of Health and Human Services Alex Azar has been talking to dozens of congressional Democrats, including House Ways and Means Committee Chairman Richard Neal (D-Mass.). He also met with Democrats on the Senate Finance Committee on Wednesday.

“We’re hopeful,” Welch told The Hill. “I spent some time at Camp David talking with Mick Mulvaney about it.”

“He brought it up, he was just very affirmative about the president’s desire to make some progress on this,” Welch added.

Despite the flurry of talks, there is still plenty of reason to doubt that a breakthrough on drug prices, or any major bipartisan goal, can be accomplished. Democrats and Trump are still dealing with the fallout from the border wall standoff, and bracing for a contentious legal fight after the president on Friday declared a national emergency at the border.

Trump has also recently cast doubt on working with Democrats, who with control of the House have stepped up their investigations into his campaign and administration. During his State of the Union address, he derided them as “ridiculous partisan investigations,” and warned the probes would hurt the chance for bipartisan achievements.

And with 2020 quickly approaching, a number of Senate Democrats have jumped into the presidential race, complicating hopes for a bipartisan deal. For some Democrats, there is little upside to giving Trump a major legislative victory heading into an election.{mossecondads}

And both sides are rife with skeptics that those across the table are ready to push ahead on the issue.

“I think the administration needs to stand up to the drug lobby and they won’t any more than they stand up to the gun lobby or Wall Street,” said Sen. Sherrod Brown (D-Ohio), a possible presidential candidate who attended the meeting with Azar on Wednesday.

Still, Brown called Azar “very smart” and said the administration had proposed “a few good things” on drug prices.

Other key Democrats struck a more hopeful note.

Neal, the Ways and Means chairman, said at a hearing on drug prices on Tuesday that he has had “encouraging conversations” with Azar, specifically on a proposal to make drug companies pay rebates back to the government if their prices for certain drugs in Medicare Part B rise faster than the rate of inflation.

“Secretary Azar and the Trump Administration are committed to working across the aisle and have made it clear that all options that preserve drug safety, protect innovation, and keep patients at the center are on the table,” Health and Human Services spokeswoman Caitlin Oakley said in a statement after Azar’s meeting with Senate Democrats on Wednesday.

House Democratic leaders are planning to move first on a package of “low-hanging fruit” drug pricing bills that are smaller measures that have some bipartisan support, before later moving on to more partisan proposals like allowing Medicare to negotiate drug prices.

It is possible that the smaller, bipartisan measures could make it through the Senate as well, given that Senate Finance Committee Chairman Chuck Grassley (R-Iowa) supports several of the key components, such as preventing drug companies from using gaming tactics to delay competition from cheaper generic drugs.

House Democrats are then expected to move on to a more partisan bill on allowing Medicare to negotiate drug prices. That measure has little, if any, chance of making it through the Senate but will allow Democrats to showcase their priorities.

Democratic leaders have begun working on the Medicare negotiation bill, but have not yet settled on the details. One major question is what enforcement mechanism they will include in the bill to force drug companies to the table if they decline to negotiate.

“We’re working on it; we don’t have a draft yet,” House Energy and Commerce Committee Chairman Frank Pallone Jr. (D-N.J.) said of the Medicare negotiation bill on Wednesday.

The vast number of issues at play in drug pricing and the large number of important players, on Capitol Hill and beyond, make the prospect of any action challenging.

Still, in the upper chamber, one senior lawmaker held out hope that the administration and Democrats could move forward.  

Sen. Ron Wyden (D-Ore.), the top Democrat on the Senate Finance Committee, said that he secured a commitment from Azar at the meeting Wednesday to work with him on another priority, Wyden’s bill to cap seniors’ out-of-pocket drug costs in Medicare.

“He started in talking about how much he favors an out of pocket limit for seniors and I said ‘Secretary, I’ve had a bill on that for two years,’ and finally I said, ‘Will you send your people over to talk to mine so we can pass that bill quickly?’ ” Wyden recounted.

Wyden said that Azar agreed.

“If the administration will do what they said they were going to do,” Wyden added. “I said, ‘I’ve had this bill for two years, let’s go’ and he said, ‘Ok.’ ”