The GOP’s reluctance to challenge rising prescription drug costs could be a political liability for the party in 2020.
Outrage over increasing prices has propelled the issue to the top of voters’ minds heading into the November elections, when Republicans hope to keep control of the Senate and retake the House.
But proposals that would limit what drug companies can charge for their products face opposition from Republicans, presenting an obstacle to c ongressional passage.
Senate Majority Leader Mitch McConnell (R-Ky.) has said he won’t hold a vote on a House-passed bill supported by Democrats that would require the federal government to negotiate lower prices for some drugs covered by Medicare.
He is also reluctant to hold a vote on a separate bipartisan bill, sponsored by Sen. Chuck Grassley (R-Iowa), that would limit the price increases drug companies typically make every year.
But as Republicans fight to keep control of the Senate, doing nothing on an issue of vast importance to voters is also a gamble.
“I made it very clear, just strictly from a political standpoint, that every one of these senators is hearing the same thing I am in Iowa: People are fed up with big increases in drug prices,” said Grassley, chairman of the Senate Finance Committee.
“And there’s 22 Republicans up for reelection and they need an answer to that.”
While Grassley says the bill has the 60 votes needed to pass the Senate, he needs more support from Republicans before McConnell will allow a vote on it.
The majority leader wants to avoid forcing his members to vote on something that would divide the party, especially before a crucial election. Some Republicans who are locked in competitive races, like Sen. Cory Gardner (Colo.), have not signed on to the bill.
“We’re focused on things Republicans can agree on,” said a source familiar with the issue.
Many Republicans oppose the provision of the Grassley bill that would require drug companies to pay back Medicare if they increase their prices faster than the rate of inflation.
The pharmaceutical industry, which opposes the legislation, argues capping price increases would hurt innovation and the development of new products. Many Republicans agree.
“I think there is an interest in doing something about the very high cost of prescription drugs,” said Sen. Mike Rounds (R-S.D.), who is up for reelection this year.
“That challenge will be gathering consensus for changes that would be necessary. The concern that many of us have is we don’t want to limit the research and the desire for improvements of those drugs, and getting that balance is going to be the challenge.”
High drug prices are one of the top issues lawmakers hear about from their constituents. About 1 in 5 adults say they or someone in their household has been unable to afford their prescription drugs in the past year, according to a Gallup poll released in November.
“They are not happy with drug prices,” acknowledged Sen. Joni Ernst (R-Iowa), who is also up for reelection in November in a race that could become competitive, according to the Cook Political Report.
Asked if she supports Grassley’s bill, she replied: “I do have a couple of issues with the bill that I am trying to work through.”
Drug companies raised prices this month on hundreds of drugs by a median of 5 percent, according to health care research firm 3 Axis Advisors, driving more scrutiny and outrage from advocates and lawmakers.
But getting anything through Congress, especially in an election year when members are less willing to vote on controversial issues, will be tough.
While House Democrats passed a bill late last year that would let Medicare negotiate with drug companies for lower prices — something it is currently prohibited from doing — Republicans are in stringent opposition, including Grassley. McConnell has said the bill is “dead on arrival.”
Grassley considers his plan, which he’s worked on with Finance Committee ranking member Ron Wyden (D-Ore.), a compromise between the two sides, but some Republicans still think limiting price increases goes too far toward government control of private businesses.
Grassley still hopes to get more Republican support and attach his measure to a must-pass package of bills in May that would extend funding for several health programs.
That gives him time to get more Republicans on board his plan. However, some members seem unwilling to budge on what they view as “price controls.”
And removing the provision that caps drug price increases would likely mean losing the support of Democrats. Grassley has insisted throughout the whole process that the bill needs to be bipartisan to work.
“Chairman Grassley is in a very difficult position as he tries to reconcile those two competing visions: one collectivist and the other market-oriented,” said Sen. Todd Young (R-Ind.), chairman of the National Republican Senatorial Committee, the Senate GOP’s campaign arm, referring to the differences between Democrats and Republicans on drug pricing.
“There are a lot of my colleagues that just cannot come to terms with a Democrat’s approach.”
Other Republicans support a measure sponsored by Rep. Greg Walden (R-Ore.) and Sen. Mike Crapo (R-Idaho.) that would crack down on tactics drug companies use to delay competition from cheaper generic drugs, require companies to submit justifications for large price hikes to the government and limit what seniors pay out of pocket for drugs to $3,100 every year.
These ideas are also politically popular, according to polls.
But it wouldn’t stop drug companies from increasing the prices of their products year after year.
“We need to see action, not around the edges, but to meaningfully lower drug prices,” said Ben Wakana, executive director of Patients for Affordable Drugs, a group that supports the Grassley-Wyden bill and price negotiation. “Patients want to see lower prices at the pharmacy counter.”
Grassley also dismissed the proposal, saying his plan is the only one that could pass Congress.
“It also shows the strength of Big Pharma because it leaves out the one thing in our bill Big Pharma doesn’t like,” Grassley said, referring to the caps on price increases.
Grassley also said the bill is intended to give political cover to Republicans up for reelection.
Indeed, House Speaker Nancy Pelosi (D-Calif.) and Democrats passed a bill late last year that would require Medicare to negotiate the prices it pays for prescription drugs.
Price negotiation has been incredibly popular in polls among voters in both parties, including 85 percent of Republicans, and Democrats plan to run on it in 2020.
In response, the American Action Network — a group aligned with House GOP leadership — starting airing ads in a $4 million campaign this week bashing Pelosi’s plan as “socialism” while boosting the Walden-Crapo proposal. The ads will air in 28 House districts, including those where Republicans are running competitive races.
Asked how Senate Republicans would respond to Democratic attacks on drug pricing, a spokesperson for the National Republican Senatorial Committee responded: “Republicans are committed to lowering health care costs through a variety of ways. Democrats will be forced to defend why their party aims to eliminate employer-based health care coverage through Medicare for All.”