HEALTH CARE BRIEFING: Defectors Snarl Democrats’ Drug Price Push

By Brandon Lee

Bloomberg Government subscribers get the stories like this first. Act now and gain unlimited access to everything you need to know. Learn more.

Democrats’ entire health agenda is in jeopardy after a trio of House Democrats signaled they’re opposed to a bill empowering the government to demand lower prices for medicines while limiting future drug price increases based on inflation.

Reps. Kurt Schrader (Ore.), Kathleen Rice (N.Y.) and Scott Peters (Calif.) all indicated yesterday they won’t support a drug pricing bill being considered by the House Energy and Commerce Committee. That measure would reduce government spending on medicine by at least $450 billion and could lower medicine costs broadly for Americans, supporters say.

The drug pricing bill is slated to pay for a significant portion of Democrats’ wide-ranging domestic policy legislation, which could cost as much as $3.5 trillion. Peters and Schrader said yesterday they want their party instead to consider a narrower drug price negotiation proposal they designed. Rice is also a supporter of that bill.

“We need to be serious about how to address this issue by ensuring we champion legislation with broadly supported policies that have the bipartisan, bicameral backing needed to pass Congress,” Schrader said in a statement.

If three Democrats join all Republicans on the committee to oppose a bill, it would cause a tie and withhold the majority needed to approve legislation. Republicans oppose Democrats’ drug bill. On the House floor, Democrats can only lose three members, if all members are voting, and still pass the bill.

The Peters-Schrader bill would permit the government to negotiate better prices for just Medicare Part B, which pays for drugs administered by doctors and at hospitals, and would cap what seniors pay for medicines each year relative to their income. The legislation would establish a $50 per month out-of-pocket cap for Medicare beneficiaries for insulin. It also includes an inflation-based cap on drug price increases under Medicare. Read more from Alex Ruoff.

  • Meanwhile, drug companies are launching a seven-figure ad campaign aimed at defeating support for House Democrats’ drug pricing legislation, Alex Ruoff reports. The Pharmaceutical Research and Manufacturers of America will feature ads in various publications and digitally starting tomorrow, including an open letter signed by every member company.

Wyden Explains Drug Pricing Plan: The head of the Senate Finance Committee said yesterday he’s seeking common ground with his colleagues on drug pricing, finding a way to empower the government to demand lower prices for medicines that’s easily understandable by the public.

Sen. Ron Wyden (D-Ore.) told reporters yesterday he trying to find a plan that can pass both the House and Senate, a difficult task as Democrats hold slim majorities in both chambers and have detractors in their caucus. Wyden didn’t outline the details of his plan, but noted that allowing Medicare to negotiate for better prices is key.

“I think you need a system that is straightforward and ensures that he bargaining power of Medicare is carried out,” Wyden said.

Wyden said his colleagues have made clear they won’t accept the House’s favored Medicare negotiation bill (H.R. 3).

“It’s a matter of record that several senators have questions about the House bill,” he said.

STAT News first reported that Wyden is strongly considering drug pricing legislation that would peg what Medicare pays for medicines to the federal pricing ceiling program, which establishes the prices paid by the Department of Veterans Affairs, the Department of Defense, the Public Health Service, and the Coast Guard. These programs pay at most 24% less than the average price for medicines, Alex Ruoff reports.

Democrats’ Expansion of Medicaid in Hold-Out States Clears Panel: Millions of Americans in states that didn’t expand their Medicaid programs under the Affordable Care Act could get government-sponsored health insurance under a measure approved by a House panel Wednesday.

The House Energy and Commerce Committee voted 30-27 to advance the legislation. It’s slated to be part of Democrats’ sweeping domestic policy package.

The proposal would for the first time extend the ACA’s insurance subsidies to Americans making less than 138% of the poverty level. Roughly 2 million Americans live in states that declined to expand their Medicaid programs for people whose incomes are too high to qualify for the low-income health program. Read more from Alex Ruoff.

Also Happening on the Hill

Scrap Proposed Medicare Pay Cuts, House Members Ask: More than 70 bipartisan House members have joined a slew of medical organizations in calling for the Biden administration to nix portions of a proposed rule that would cut Medicare payment rates for some specialists by up to 20% next year.

The lawmakers say the cuts in the proposed 2022 Medicare Physician Fee Schedule would undermine Health and Human Services Department efforts to improve health equity by cutting reimbursements for specialists who treat cancer, kidney failure, artery disease, and other diseases that disproportionately affect Black and Latino beneficiaries. Read more from Tony Pugh.

The Coronavirus Pandemic

Biden Seeks Pledge of One Billion Shots Amid Scarcity: Biden plans to call on foreign leaders to collectively donate one billion Covid-19 vaccines with the aim of inoculating 70% of the world in the next year as many countries are struggling to obtain shots. The U.S. will also call for the donation and delivery of one billion test kits by 2022 and an acceleration of a previously announced pledge of 2 billion shots, according to an invitation obtained by Bloomberg to a vaccine summit to be hosted by Biden next week.

Biden planned the summit next week to coincide with the leaders’ sessions of the United Nations General Assembly, which Biden will attend on Sept. 21. The invitation was reported earlier by the Washington Post. The vaccine push comes as the president tries to ward off international criticism of his plan to start giving booster shots this month—giving additional doses to Americans while many around the world have yet to receive their first. Read more from Josh Wingrove.

CDC Chief ‘Hopeful’ for Biden Booster Timeline: U.S. health leaders expressed optimism the Biden administration’s planned Covid-19 booster rollout will move ahead next week as expected, even as scientists question the need for additional shots. “We are planning and I’m hopeful for the timeline that’s been mapped out,” Rochelle Walensky, director of the Centers for Disease Control and Prevention, said yesterday at Research!America’s national health research conference. Jeannie Baumann has more.

  • Also at the event, former FDA Commissioner Scott Gottlieb said drugmakers should be able to bring drugs to market that can help those who are sick with Covid-19, similar to how Tamiflu fights off influenza. “I’m almost fairly certain that we’re going to get an antiviral drug that inhibits viral replication. This shouldn’t be a hard virus to drug,” said Gottlieb, who was FDA chief during the Trump administration and was an early public health leader on the virus. Read more from Baumann.

U.S. to Supply Covid-19 Drugs Amid Surge: The U.S. government plans to more directly control where Covid-19 antibody treatments are sent amid a surge in infections and hospitalizations in states with large pockets of unvaccinated people. Hospitals and other care providers will no longer be able to directly order monoclonal antibody therapies from distributors, according to a Sept. 13 update posted on the Department of Health and Human Services website. Read more from Riley Griffin and Emma Court.

Vaccine Mandate Risks Overwhelming U.S. Testing Capacity: The U.S. may not have enough tests to keep pace with the Biden administration’s tightened workplace Covid-19 mitigation measures. Under regulation expected in the coming weeks, companies with 100 or more employees must require workers get vaccinated or undergo weekly testing. That could represent nearly double the volume of tests already being processed, may make rapid tests more scarce, and lengthen wait times. Emma Court has more.

  • Meanwhile, an Arizona lawsuit filed yesterday against the Biden administration’s Covid-19 vaccine requirements is the “first salvo” challenging the federal government on the issue, state Attorney General Mark Brnovich (R) said. Brnovich, who said Arizona is the first state to file a complaint against Biden’s employer vaccine-or-test rule, is asking the U.S. District Court for the District of Arizona to declare the policies unconstitutional. Read more from Brenna Goth.
  • Prior litigation over emergency health and safety regulations and executive orders for U.S. contractors provides clues to how courtroom battles may unfold over the Biden administration’s bid to bolster vaccination rates. Attorneys say that in spite of previous emergency rules having poor track records, the new rule has a unique opportunity to succeed amid the face of the infectious delta variant. Read more from Robert Iafolla, Paige Smith, and Erin Mulvaney.
  • Two vaccine mandates imposed on health workers in New York state and New York City teachers were temporarily blocked by judges. State court judge Laurence L. Love issued a temporary restraining order yesterday barring New York City’s health department from requiring education workers to be vaccinated. Love’s order was issued just hours after a federal judge temporarily blocked New York state officials from imposing a Covid-19 vaccine requirement on health care workers who claim the shot violates their religious beliefs. Read more from Bob Van Voris, Erik Larson and Chris Dolmetsch.

More Headlines:

What Else to Know Today

DoJ Seeks Order Blocking Texas Anti-Abortion Law: The U.S. Justice Department asked for an emergency court order to block a restrictive anti-abortion law in Texas, the first of what is likely to be an extended legal battle that reaches all the way to the Supreme Court. The 47-page request, filed in federal court in Austin late yesterday, seeks a temporary restraining order or preliminary injunction halting enforcement of the law, known as Texas Senate Bill 8, which bars almost all abortions after the sixth week of pregnancy, before many women know they are pregnant. Read more from Chris Strohm.

Price Transparency Rules Pose Burden for Rural Centers: The Medicare and Medicaid agency’s requirement that hospitals list prices for common services is straining rural hospitals that were already at risk of shutting down due to the financial pressures of the pandemic. Many hospitals have already hesitated to comply with a Trump-era rule that required hospitals to reveal prices for outpatient services, citing the burdens and expenses of gathering and publishing that data. Read more from Allie Reed.

Health Coverage Steady Despite Drop in Employer Insurance: The Census Bureau found the percentage of Americans without health insurance stayed essentially the same at 8.6% in 2020, but private insurance covered dropped by 0.8%. The percentage of people with health coverage for some or all of 2020 was 91.4%. The number of people who didn’t have health insurance stood at around 28 million in 2020, one bureau official said. That wasn’t statistically changed from 2018, she said. Sara Hansard has more.

More Headlines:

With assistance from Alex Ruoff

To contact the reporter on this story: Brandon Lee in Washington at blee@bgov.com

To contact the editors responsible for this story: Zachary Sherwood at zsherwood@bgov.com; Giuseppe Macri at gmacri@bgov.com; Michaela Ross at mross@bgov.com

Stay informed with more news like this – from the largest team of reporters on Capitol Hill – subscribe to Bloomberg Government today. Learn more.

Top