Democrats reach deal to control drug prices in bill

WASHINGTON – House Democrats on Tuesday reached a deal to add a measure to cut prescription drug costs to President Biden’s $ 1.85 trill...


WASHINGTON – House Democrats on Tuesday reached a deal to add a measure to cut prescription drug costs to President Biden’s $ 1.85 trillion social safety net plan, agreeing to allow the government for the first time negotiating the prices of Medicare-covered drugs as they pushed for a quick vote on the bill.

The negotiators were also lobby for an expensive deal reinstate a federal deduction, capped in the 2017 tax cuts signed by President Donald J. Trump, for state and local taxes, which would benefit residents of high-income states like New York and New Jersey.

The supply of prescription drugs is limited. Beginning in 2023, negotiations could begin on what Senator Ron Wyden of Oregon has called the most expensive drugs – treatments for cancer and rheumatoid arthritis, as well as blood thinners. Most drugs would still enjoy patent exclusivity for nine years before negotiations could begin, and more complex drugs, called biologics, would be protected for 12 years.

But for the first time, Medicare, the federal health insurance program for people 65 years of age or older and for people with disabilities, would be able to step in after these periods, even if drug companies acquire patent extensions or play differently with the patent system.

“The pricing of prescription drugs has always been a major issue for Americans year after year, including the vast majority of Democrats and Republicans who want to see a change because they just can’t afford their drugs. New York Democrat Senator Chuck Schumer said. and the majority leader. “Today we have taken a big step forward to help alleviate this problem. “

President Nancy Pelosi of California said that “Democrats will engage in strong drug price negotiations to lower prices for our seniors and stop Big Pharma’s outrageous price hikes above inflation.”

Stephen J. Ubl, president and CEO of Pharmaceutical Research and Manufacturers of America, the industry’s leading trading group, criticized the deal.

“While we are excited to see changes in Medicare that cap what seniors pay out of pocket for prescription drugs, the proposal allows insurers and middlemen like pharmacy benefit managers to get away with it.” when it comes to reducing costs for patients at the pharmacy counter, ”says Ubl. “It threatens innovation and makes a broken health care system even worse. “

The completion of the prescription drug section could be one of the latest major changes to the sprawling climate change and social safety net bill that Democratic leaders hope to put to a vote in the House this week. . Other issues remained to be resolved, in particular a plan to fight against methane, a potent greenhouse gas, and a measure to provide work permits and protection against deportation for undocumented migrants. Democrats also want to tackle a growing backlog of green card applications.

Top Democrats appeared determined to move forward with the votes as early as Thursday, even without a rock-solid commitment from recalcitrant Senate moderates to vote for the final package. Mr Biden, speaking to reporters in Scotland, said the Senate’s top Democratic skeptic, Joe Manchin III of West Virginia, would return.

“He will vote for it if we have in this proposal what he anticipated,” Biden said at a press conference before leaving a climate summit in Glasgow. “I believe Joe will be there.”

Passing the social safety net and climate bill would free the House to also give final approval to a $ 1,000 billion infrastructure bill that was passed by the Senate in August, offering to Mr. Biden a long-delayed legislative victory. Mr Schumer said on Tuesday he hoped the domestic policy plan would be ready for debate the week of November 15.

On Tuesday, five moderate and conservative Democrats wrote to Ms Pelosi warning her that they would withhold their vote until non-partisan markers had assessed the full cost of the legislation, and asked her to wait to see herself. ensure that every proposal in the bill can be adopted by the Senate. A copy of the letter, reported by Politico, was obtained by The New York Times.

“Better to do it right than to rush its review unnecessarily just so our voters can see the negative impacts of our unintended consequences,” wrote lawmakers, including Reps Stephanie Murphy of Florida and Jared Golden of Maine.

But one of the signatories, Rep. Kurt Schrader from Oregon, signaled some flexibility, saying he would not stand for a full report on the impact of the legislation, which could take weeks.

Because Republicans are unanimously opposed to the bill, Democrats are pushing it through Congress using a fast-track process known as budget reconciliation that shields tax measures from obstruction and allows them to pass a majority vote. simple. But given their narrow margins of control, to win even a simple majority, they must gain the support of all of their 50 senators and almost all of their members in the House.

Ms Pelosi told reporters she hoped to have a final bill drafted as early as Tuesday evening.

The prescription drug compromise was fought hard and forced Democrats to overcome a lobbying assault from the powerful pharmaceutical industry, which succeeded in weakening their initial proposal to allow the government to negotiate prices over a larger universe of medications. The final deal includes an annual cap of $ 2,000 on personal spending for elderly Americans facing catastrophic health problems, a strict monthly cap of $ 35 on insulin spending, and automatic discounts on drugs whose prices increase faster than inflation.

But the pharmaceutical industry has won its share of concessions. The inflation rebates initially contained a “look back” provision that would have assessed the discounts on drug prices which began to skyrocket as early as 2012. This would have generated one-time levies on the order’s pharmaceutical companies. billions of dollars. And some Democrats wanted to immediately grant Medicare price negotiating power, with no patent exclusivity period.

Yet proponents of the compromise believe the negotiating powers it grants Medicare will be a first step in securing the broader powers that Democrats have campaigned on for decades.

“I don’t think it’s just a camel’s nose in the tent,” said Senator Christopher S. Murphy, Connecticut Democrat and one of the negotiators. “I think we put the head and part of the body in there as well.”

The legislation would require substantial price reductions for drugs under negotiation, starting in 2025. And, they said, rules limiting ever-expanding patent protections will be key to cutting costs.

“The problem of perpetuating patents so that tiny changes allow these companies to maintain monopolies for years and years and years is wrong,” said Senator Elizabeth Warren, Democrat of Massachusetts. “This violates the basic principle of granting these exclusive licenses through patents, and has been abused by many large pharmaceutical companies and must stop.”

Changes to Medicare prescription drug benefit are likely to have a big impact on consumers even sooner. Currently, there is no limit to the amount that patients can be asked to spend on their medications, and many Medicare beneficiaries are faced with $ 15,000 bills or more each year if they take expensive drugs. In addition to setting an annual limit on direct spending, the plan would smooth spending throughout the year, eliminating the so-called donut hole when many beneficiaries are responsible for their entire drug bill.

Juliette Cubanski, deputy director of the Kaiser Family Foundation, said the program would solve key problems in the country’s drug pricing system.

If this becomes law, she said, “it would be quite a significant achievement, especially in light of the setback they are experiencing from industry stakeholders, who have invested a lot of money in not to see these policies come into effect “.

Mr Schumer was quick to say he got approval for the deal from Arizona Democrat Sen. Kyrsten Sinema and another bill-resistant centrist who opposed the proposal a lot. larger chamber on prescription drugs.

Her office then released a statement saying she welcomed “a new agreement on a historic and transformative Medicare drug negotiation plan that will reduce out-of-pocket expenses for the elderly – ensuring drug prices cannot not rise faster than inflation – save taxpayers’ money and protect innovation. to ensure Arizonans and Americans continue to have access to life-saving drugs, as well as new remedies and therapies.

The state and local tax deal was still in the works on Tuesday, but Democrats said it would suspend a $ 10,000 cap on the so-called SEL deduction for five years. The suspension would come into effect for deductions related to property taxes and state and local income taxes accrued in 2021 and through 2025.

It was not clear whether the deal would apply across the board or be subject to an income cap to prevent wealthier Americans from getting what amounts to a tax cut.

Senator Bernie Sanders, an independent from Vermont and chairman of the budget committee, warned he would oppose the provision unless it is limited to the middle class.

“In a time of massive income and wealth inequality,” he said in a statement, “the last thing we should do is give more tax breaks to the very rich.”

Margot Sanger Katz contributed reports.

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Newsrust - US Top News: Democrats reach deal to control drug prices in bill
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