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Hillary Clinton’s response to a question about her drug costs plan in Saturday’s presidential debate is likely to invite more scrutiny of a key part of that plan: her cap on out-of-pocket expenses.

During the Democratic presidential debate in Des Moines, Clinton was asked about her proposal to limit out-of-pocket expenses to $250 per month, part of a broader plan to put the brakes on rising prescription drug costs. The critical question: wouldn’t that simply translate into higher insurance premiums for consumers?

Clinton’s answer: “There’s more to my plan than just the cap.”


She emphasized other parts of her plan, like giving Medicare the power to negotiate lower prices for seniors. “American consumers pay the highest prices in the world for drugs that we help to be developed,” Clinton said. “We have to go after price gouging and monopolistic practices and get Medicare the authority to negotiate.”

But Clinton never did answer the question about whether the cap on expenses would backfire on consumers. That’s a question she’s likely to face again during the campaign, because some critics think her drug-costs cap would be a boon to the pharmaceutical industry by eliminating pressure from consumers to hold down prices or negotiate discounts.


If that happens, the critics believe, drug companies could charge whatever they want and health insurance companies would have to cover the costs – but then they would pass on those costs to consumers in the form of higher premiums.

The exchange was one of the highlights of the health care discussions during the debate. Later, Sen. Bernie Sanders of Vermont reiterated his calls for a single-payer health care system and made the sharpest jabs at the industry.

One of his zingers: “Now what we have to take on is the pharmaceutical industry that is ripping off the American people every single day.”