WASHINGTON — President Trump on Tuesday left Congress a two-syllable mandate on the issue of prescription drug pricing: “Do more.” To some Democrats, the words presented an open invitation to collaborate. Others were left confused as to what, exactly, the White House wants.
In interviews following Trump’s second State of the Union address, the divide among Trump’s opposition party was apparent — between lawmakers prepared to cross partisan lines, those entirely opposed to Trump’s approach, and others waiting for more detailed direction.
“They’ve been calling me and asking me the numbers of my bills,” Richard Durbin (Ill.), the Senate’s second-ranking Democrat who has introduced a slew of drug pricing bills, including requiring drug makers to disclose their prices in television ads and cutting drug makers’ exclusivity when they hike their prices, told STAT. “I’m very pleased with his approach.”
Others dismissed many of the president’s policy ideas outright — including his signature proposal to cap U.S. drug payments based on prices paid abroad.
“He is still pursuing the phony approach that if we raise prices on people in foreign lands, somehow prices will go down here,” said Rep. Lloyd Doggett (D-Texas).
The fate of Trump’s drug-pricing agenda is increasingly tied to whether he can get Democrats to support some of his ideas. While the administration has largely pursued reforms that can be done without the help of Congress, it has recently called for legislation to shore up Trump’s more sweeping ideas.
While Democrats differed on how substantive the president’s policy requests truly were, most acknowledged he had taken the correct tone about reining in drug costs and the industry as a whole.
“He said the right things on us getting ripped off by Big Pharma,” Rep. Peter Welch (D-Vt.), a member of House Energy and Commerce Committee and one of Washington’s most outspoken Democrats on the issue of high drug prices.
Others, like Rep. Raja Krishnamoorthi (D-Ill.), criticized the president for a lack of detail.
“I liked the sentiments,” he said, “but the specifics were few and far between.”
“He didn’t go into any detail,” said Sen. Jeff Merkley (D-Ore.). “So far it’s been all hat, no cattle.”
Others still — including Doggett, the author of the most aggressive drug-pricing bills currently before Congress — dismissed many of Trump’s proposals outright.
Doggett even appeared to swipe at Trump’s health secretary, the former Eli Lilly executive Alex Azar, making reference to “appointees that were out gouging people with these high prices only months before [Trump] appointed them.”
A version of the international pricing model that Doggett vocally opposed, however, already has support from Democrats — and one of the president’s most vocal critics, to boot: Sen. Bernie Sanders (I-Vt.).
Reference-pricing legislation, said Rep. Peter Welch (D-Vt.), would “pass with or without a majority of the Republicans.”
“With the president’s advocacy,” Welch added, “a lot of Republicans would side with their constituents and not with pharma.”
While Trump’s speech was light on actual legislative proposals, the administration has been increasingly focused on winning congressional support for parts of its drug pricing plan. Azar met with a number of Senate Republicans last month to outline that agenda, and he has made multiple public pleas in recent days for Congress to pass legislation on the administration’s newest idea of banning drug rebates in the Medicare and Medicaid programs.
A fact sheet released by the White House during the speech also called on Congress to place a cap on the amount Medicare beneficiaries can spend on drugs, a proposal that has not come up previously from the Trump administration.