WASHINGTON — Rep. Francis Rooney doesn’t sit on any of the congressional committees that deal with health care policy. His last government job was a stint as U.S. ambassador to the Holy See. In politics, he is best known as a Republican Party megadonor, the product of a lucrative career as a finance and construction executive.
But suddenly, he’s an unlikely leading man in an increasingly noisy health policy fight over drug prices.
The second-term congressman from Florida is the only Republican co-sponsor on a bill to allow Medicare for negotiate prices, traditionally a nonstarter for the GOP. Last Congress, he was one of two Republicans on another aggressive bill to police drug price increases. Rooney even introduced a bill mirroring a Sen. Bernie Sanders (I-Vt.) proposal that would cap U.S. drug payments based on prices paid overseas.
Nearly every other drug-pricing bill was either fully bipartisan — or backed exclusively by Democrats.
“I am really excited that Speaker Pelosi has picked [drug pricing] up so strongly,” Rooney told STAT in an interview, “and that people of all ideologies and parties are realizing that pharma … gives more money to politicians than any other special interest.”
Rooney’s eyebrow-raising enthusiasm for part of Nancy Pelosi’s legislative agenda is rare for a Republican. And so is his willingness to take on the drug industry and, in some cases, buck Republican orthodoxy on the issue — all stances that come as the Trump administration and newly empowered congressional Democrats are increasingly eyeing drug pricing policy as one of only a handful of opportunities for consensus.
It’s not clear, however, whether Rooney is the first among many Republicans who will break ranks to back previously far-fetched drug industry reforms — or whether he’ll remain a rare voice within a sea of GOP lawmakers unwilling to embrace an ideology long espoused by Democrats.
His Democratic co-sponsors, at least, say his support instantly lends a measure of credibility to bills that could otherwise be seen as partisan noisemaking.
“What’s different here is that in the last session, Paul Ryan would not allow any bill on the floor that was going to upset pharma,” said Rep. Peter Welch (D-Vt.) said. “We just couldn’t have the debate.”
Now, Welch told STAT, Rooney is “making it acceptable to stand up to Big Pharma.”
Rooney, at least for now, remains a mystery to the usual suspects who toil on drug pricing policy and analysis in Washington. Several lobbyists, when surveyed about Rooney’s work on pharmaceutical issues, asked to be reminded who he was.
Before he came to Capitol Hill in 2017, Rooney was a successful executive both at his financial firm, Rooney Holdings, Inc., and a construction firm that has built multiple NFL stadiums. His overseas posts have carried him from central Europe to Central America — in the mid-2000s, Rooney served as U.S. ambassador to the Vatican, and he has held a board position for the Panama Canal Authority.
Rooney’s district itself may offer more clues to his interest in drug pricing. The median age in Rooney’s Gulf Coast Florida district is above 51, and nearly one-third of the district’s residents are 65 year or older — the age of Medicare eligibility. Rooney’s legislation to force Medicare negotiation, in particular, could have a major impact on the people who elected him.
To Rooney, it’s also a matter of fairness.
“I have to compete in all my businesses,” he said. “I don’t understand why they don’t.”
But as the only Republican to support Medicare negotiation, and one of two Republicans to support an effort to force drug companies to publicly justify some price increases, Rooney has strayed far from typical GOP stances on drug-pricing.
This time around, Rooney has jumped into the fray early. Just weeks into the new Congress, he and Welch introduced a new bill that would allow Medicare to directly negotiate drug prices with manufacturers. The duo isn’t stopping at legislation, demanding scrutiny of the drug industry mega-merger between Celgene and Bristol Myers-Squibb. And Rooney is celebrating the fact that accepting campaign contributions from major drug companies carries more stigma than ever. (He takes next to none.)
“I didn’t take this job to do a bunch of messaging and posturing and deceitful politics,” he said. “Most things work better when there’s a Democrat and a Republican on the masthead.”
This Congress, he is vocally questioning Republican orthodoxy. In his conversation with STAT, he challenged Sen. Chuck Grassley (R-Iowa) to consider bills that would allow for Medicare negotiation — and fondly recalled that Medicare negotiation was once a plank in President Trump’s successful White House bid. Regarding health secretary Alex Azar, a former pharmaceutical executive, he also expressed cautious optimism — but used the analogy of a “cat in the henhouse.”
Rooney is actively educating and recruiting other Republican lawmakers to support the legislation with Welch, he told STAT. But whether he has the sway to push the Republican conference remains unclear: Rooney does not sit on the Ways and Means or Energy and Commerce committees, giving him little few opportunities to directly sway health care legislation.
In fact, a bill Rooney introduced last year with Welch’s support was referred to both committees, which were Republican-controlled at the time. His bill, which would have mandated a study of using an international price index to cap Medicare drug reimbursement rates, never received a hearing. The Trump administration, just weeks after Rooney’s bill, introduced a similar proposal that the pharmaceutical industry has fiercely resisted.
Republicans on Capitol Hill have remained largely silent on that Trump administration proposal, which is also similar to a bill introduced by Sanders.
Rooney’s voice is also being amplified by the outside group Patients for Affordable Drugs — a political group backed by the billionaire couple John and Laura Arnold — whose political arm spent $10 million to highlight drug pricing as a 2018 campaign issue.
In a decidedly Republican district, Rooney may not have needed P4AD’s six-figure external ad buy. But his vocal stances caught the attention of David Mitchell, the group’s founder and a longtime political messaging strategist for the left-leaning firm GMMB.
Rooney “has the courage to stand up to Big Pharma,” according to Mitchell, who also cited Grassley and Sen. Bill Cassidy (R-La.) as Republicans willing to shrug off the drug industry’s protests.
“I’d say Francis Rooney is among a growing group of Republicans ready to act to help Americans get a better deal on prescription drugs,” Mitchell said.
In a divided Congress, and in a Washington climate in which drug companies and pharmacy benefit managers are alternately resisting proposals aimed at lowering drug prices, Rooney acknowledged that his legislation with Welch faces a steep climb.
But, he insists, considering that legislation to be dead on arrival in a GOP-controlled Senate is premature.
“My goal is to accomplish something that’s important,” Rooney said, “regardless of who you have to run over.”