WASHINGTON — Two top Democratic lawmakers are questioning Speaker Nancy Pelosi’s strategy to couple legislation to lower prescription drug costs with far more contentious Obamacare bills, saying the tactic nixes potential for a bipartisan win.
Democratic leadership plans to hold a floor vote Thursday on the combined package of health care bills — effectively rebuking the Trump administration for its attempts to roll back the Affordable Care Act and simultaneously daring Republicans to vote against drug pricing reforms that are increasingly popular.
Republican lawmakers vowed to oppose the package, despite their support for the drug pricing legislation. The Trump administration threatened a veto. And in a rare criticism of leadership, even some Democrats openly lamented the strategy to couple the health issues together.
“I’m not a fan of what happened,” said Rep. Anna Eshoo (D-Calif.), a longtime Pelosi ally whose House subcommittee oversees most health legislation, though she acknowledged that “one has to pay for the other.”
Rep. Peter Welch (D-Vt.), in a brief interview, said that packaging the bills together — even to assuage cost concerns — was a lost opportunity for bipartisan consensus.
“We did this without a food fight in the committee, but now by packaging it together with the ACA, it creates another issue,” he said. “So my preference would be to do them separately and take advantage of the bipartisan support.”
In a subsequent phone call to STAT, Welch attempted to clarify his remarks. He said he was not questioning party leadership’s strategy — merely describing his own view of the ideal outcome.
The controversy, lawmakers and aides conceded, calls into question whether the Democratic Caucus is unified in its approach to lowering drug costs — and whether it can marshal the widespread political momentum on drug prices into actual legislative action. In particular, the quick descent into partisan politics on a seemingly bipartisan issue could bode poorly for a more aggressive drug-pricing package said to be in the works between Pelosi’s office and the White House.
Democrats have labored since February to advance the drug pricing legislation through the formal committee process. The policies they incorporated into the package — none of which is seen as especially controversial or sweeping — include the long-stalled CREATES Act and another bill to prohibit “pay-for-delay” practices. Both measures aim to bring generic drugs to market faster in hopes the competition will lower drug prices.
“I took the bills up as individual, free-standing bills — I’m not a fan of big packages — and was able to develop bipartisan support, which I think is a real compliment to the legislators,” Eshoo said of the process up until this point, which played out largely in her committee.
But Democratic leadership, including Pelosi and House Majority Leader Steny Hoyer (D-Md.), decided this week to pair the bills together with another set of policies aimed at shoring up the ACA. Those bills would ban so-called “junk insurance” plans and restore funding for efforts to market the ACA and help Americans buy insurance through its marketplaces.
Hoyer, speaking to reporters on Wednesday, said that forcing Republicans to vote on the insurance protections alongside the drug-pricing bills was a response to the GOP’s ongoing attempts to roll back the Affordable Care Act.
Aides also cast the difficult vote as penance for the eight years in which a GOP-controlled House insistently voted to repeal the Affordable Care Act and otherwise derail the agenda of former president Barack Obama. The Trump administration, too, is actively supporting a lawsuit to overturn the ACA and has used its administrative powers to make it easier to sidestep the highly regulated insurance markets the law created.
“We have packaged these bills because we think they are all part and parcel of what we pledged to the American people: bringing down prices and making health care available at a level that they need to protect themselves and their families,” Hoyer said. “I regret that the administration continues to try to undermine the ACA.”
Other Democrats emphasized the advantages of pairing the drug pricing bills, which will save the federal government money, with the ACA-related bills. By enrolling millions more Americans in the federal program, those provisions could cost the government billions of dollars over the next decade.
Republicans, too, have expressed frustration that once-bipartisan drug pricing measures had devolved into fights surrounding the Affordable Care Act.
The Trump administration on Tuesday made its position on the bill public: it supports the drug-pricing provisions, but would veto any package that contains the legislation rolling back its actions on health insurance.
“They could have a unanimous vote on the drug bills and we could get them down to the president’s desk,” Rep. Greg Walden (Ore.), the Energy and Commerce Committee’s top Republican, told reporters last week. “Why they’ve chosen to pull these two together is beyond me. It’s unfortunate. It’s unnecessary and I wish they wouldn’t do it.”
Rep. Mark Meadows (N.C.), a Republican who chairs the hard-right House Freedom Caucus, called the Democratic strategy “a wasted opportunity.”
“You’ve got the chairman of the Freedom Caucus willing to work with Democrats on making real, structural reforms on prescription drug prices,” he told STAT. “And what do they do? They put a poison pill in, trying to augment a failing health care-delivery system.”
Rep. Buddy Carter (R-Ga.), said at an event Wednesday that he would vote against the measure even though it contains a bill he co-authored — a measure to start the clock more quickly on the six-month exclusivity period awarded to a first-time generic drug approval.
Nicholas Florko contributed reporting.