- The Washington Times - Wednesday, December 11, 2019

House Democrats teed up a Thursday vote on their contentious drug-pricing bill by appealing to Republicans’ loyalty to President Trump, saying the effort echoes his 2016 rhetoric on government negotiation and his push to align prices with other countries’.

House Speaker Nancy Pelosi and her troops plan to approve the bill as part of a flurry of end-of-year action, hoping it will serve as an aggressive marker for the 2020 campaign and prove that Democrats can pass an agenda while pursuing impeachment.

The bill would require the federal government to negotiate down maximum prices for insulin and dozens of single-source, brand-name drugs that are among the priciest covered by Medicare. The negotiated price would not be allowed to exceed 120% of the average price of Australia, Canada, France, Germany, Japan and the United Kingdom.

House Republicans have rejected the bill and offered competing measures. Yet Democrats say Mr. Trump should be on their side, saying he promised to “negotiate like crazy” during his first campaign and often fumes about a mismatch between what U.S. consumers pay and the rest of the developed world.

“There is every reason in the world for Republicans to join us to pass this bill. Even the president has supported its key provisions,” Mrs. Pelosi said. “On Medicare negotiations, he said, ’When it comes time to negotiate the cost of drugs, we are going to negotiate like crazy.’ I hope so. And, on international benchmarking, saying, ’It’s unacceptable that Americans pay vastly more than people in other countries for the exact same drugs, often made in the exact same place.’”

But the White House and its allies say the House measure is too extreme. They argue the bill’s massive penalties on drugmakers that refuse to negotiate would kneecap the industry and limit options for Americans.

“This bill, H.R. 3, runs the risk of quickly stifling innovation in the new-drug space,” said Rep. Michael Burgess, Texas Republican.

Lawmakers don’t expect the bill to see daylight in the Republican-led Senate, which is debating a bipartisan bill that would force drug makers to reimburse Medicare if prices rise much faster than inflation.

Mr. Trump has endorsed that bill, saying it’s a reasonable compromise and would help seniors.

It’s not clear if and when it will get a floor vote, however, because the inflation cap is splitting the Senate GOP conference.

Congress’ best hope for a resolution may be a bill negotiated by a conference of both chambers, although the House bill recently moved to the left.

The Congressional Progressive Caucus said it got Mrs. Pelosi to agree to increase the minimum number of drugs subject to negotiation from 25 to 50, starting in the second year of implementation. It was one of several concessions the group demanded as leaders pushed for a strong vote on the bill named for the late Rep. Elijah E. Cummings, Maryland Democrat.

“While we didn’t get everything we wanted, the changes we have negotiated over the past few months will bring relief to millions of American who would otherwise have been left out of this landmark legislation,” said the caucus’ co-chairmen, Reps. Pramila Jayapal of Washington and Mark Pocan of Wisconsin.

Democratic leaders showcased the final product Wednesday by highlighting the alarming number of people who cannot afford prescribed medicines.

“People cutting pills in half, people not taking their medication,” Mrs. Pelosi said. “Many times fathers are saying, ’I can’t help my child.’”

Yet direct negotiation has been a step too far for the president. Instead, he has tried to clear the backlog of generic-drug applications to spur competition, while using the bully pulpit to make drug makers think twice about raising prices. He also has floated a regulation that would allow states to import drugs from Canada.

Democrats argue the bill is of the same spirit as Mr. Trump’s proposed International Pricing Index (IPI), which would align prices for doctor-administered drugs under Medicare Part B to what other developed nations pay.

“Americans are being ripped off. The status quo is simply not acceptable,” said House Energy and Commerce Committee Chairman Frank Pallone of New Jersey. “By paying so much more here, we’re subsidizing what goes on in other countries.”

Republicans are unlikely to be persuaded by that argument. Some of them are skittish about Mr. Trump’s pricing index, and the administration says its version is a limited approach that lowers Part B prices from levels that are inflexible and unfair.

• Tom Howell Jr. can be reached at thowell@washingtontimes.com.

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