Democrats reach deal on Medicare prescription drug prices in social spending bill

WASHINGTON — Hoping to show progress on a 15-year-old campaign promise, Democrats say they have reached an agreement to allow Medicare to negotiate prices on a limited number of prescription drugs as part of their social spending and climate plan.

Medicare drug price negotiation was one of the final unresolved issues on the $1.85 trillion bill, which Democrats hope to finish writing as soon as Tuesday.

Other policy issues still subject to negotiation include climate and immigration.

The drug-price proposal was left out of a framework released last week by the White House, and some Democrats had been fighting to find a way to include a modified version.

Senate Majority Leader Charles E. Schumer, D-N.Y., said Tuesday that a deal had been reached and that a key holdout, Sen. Kyrsten Sinema, D-ariz., supported the plan. “This deal will directly reduce out-of-pocket drug spending for millions of patients every time they visit the pharmacy or doctor,” Schumer said.

Like the social spending bill on the whole, the revised Medicare negotiation plan would be dramatically more limited in scope than what many progressive Democrats had hoped for.

The plan is expected to allow Medicare to negotiate prescription drug prices in certain situations, including for drugs that are no longer under “exclusivity,” or protected from competition while they are still new to the market, according to lawmakers and aides.

Insulin would also be subject to negotiation, a move that is likely to be politically popular because of recent and dramatic increases in the price of the widely used drug. Seniors would also benefit from a new $2,000 cap on out-ofpocket drug costs, Schumer said.

The plan is expected to include a cap on price increases. If a drug’s price rises faster than inflation, its manufacturer would have to pay a rebate, a tool that policymakers say will serve as an incentive for the pharmaceutical industry to keep prices low. The rebate requirement would apply in Medicare and in commercial insurance plans, meaning the policy will apply to millions of Americans.

Negotiations have been underway since late last week between the White House and a handful of lawmakers who opposed the House’s original, expansive drug negotiation plan, including Sinema and Rep. Scott Peters, D-calif. Those lawmakers said they were worried policy would stifle drug innovation.