Pelosi unveils plan to curb drug prices

Proposal to let government negotiate costs draws disapproval of Republicans

WASHINGTON — House Speaker Nancy Pelosi on Thursday released her long-awaited plan to curb soaring prices of prescription drugs, hoping to prod the Senate to move and heat up congressional negotiations with the White House on a popular but elusive goal.

Pelosi’s plan, which she laid out at a morning news conference, would allow the government to negotiate the price of insulin and as many as 250 name-brand drugs each year for Medicare beneficiaries — an idea that many Republicans are against but that President Donald Trump embraced during his 2016 campaign. Drug companies also would have to offer agreed-on prices to private insurers or face harsh penalties, which could give the package broader appeal with voters.

The hit to noncompliant companies would be even stiffer than the penalty in a draft of her plan that circulated last week. The penalty extracted from a company unwilling to comply would be equal to 65% of the previous year’s sales of the drug in question, but would gradually increase by 10 percentage points every quarter that the company refused to offer the government’s price, to a maximum of 95%. Pelosi said that the House Energy and Commerce Committee would hold the first hearing on the bill Wednesday and that she hoped the committees of jurisdiction would begin drafting final legislation next month.

But even as Pelosi introduced the bill, Republicans on that committee indicated they had no intention of getting behind it. In a statement, all 24 accused Pelosi of “pushing a socialist proposal to appease her most extreme members.”

“It does not have to be this way,” Republican members, led by Rep. Greg Walden of Oregon, said. “There are bipartisan solutions to bring down prices for patients and create real transparency and accountability for this system.”

The bill’s main competition for now is a bipartisan but embattled drug-pricing package from leaders of the Senate Finance Committee, Sens. Charles Grassley, R-Iowa, and Ron Wyden, D-Ore., who are lobbying fiercely to build support for it.

Most notably, the bill would require drug companies to pay rebates to Medicare if they raised prices faster than inflation, and it would cap outof-pocket drug costs for Medicare beneficiaries, proposals that are also in the Pelosi bill. Most Republicans on the committee voted against it, saying it smacked of government price fixing. But Grassley has been working hard to win more support, using Pelosi’s bill as a cudgel as he warns that the speaker’s proposals could succeed if his fail.

The speaker also could prompt the president to act. He has made drug prices a major theme of his re-election campaign but has not scored an accomplishment to take on the trail next year. The question now is whether Trump will get behind the Finance Committee bill, stepping up pressure on Sen. Mitch McConnell, the majority leader, or possibly even side with Pelosi, whose bill includes a version of an idea he really likes: to base the price Americans would pay for some drugs on the lower prices paid in other countries.

“Hopefully we can come to some agreement about what is best for the American people,” Pelosi said at the news conference at the Capitol, flanked by Reps. Richard Neal of Massachusetts, the Ways and Means Committee chairman, and Frank Pallone of New Jersey, the Energy and Commerce chairman. “My conversations with the president have been about making this a priority; I believe he considers it one, and so we can work together.”

There was no immediate response from the White House, but last week, a spokesman said that Trump “welcomes the speaker’s ideas to help build bipartisan, bicameral consensus for the American people.”

Pelosi would first have to bring both liberals and centrists in her caucus on board; she has already worked to win liberals by dropping an initial proposal that would have let the Government Accountability Office, an independent investigative arm of Congress, decide a drug’s price if the government and manufacturer could not agree.