Drug price rules weakened in bill as debate begins

WASHINGTON — The Senate parliamentarian on Saturday dealt a blow to Democrats’ plan for curbing drug prices but left the rest of their sprawling economic bill largely intact as party leaders prepared for first votes on a package containing many of President Biden’s top domestic goals.

Elizabeth MacDonough, the chamber’s nonpartisan rules arbiter, said lawmakers must remove language imposing hefty penalties on drugmakers that boost their prices beyond inflation in the private insurance market. Those were the bill’s chief pricing protections for the roughly 180 million people whose health coverage comes from private insurance, either through work or bought on their own.

Other major provisions were left intact, including giving Medicare the power to negotiate what it pays for pharmaceuticals for its 64 million elderly recipients, a longtime goal for Democrats. Penalties on manufacturers for exceeding inflation would apply to drugs sold to Medicare, and there is a $2,000 annual out-of-pocket cap on drug costs and free vaccines for Medicare beneficiaries.

Her rulings came as Democrats planned to begin Senate votes Saturday on their wideranging package addressing climate change, energy, health care costs, taxes and deficit reduction. Party leaders have said they believe they have the unity they will need to move the legislation through the 50-50 Senate, with Vice President Kamala Harris’ tiebreaking vote and over solid Republican opposition.

“This is a major win for the American people,” said Senate Majority Leader Chuck Schumer, D-N.Y. “And a sad commentary on the Republican Party, as they actively fight provisions that lower costs for the American family.” Schumer said MacDonough’s decision about the price cap for private insurance was “one unfortunate ruling.” But he said the overall bill “remains largely intact.”

The ruling followed a 10-day period that saw Democrats resurrect top components of Biden’s agenda that had seemed dead. In rapid-fire deals with Democrats’ two most unpredictable senators — first conservative Joe Manchin of West Virginia, then Arizona centrist Kyrsten Sinema — Schumer pieced together a broad package that, while a fraction of earlier, larger versions that Manchin derailed, would give the party an achievement against the backdrop of this fall’s congressional elections.

J. Scott Applewhite / Associated Press Sen. Joe Manchin, D-W.Va., briefs reporters Monday. He played a central role in negotiations over the plan that addresses climate change, energy, health care costs and deficit reduction.