Senate finance chairman Ron Wyden (D-Ore.) Said he hoped Democrats could still find a way to address the rising cost of prescription drugs, but acknowledged industry power to prevent even modest change.
“Pharma is everywhere,” he told reporters on Thursday. “You have more lobbyists than anyone else.”
The Pharmaceutical Research and Manufacturers of America (PhRMA) spent more than any other health group to shape the legislative package. But other deeply rooted players – from the country’s largest insurance companies to dental offices – are poised to claim significant victories while avoiding threats to their profits.
Congress stands ready to extend federal subsidies for the purchase of Obamacare covers until 2025, a provision preferred by large insurers who sell plans in the individual market. The Democrats will also subsidize private health insurance for about two million low-income people in states that refused to expand Medicaid instead of creating a new Medicaid-like program Another boon for health insurers and medical providers who make far more money in the private insurance market than they do with Medicaid. The Democratic promise to provide dental insurance to all seniors at Medicare was also thwarted after insurance companies and the dental industry opposed it.
Progressives on Capitol Hill say they plan to further reduce the influence of the industry, especially on the drug price front.
“The challenge we face at this truly unusual moment in American history is whether we have the courage to stand by the American people and take on very powerful special interests,” said the Senate Chairman of the Budget, Bernie Sanders, told reporters on Wednesday night. “When we fail, when the American people don’t believe the government can work for them and are dominated by powerful special interests, the very fabric of American democracy is in jeopardy.”
The healthcare industry is not monolithic, and several provisions under consideration have pitted insurers, pharmaceutical companies and medical providers against each other. But lawmakers, staff, lobbyists, and attorneys all confirmed that the industry has shifted a number of policies in their favor, so some Democrats have to worry that they’ve missed their last and best chance to tackle drug prices before a mid-term election, the power could return to them Republicans.
“It is honestly unscrupulous at the moment, after all these years and with the popularity of this topic, that we did not manage to do this,” said MEP Susan Wild (D-Penn.) On Thursday to POLITICO.
Wild added that she would not settle for a watered-down version that allowed the government to negotiate prices for a much smaller number of drugs.
“I don’t care about crumbs,” she said. “The danger of making a half-assed version is that people suddenly think, ‘Oh, we have something with prescription drugs, so we’re not going to do anything else.'”
The recent attempt by the Democrats to allow Medicare to negotiate prices for certain expensive drugs has been the biggest threat to industry profits in decades. In response, drug lobbyists spent millions on advertisements and inundated legislators with campaign money – especially on middle-class Democrats who are most likely to defy the party line, such as Sens. Kyrsten Sinema (D-Ariz.) And Bob Menendez (DN.J .) and Rep. Scott Peters (D-California).
The tight margins of the Democrats in each chamber meant that the powerful drug companies only had to pull a few members out to halt reforms.
“The moderates and progressives gap has been helpful in breaking the drug price title because any kind of moderate shift or reasonable change you proposed could win some moderates but you would lose some progressives,” said a healthcare provider lobbyist who asked for anonymity in order to speak freely during delicate negotiations.
The pharmaceutical industry, corporate groups, conservative advocacy groups, and a union have spent more than $ 30 million advertising against Congressional drug price proposals since summer, according to POLITICO-screened nonprofit patients for affordable drugs and AdAnalytics data. Many of these ads ran nationwide, while some targeted Democrats in swing districts like Wild, who are facing difficult re-election campaigns in 2022.
“Many of us frontliners have all kinds of commercials going on in our district, scare tactics, trying to convince seniors and others in need of drugs that the government will somehow decide what drugs to take if we can manage that, or that they will not have access to their drugs because there will be no innovations, “Wild told reporters on Wednesday.
In advertisements and conversations with lawmakers, the pharmaceutical industry cited its work on developing coronavirus vaccines and therapeutics, arguing that compromising the bottom line could reduce R&D investment and jeopardize the long-term fight against the disease.
Although the industry is now on the cusp of a legislative victory, progressives like Wyden still insist that drug price reform is part of the final package. A pharma lobbyist said they were simply “waiting for the next shoe” – pointing to the possibility that Democrats could look for other ways to cut drug costs – while PhRMA downplayed the importance of Biden’s proposed deal.
“This is a framework,” said Brian Newell, a PhRMA spokesperson. “This year we are ready to work with policymakers to pass meaningful reforms that will cut drug costs out of pocket for patients.”
Other health groups that could benefit from it were more eager on Thursday to tout the setting as a clear victory.
The Blue Cross Blue Shield Association said it was “satisfied” with the Democratic bill. The Partnership for the Future of Healthcare in America – which has fought Medicare for All and other advanced health proposals on behalf of hospitals, insurers and pharmaceutical companies, also praised the bill, saying it “focuses on building on the current system rather than starting over with new, unaffordable health systems. ”
The American Hospital Association and the Federation of American Hospitals, both of which have pushed for the Affordable Care Act subsidies and the solution of the Medicaid loophole, also cheered the result.
“It’s better to be in the movie than on the cutting room floor,” said Chip Kahn, director of the Federation of American Hospitals. “We like what we do in the [framework] in terms of coverage and we’ll stick with it ‘to make sure the supplies stay in.
The elimination of drug price controls could also give the GOP fodder for next year’s elections, said Joe Grogan, a former senior domestic policy adviser to President Donald Trump and a drug lobbyist who was an influential figure on the issue during the previous administration.
“It’s right there, like a giant meatball in front of you, to say, ‘Look, the president’s campaign, the president’s governance, has failed to deliver on its election promises on a whole range of issues,'” he said. “I think it’s another broken promise.”