Dems fear Sinema's still not there on a prescription drug plan

In particular, Peters said, Senator Kyrsten Sinema (D-Ariz.) Has not deviated from her stance almost a month ago, which opposes the current drug price reforms that are under discussion.

“Senator Sinema is not yet in favor of a proposal on how to deal with prescription drugs,” he said in an interview this week. “And I’m trying to get them to get in my way because I honestly think it would be just good to end this problem.”

Sinema spokesman John LaBombard dismissed Peters ‘characterization of the Senators’ position, saying Sinema “is carefully considering various proposals on the matter” in its “direct negotiations” on the $ 3.5 trillion package. Sinema generally supports the idea of Lowering drug prices but has refused to say which proposals, if any, she would support.

Nonetheless, the inability to reach consensus on prescription drug prices is just one of many hurdles Democrats face as they struggle to meet their new October 31 deadline. Although a number of other Democrats have been known to be reluctant to back up drug pricing, Sinema’s support in the 50-50 Senate is imperative. To achieve a breakthrough, Biden’s team is increasingly involved in shaping the talks as they decide how many programs to cut and which to remove entirely from the plan.

For months, the White House had largely submitted to the leaders on Capitol Hill to iron out differences over central prescription drug policy. However, in recent weeks it has been actively reaching out to moderates in the House and Senate to push for their support and has highlighted the importance of drug prices in meetings with lawmakers. Peters said the White House has been more directly involved with drug pricing lately and that “we understand where we are better”.

White House officials have also noted the unlikely agreement between Sens. Bernie Sanders (I-Vt.) And Joe Manchin (DW.Va.) to allow Medicare to negotiate drug prices and consider the provision to be one of many major priorities in the package, according to a source familiar with the management mindset. Lowering the cost of prescription drugs is one of the most popular elements of Biden’s plan, and many Democrats see it as key to their success in mid-2022 and beyond. This is especially true as previous commitments to bring Medicare down the age and create a public insurance option have been pushed aside.

Many lawmakers, including Peters, are confident that they can still strike a balance between the progressive-favored comprehensive HR.3 bill that would enable Medicare to negotiate directly with drug companies, and the version adopted by the centrists of the House of Representatives and would negotiate lower prices for a much narrower range of drugs. Members argue that a watered-down law on drug negotiations could be the best they can hope for, given the tight voting margins of Democrats and the onslaught of opposition from the pharmaceutical industry.

“There will still be some [drugs] that’s going to stay at the higher price, but that’s how the compromise is worked out, “said Susan Wild (D-Penn.) MP, a frontline member active in the talks on the directive. “I’ll agree if that’s what we need to get it through. But I still shudder to think that Americans would ever pay more than other countries for an identical drug. I think that’s just outrageous. “

House progressive, outside advocacy groups and Sanders are still pushing for the most aggressive version of the bill, blaming those who oppose it with shilling for the pharmaceutical industry. People in this camp say they fear that a narrower, more moderate prescription drug bill will not deliver the federal savings needed to pay for the party’s plans to expand Medicare, Medicaid, and Obamacare, and that it will keep the promises of the Failure to comply with election campaigns can lower health costs for patients.

Although behind the scenes negotiations continue, lawmakers in both camps say they lack clarity as to where the other stands.

“I heard that [Sen. Sinema] opposes Medicare negotiating prescription drug prices, ”Sanders told reporters Thursday, lamenting that he had not heard directly from her what she was ready to vote for. “I have heard that. Maybe I’m wrong. ”

Sen. Bob Menendez (DN.J.), a major stranger to drug pricing who previously criticized his colleagues for using the pharmaceutical industry as a “piggy bank” for other priorities, is also frustrated with the lack of detail.

“Discussions and actually receiving a proposal are two different things,” he said. “Show me a suggestion and I’ll tell you how I feel.”

Members of Congress and outside supporters said the recent showdowns in raising the debt ceiling and passing a provisional spending bill had distracted them and devoured valuable time they could have spent working on drug pricing and other parts of the reconciliation bill.

And since there are only a few weeks left to an agreement, the list of open questions about the draft law remains long. How many and which drugs are being negotiated? Will the government use an international or national yardstick for these negotiations and how will it penalize drug companies that refuse to comply? How much can the government reclaim from companies that raise prices faster than inflation?

Another major catch in the bill is whether Democrats can and should apply Medicare-negotiated rates outside of Medicare to benefit people who get their insurance through work or in the individual market.

Many lawmakers and outside advocates say the Senate MP is likely to turn down an attempt to extend the lower rates to private insurance plans, though her office has not yet formally ruled the issue. Some are already arguing that losing broader politics is an acceptable sacrifice.

“History shows that changes made to Medicare almost always move into the private sector,” Senate Finance Chairman Ron Wyden (D-Ore.) Recently told reporters. “Because Medicare is the flagship of the federal program, and when the private sector finds out about it [the lower drug prices], they will insist. “

Above all of the prescription drug policy debate hangs the prospect of failure and what that would mean for both the Democratic Party and the larger bill itself. Some in the party fear it could spark serious backlash if, for example, it promises to cut drug prices across the board but leaves out the majority of the country on private insurance.

“I don’t think telling voters, ‘Sorry, you are too young to have access to affordable prescriptions’ will be very popular,” a lawyer familiar with the negotiations told POLITICO.

Sanders agreed, saying POLITICO Democrats should still fight for the inclusion of politics, even if there is a risk that it will be eliminated by the MP instead of taking it out preventively.

The Democrats also warn that if lawmakers cut prescription drug policies too far, they will be forced to make additional, painful sacrifices elsewhere.

“HR.3 has achieved a certain turnover”, Rep. Peter Welch (D-Vt.). “What if this turnover suddenly halves? It’s going to have a really negative impact on our health care capabilities, and members are going to get upset about it. There are side reactions for every action. “

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