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House panels advance Pelosi drug pricing bill after GOP amendment marathon

Two House panels advanced Speaker Nancy Pelosi's legislative package aimed at lowering prescription drug prices to the chamber's floor for consideration — a bill Senate Majority Leader Mitch McConnell, R-Ky., said is dead on arrival on his side of the Capitol.

Pelosi is aiming to bring the bill, the Lower Drug Costs Now Act of 2019 (H.R. 3), to the House floor for a vote the last week of October.

SNL ImageHouse Speaker Nancy Pelosi, D-Calif., flanked by Energy and Commerce Committee Chairman Frank Pallone, D-N.J., and Education and Labor Committee Chairman Bobby Scott, D-Va.
Source: AP Photo

During an Oct. 17 news conference, Pelosi revealed that she plans to rename the bill for Rep. Elijah Cummings, chairman of the House Oversight and Reform Committee, who died early that morning from complications associated with longstanding health issues.

"So appropriate because Elijah was a fighter for lowering the cost of prescription drugs, reaching across the aisle to do so," Pelosi said.

At a 10-hour markup session, the House Energy and Commerce Committee voted 30 to 22 in favor of H.R 3, which would give the federal government the power to negotiate the prices of the most expensive prescription drugs on behalf of the Medicare program and the commercial insurance market.

Earlier in the day, the House Education and Labor Committee voted 27 to 21 to advance the bill.

The Ways and Means Committee, which held a hearing on Oct. 17 on the legislation, plans to hold its own markup session next week.

The legislation would allow the federal government to set a maximum price on as many as 250 drugs that lack competition in the U.S., with Medicare beneficiaries paying no more than $2,000 out of pocket each year for their medicines.

Under the bill, the government would rely on prices set by foreign nations to gauge what the U.S. would pay for its medicines — a provision that mirrors a pending proposal from the Trump administration.

Republicans on the Energy and Commerce Committee tried to strike down the foreign reference pricing measures in H.R. 3 by offering an amendment.

"I oppose international price indexing no matter who proposes it," said Rep. Larry Bucshon, R-Ind., the sponsor of the amendment.

Reference pricing is a form of price controls that would damage innovation and limit access to new treatments, Bucshon said.

He cited the Oct. 11 preliminary estimates on the Pelosi bill from the Congressional Budget Office, which said enactment of the legislation would result in a drop in drug industry revenues of up to $1 trillion over the next 10 years, possibly leading to a reduction of eight to 15 new medicines coming to market.

Democrats on the committee, however, were quick to point out that the CBO also found that implementing H.R. 3 would save the Medicare program $345 billion between 2023 and 2029. Premiums for beneficiaries in the Medicare Part D prescription drug program would also be lower if the bill became law, according to the CBO.

Hundreds of amendments

Republicans on the Energy and Commerce Committee had threatened to offer hundreds of amendments to slow down the Pelosi bill — posting photos and videos of boxes filled with documents headed to the hearing room — though the GOP lawmakers stopped short of bringing all of those measures forward during the Oct. 17 markup session.

Some of the bills were intended to take shots at Democrats — particularly Pelosi and her senior health policy adviser Wendell Primus.

One Republican amendment sought to change the name of H.R. 3 to the Puts the Elderly Last and Only Stifles Innovation Act, or PELOSI Act. Another measure suggested renaming the bill to the Promoting Rationing in Medicine Under Socialism Act, or PRIMUS Act.

A number of the measures were aimed at excluding drugs to treat certain diseases from pricing negotiations in H.R. 3, though some of those appeared to be a joke, like the amendment to exclude tinea cruris, commonly known as jock itch.

But Rep. Buddy Carter, R-Fla., stressed that he was serious about excluding any treatments for Alzheimer's disease from pricing negotiations, insisting companies would no longer pursue drugs to treat the condition if they thought they would lose money on those medicines.

Carter's amendment, however, failed.

Energy and Commerce Committee Chairman Frank Pallone, D-N.J., said that while he appreciated the amendment, he questioned whether members of Congress were in the best position to decide which diseases merit special consideration for exclusion above others.

Rep. Mike Doyle, D-Pa., said it was "insulting" and "shallow" for any lawmakers to suggest the biopharmaceutical industry would back away from research and development of certain diseases "unless they make a bunch of money."

In an attempt to get Democrats to drop Pelosi's drug pricing package, Rep. Greg Walden, R-Ore., offered up a rival bill containing bipartisan measures already adopted by the Energy and Commerce Committee, like the CREATES Act, which would ensure that manufacturers of generic drugs could access the samples of brand-name medicines they need to complete their bioequivalence studies for U.S. approval.

But Walden's measures failed.

Also rejected was an amendment from Rep. Morgan Griffith, R-Va., aimed at invalidating H.R. 3 in its entirety if any provision was found by a court to be unconstitutional.