Republicans on the House Ways and Means Committee made a number of attempts to try to stop or at least slow down Speaker Nancy Pelosi's drug pricing legislation, but Democrats prevailed, favorably reporting the bill to the House floor after a more than 12-hour markup session.
At the Oct. 22 hearing, the panel voted 24 to 17 to advance the bill, with Rep. Lloyd Doggett, D-Texas, weighing in as "present."
Ways and Means Committee Chairman Richard Neal, D-Mass.
The Ways and Means Committee was the final of three panels to hold a markup session on the legislation. On Oct. 17, the House Energy and Commerce and Education and Labor Committees held their own markup sessions, where Republicans also made unsuccessful attempts to make changes to the bill.
The legislation, known as H.R. 3, was renamed by the Ways and Means Committee to bear the name of Rep. Elijah Cummings, D-Md., the head of the Oversight and Reform Committee, who died Oct. 17 after experiencing longstanding health challenges.
"He was a man of principle who believed in this institution and its power to do good," Ways and Means Chairman Richard Neal, D-Mass., said. "A fitting legacy for this great public servant, the Elijah E. Cummings Lower Drug Costs Now Act will do tremendous good for seniors and working families across our nation."
House Democratic leaders are expected to bring the bill to the floor for a vote early 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 H.R. 3, 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.
If a manufacturer refused to participate in any part of the negotiation process or does not reach agreement on a price, the company would be charged an escalating penalty based on the drug's gross sales up to a maximum of 95%.
At the Ways and Means Committee hearing, Republicans offered a number of amendments, many of which echoed measures brought up by their colleagues at the Oct. 17 Energy and Commerce Committee markup session.
Republicans specifically targeted the provisions in Pelosi's bill that 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.
Rep. Tom Reed, R-N.Y., insisted that the bill would put too much weight in the hands of the federal government by allowing it to force drugmakers through the use of the penalties to accept the negotiated prices or "you're out of luck."
"That is not a fundamental fair negotiation," Reed said.
But Rep. Don Beyer, D-Va., said what was not just was prohibiting Medicare from negotiating directly with drugmakers on prices.
"Nowhere else in our capitalist economy do we prohibit competition," Beyer said.
Rep. George Holding, R-N.C., also offered an amendment to strike the provision in H.R. 3 that would use an international reference pricing scheme for negotiating what the U.S. would pay for medicines.
"It would be a mistake to model our policy after others, such as France," Holding said, insisting patients in foreign nations have less access to prescription drugs than Americans.
Relying on international reference pricing would be akin to government price setting and controls, Holding said.
But Democrats argued that simply because drugmakers sell medicines in the U.S. does not mean Americans can afford to buy them.
Republicans offered a number of amendments aimed at excluding certain diseases, like Alzheimer's and cancer, from the negotiation process in H.R. 3, repeating similar attempts made by their party members at the Oct. 17 Energy and Commerce markup. But all of those amendments failed.
Texas Democrat Doggett also tried to convince his colleagues to amend the Pelosi bill by adding measures that would permit the government to negotiate the prices for all medicines covered by Medicare and the drugs purchased by Americans with no insurance. But both of those measures failed, with only a few of Doggett's Democratic colleagues offering their support.
Doggett, however, said he was not giving up and hoped that as H.R. 3 moved to the House floor, there would be an opportunity to make more improvements to it "so that it can fulfill the promise that it holds."
The Texas lawmaker said he hoped Democrats would support repealing the so-called noninterference clause in the Medicare Part D prescription drug program.
That clause, adopted as part of the 2003 Medicare reform law, forbids the U.S. Department of Health and Human Services from playing any role in negotiating or setting drug prices in the program.