U.S. House Republicans are trying to put Democrats in a corner by offering an alternative drug pricing package pumped full of provisions already adopted on a bipartisan basis by various Capitol Hill committees.
Democrats wrote a number of those provisions. The House Republican legislation is intended to rival Speaker Nancy Pelosi's drug pricing package, H.R. 3.
House Republican leaders said they have White House support on their package, known as the Lower Costs, More Cures Act, or H.R. 19.
Republican Reps. Kevin Brady of Texas, Greg Walden of Oregon and Kevin McCarthy of California.
"All of these can be signed by President Trump this year," Rep. Kevin Brady, R-Texas, ranking member on the House Ways and Means Committee, told reporters Dec. 9.
Republicans have rejected the idea of giving 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 — the central provision in Pelosi's bill.
House Republican committee chiefs noted that Senate Majority Leader Mitch McConnell, R-Ky., has already said he has no plans to bring up H.R. 3 for a vote in his chamber.
"It's deader than a doornail," Brady told reporters.
Brady and his Republican colleagues said they plan to ask the chamber's Rules Committee during its Dec. 10 markup session for the Pelosi bill to allow them to bring up their competing package of measures for a vote.
Rep. Greg Walden, R-Ore., ranking member on the House Energy and Commerce Committee, had tried a similar move by offering an amendment as a substitute for H.R. 3 during that panel's Oct. 17 markup hearing for the Pelosi bill. But the panel defeated Walden's effort in a 30-22 vote.
Much of what was in Walden's Oct. 17 amendment was included in the House Republicans' bill, an aide confirmed.
Other bipartisan measures to lower drug costs also were added to H.R. 19 from several other bills adopted by committees from both parties, including some provisions from a legislative package from Sens. Chuck Grassley, R-Iowa, chairman of the Senate Finance Committee, and Ron Wyden, D-Ore., the ranking member.
Walden said H.R. 19 includes "upwards of 90%" of the Senate Finance Committee bill.
The Oregon lawmaker, however, said his Republican colleagues were not willing to include a key measure from the Finance Committee's bill to require drugmakers to pay rebates to Medicare if the companies increase their prices faster than inflation.
Walden said that provision would be imposing price controls on biopharmaceutical manufacturers, repeating a claim made by a number of Republicans.
Grassley and Wyden have been unwilling to part with that provision and kept it in their revised package, despite other House and Senate Republicans objecting to it.
House Republicans, however, did include the Grassley-Wyden provisions that would cap Medicare Part D prescription drug program beneficiaries' out-of-pocket maximum at $3,100 and eliminate the so-called doughnut hole — a period in the benefit when enrollees are responsible to cover all costs.
Minority Leader Kevin McCarthy, R-Calif., said assigning the number 19 to the bill underscores the opportunity to still adopt bipartisan legislation aimed at lowering Americans' prescription drug costs before 2019 runs out.
Republicans noted the House has already adopted some of the measures in H.R. 19, including the CREATES Act. The act would make it easier and faster for generic-drug companies to sue brand-name biopharmaceutical makers when those manufacturers withhold samples of their medicines that their competitors need to conduct required studies for U.S. approval.
House Minority Leader Kevin McCarthy
Another provision in H.R. 19 would end a gaming tactic known as "parking," where the first generic-drug company to file a U.S. application holds off on entering the market to delay the start of the 180-day exclusivity period it was granted in an attempt to block competitors.
The tactic is often used because the generic-maker has entered into an agreement in which it is paid by the branded company to delay the market entrance of the lower-cost product — called pay-for-delay deals.
The House Republican bill also has a provision aimed at prohibiting those agreements.
In addition, H.R. 19 has a measure that would limit the potential for so-called evergreening by brand-name drugmakers by restricting manufacturers from obtaining new exclusivities on previously approved clinical entities.
Also included in H.R. 19 is a provision to create a chief pharmaceutical negotiator at the Office of the U.S. Trade Representative — another measure Republicans sought to pass during the earlier markup sessions.