Democrats called on Republicans to drop their pursuit of trying to sink the Affordable Care Act and urged their rivals to instead join them in taking on the biopharmaceutical industry.
"I hope my Republican colleagues and President Trump will have the guts," declared Sen. Bernie Sanders, I-Vt., who co-sponsored a bill in the Senate with 15 Democratic lawmakers aimed at reducing the costs of prescription medicines.
The Democrats are promoting the legislation as a way to improve the ACA rather than Republicans dismantling it — a pursuit Speaker Paul Ryan, R-Wis., said he has not yet abandoned.
Rep. Elijah Cummings, D-Md., one of the co-sponsors of the House companion bill, said "without a shadow of a doubt," congressional action was the only way to address the "unconscionable prices" being charged by some drugmakers.
Cummings and Rep. Peter Welch, D-Vt., another co-sponsor of the House bill, met with Trump at the White House on March 8 to talk about some of the ideas the two congressmen had in mind for bringing down drug costs.
While Cummings and Welch said the discussions revolved around permitting Medicare — the government's insurance program for seniors and the disabled — to negotiate prices directly with biopharmaceuticals firms, Trump administration officials said the meeting focused on FDA reform as a way to reduce drug costs.
On the campaign trail, Trump often said he wanted Medicare to have the authority to negotiate prices, although he has sent some mixed signals on that front since entering the White House.
Cummings, however, was adamant that Trump backed the Medicare approach — revealing on ABC's This Week on March 12 that the president had made two follow-up phone calls to the congressman the day after the two men met.
Democrats said their comprehensive legislative package offered a range of provisions on which to find bipartisan consensus.
Along with the Medicare negotiation measure, the legislation, known as the Improving Access to Affordable Prescription Drugs Act, would close the so-called doughnut hole — the gap when beneficiaries of the program are required to cover all out-of-pocket costs — in 2018, two years earlier than the current law mandates.
The Democrats' House and Senate bills would restore a requirement forcing drugmakers to pay rebates on their medicines for the so-called dual eligibles — beneficiaries who qualify for both Medicare and Medicaid — and would extend those rebates to other Medicare beneficiaries in low-income-subsidy plans.
Another provision in the legislation would permit wholesalers, pharmacies and individuals to import qualifying prescription drugs manufactured at FDA-inspected facilities from licensed Canadian sellers and, after two years, from Organization for Economic Co-operation and Development countries that meet standards comparable to those in the U.S.
Sanders and Cummings and a coalition of other lawmakers recently introduced a separate importation bill in the House and Senate — another idea Trump has backed in the past.
Among the other provisions in the legislation is a measure that would require drug companies to report their costs for research and development, manufacturing and marketing to the U.S. Department of Health and Human Services, which would make that data publicly available in a searchable format.
Drugmakers also would be required to reveal how acquisitions, federal investments, revenues and sales and other factors influence the prices of their medicines.
Under the legislation, patient-assistance programs would be required to disclose details of the benefits they provide, such as copayment coupons, to the Internal Revenue Service. The bills also call for the Government Accountability Office to study the impact of patient assistance programs on prescription drug pricing and expenditures.
Lawmakers also want the HHS Office of the Inspector General to monitor changes in drug prices and work with the Federal Trade Commission and biopharmaceutical firms to assess the extent to which an increase was due to changes in the medicine's supply chain or if there are other justifiable reasons.
If the price hike was beyond medical inflation over a one-year period or cumulatively, the drug manufacturer would be subject to a graduated excise tax, which would depend on the size of the cost increase.
The legislation would impose caps on the amounts that Americans with employer-based insurance plans would pay out-of-pocket for their medicines — limiting their costs to $250 per month for individuals and $500 for families.
The bill also would make pay-for-delay deals illegal. These are deals in which brand-name firms pay their generic competitors to keep their cheaper versions of drugs off the market for a certain period.