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Can Trump and Pelosi Strike a Deal to Bring Down Drug Prices?

Yuval Rosenberg

After a summer recess that stretched for more than a month, Congress is back in session, with lots to do. Preventing another government shutdown probably tops the agenda in the near term, even as Democrats explore a possible push to impeach President Trump, other presidential controversies and investigations proliferate and pressure continues for lawmakers to “do something” on gun control.

And that’s just the short list. Add in the U.S.-Mexico-Canada trade deal, which the administration wants Congress to approve, and the Senate’s ongoing drive to confirm presidential appointees and the remaining months of 2019 will be jam-packed. As of Tuesday, the House only has 12 legislative days left in September and 44 for the year. The Senate is scheduled to be in session slightly longer.

But there’s another key area where Congress and the president may try to make progress and live up to their campaign promised ahead of the 2020 election: Legislation to lower prescription drug prices.

“In some ways, the next few months represent the 116th Congress’s last chance to pass major legislation until 2021,” write The Washington Post’s Rachael Bade and Mike DeBonis. “Lawmakers in both parties agree the partisan politics of the 2020 election will kick into high gear as soon as January, making any dealmaking and compromise all the more difficult.”

House Speaker Nancy Pelosi is reportedly poised to unveil a new drug-pricing plan shortly. The Post’s Paige Winfield Cunningham reports:

“The proposal will represent a wish list of new powers Democrats want to give the federal government, including allowing it to directly negotiate with prescription drugmakers for certain high-cost drugs, according to several lobbyists and aides. But Pelosi is hoping President Trump — who has bucked GOP orthodoxy by supporting such negotiations — might be eager enough for a win on drug pricing that he’ll meet her at least part of the way for a grand deal by year’s end.”

Pelosi’s proposal reportedly would have the government’s negotiated prices also take effect in the private market, not just for Medicare.

The politics at play: Trump may have expressed support in the past for allowing the government to negotiate drug prices, but there are still plenty of obstacles that could derail any potential deal.

  • Some Democrats may not want to give Trump a big win on an issue that voters say is key.
  • Some Republicans would object to expanding the government’s role in drug pricing, even if the president comes out strongly in favor of it.
  • The pharmaceutical industry is lobbying furiously to prevent changes it sees as threatening its business.
  • On top of all that, Democratic investigations into the president and a Republican-led lawsuit to dismantle Obamacare could cause delicate negotiations on drug prices to collapse.

“People following the legislative debate suspect that normal partisan politics will likely take control over this particular plan,” Axios’s Sam Baker and Alayna Treene report — “except if the president is for it. That will change everything,” an industry lobbyist told Baker. But the administration is reportedly making the USMCA trade deal its top legislative priority, and any drug legislation is likely to be packaged with other sensitive legislation, meaning the path to passage will be complicated at best.

The bottom line: Whether Trump and Congress can find some consensus on drug prices is still far from certain. Kaiser Health News reports that states aren’t waiting for national politicians to get their act together: “So far this year, 33 states have enacted a record 51 laws to address drug prices, affordability and access.” But federal legislation will be necessary to really change the existing market structure for prescription drugs. If nothing comes to fruition over the next four months, Americans may be left waiting awhile before they see their drug prices change more significantly.

Read more at The Washington Post or Axios.

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