U.S. Senate Democrats are hopeful that drug pricing legislation will be passed by early next month via a budget reconciliation process requiring just 50 Democratic votes, a Democratic source with knowledge of the process told 340B Report.
“Our expectation is, we’re full speed ahead,” the source said. The Senate’s summer break begins Aug. 8 and ends on Labor Day, Sept. 5. The House’s break begins Aug. 1.
Republican sources contacted by 340B Report were not immediately available for comment on the pending legislation.
“We’re focused on getting help to folks who are getting clubbed on drug costs every single day, and we want to get that done in this work period, right now, before everybody leaves for August,” Senate Finance Committee Chair Ron Wyden (D-Ore.) said yesterday during a webinar on the drug pricing bill hosted by the news organization STAT.
“In the coming weeks, our caucus is going to be exceedingly busy as we finalize a reconciliation bill that can pass with the full support of our caucus,” Senate Majority Leader Chuck Schumer (D-N.Y.) said yesterday on the Senate floor. “We still have a lot of work to do, and nobody says it is going to be simple or easy. But lowering the costs of health care and prescription drugs will make an enormous difference in the lives of the American people.”
“Let’s get it done and give Americans a much-needed and long-awaited break,” Schumer said.
The bill would let Medicare negotiate the prices of some particularly costly single-source drugs with drug makers. The Department of Health and Human Services could begin to negotiate prices of 10 drugs starting next year, with the prices taking effect in 2026. The number would increase to 15 in 2028 and 20 in 2029.
Language in the bill that 340B hospital representatives reportedly pushed for says 340B covered entities would be able to get the lower of the 340B price or any negotiated Medicare rate.
The bill would make drug manufacturers pay Medicare rebates for many Part B and D drugs if their prices rise faster than inflation. It also would cap Part D beneficiary total out-of-pocket spending at $2,000 per year, cap premium growth at 6% per year through 2029, eliminate cost sharing for vaccines, and expand eligibility for low-income subsidies.
The bill reportedly is slated to go before the Senate parliamentarian today, which has the final say on whether its provisions qualify for inclusion in a reconciliation bill. To qualify, they must have an impact on government budget or spending.
“We’ll see how the rulings shake out, but I expect we’ll be able to move [the bill] forward with largely what we have,” the source with knowledge of the process said. “We can only speculate about what Republicans might challenge, but we’re confident that the bill has been written in compliance with Senate rules and we’re going to make that case.”
Both sides will have an opportunity today to make their arguments to the Senate parliamentarian on whether the bill’s provisions are in line with the reconciliation rules, the source said. If the parliamentarian gives the bill a green light, the source said proponents are confident that Sen. Joe Manchin (D-W.Va.), a vocal critic of his party’s previous spending packages to address climate change and social welfare challenges, would be on-board with the streamlined bill to give it the needed 50 votes.
The Senate is split 50-50, with Vice President Kamala Harris, as Senate president, able to cast the tie-breaking vote.
But the bill still faces the “vote-a-rama” gauntlet, whereby Republican opponents can offer a slew of amendments to sink the bill, the source noted.
In any event, some 340B providers remain concerned whether the updated legislation goes far enough in addressing 340B–specific issues, such as for example, whether the bill as drafted would cover manufacturers that refuse to offer 340B pricing to the contract pharmacies.
Lukewarm Support
Some progressives believe that the legislation it is too limited in scope since it only allows the government to negotiate on a limited number of drug products and that manufacturers will be able to continue to set the price for new drugs. On the other hand, Republican lawmakers and some conservative policymakers oppose the legislation for being too harsh on the drug industry. They believe that allowing the government to negotiate drug prices would discourage drug makers from developing innovative new therapies as well as cheaper, generic versions of prescription drugs.
The updated legislation would lower the federal deficit by $287 billion over 10 years, according to an estimated released last week by the nonpartisan Congressional Budget Office.
House Democrats passed a broad budget reconciliation package that included drug pricing provisions and other domestic priorities last November, but Manchin opposed the measure based on its size and scope.
