Congress is in the middle of its annual July 4th recess but before they left for home last week it was revealed that Senate Democrats are putting together a last-minute plan that would let Medicare negotiate prices directly with manufacturers for some prescription drugs, with the goal of passing it ahead of the midterm elections.
According to STAT News, it is by no means certain that Congress will pass prescription drug pricing reform as part of a broader domestic policy package being negotiated between Senate Majority Leader Chuck Schumer (D- N.Y.) and moderate Sen. Joe Manchin (D-W.V.), but this week, the chances are looking better than ever.
In order to pass a bill Schumer will need the support of all 50 Senate Democrats. Then it could be passed with only Democratic votes under the chamber’s budget reconciliation process. No Republicans are expected to support the bill.
However, it is not yet clear if it will have the support of other moderate Democrats like Kyrsten Sinema, D-Ariz., or Bob Menendez, D-N.J. Menendez is an uncertain vote because his state of New Jersey is home to 14 of the top 20 pharmaceutical companies in the world.
The new plan would impose penalties for drug companies that hike prices faster than inflation and implement a $2,000 annual out-of-pocket cap for Part D patients. Insulin would be capped at $35 a month, a provision that Democrats are also working to pass as a standalone measure.
The new agreement would also strengthen language around the Department of Health and Human Services secretary’s obligation to negotiate prices to prevent a different secretary who does not support the bill’s purpose from watering down the provisions. New language would also limit Medicare premium increases — an expected side effect of capping patient copays. The negotiation process would begin in 2023.
In addition, the new agreement would make vaccines free to Medicare patients and extend full subsidies for low-income enrollees from 135 percent of the federal poverty level up to 150 percent. The deal includes language to prevent brand-name drug makers from blocking generic products from coming to market.
TSCL welcomes this new effort, and we will closely review the bill once it is finalized.