Democrats propose plan to cut drug costs, seeking climate, tax deal

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WASHINGTON – Top Senate Democrats released Wednesday an updated plan to reduce the cost of prescription drugssignaling progress on a crucial piece of their bid to salvage part of President Biden’s stalled social safety net, climate and tax bill.

Democratic leaders negotiated the drug pricing proposal primarily with Sen. Joe Manchin III of West Virginia, a conservative-leaning Democrat who abruptly pulled out of talks on Mr. Biden’s domestic policy bill in December , thus stopping him in his tracks.

They released the plan this week in a bid to pave the way for a rollback tax and climate spending package they hope to push through the Senate as soon as this month in the face of Republican opposition. It would be paid for in part by the prescription drug proposal that is expected to save the government tens of billions of dollars in years to come.

Under the new measure, Medicare would for the first time be allowed to directly regulate prescription drug prices. It would cap the out-of-pocket amount Medicare patients can be asked to pay for prescription drugs at $2,000 per year, limit the amount drug companies can raise prices each year, and make more vaccines free for those patients. according a draft presented on Wednesday.

Its release was the most substantial progress in months toward reviving parts of Mr. Biden’s multi-trillion-dollar plan, after a painstaking series of closed-door talks in which leading Democrats worked to accommodate preferences of Mr. Manchin and other centrists. in the Senate.

With Republicans expected to be evenly opposed, it would take the support of all Democrats to advance in the equally divided Senate under special budget rules that could shield it from a filibuster.

Senator Chuck Schumer, Democrat of New York and Majority Leader, has privately expressed a desire to vote on such a bill by the end of the month. Some aides and lawmakers remain skeptical of Democrats’ ability to rally behind a less than six months to go until the midterm elections, amid lingering worries about rising inflation.

Ahead of a scheduled break in August, Democrats are also juggling a tight deadline to pass sweeping manufacturing and technology legislation meant to boost U.S. competitiveness with China and public pressure to respond to the Supreme Court’s decision to cancel Roe v. Wade, the landmark case that granted a constitutional right to abortion.

In an effort to begin clearing procedural hurdles and pave the way for quick action if a broader deal can be reached, leading Democrats on Wednesday asked the Senate congressman to begin reviewing the updated version of the plan. drug pricing, according to an official familiar with the private discussions that disclosed them on condition of anonymity. Since Democrats plan to use the expedited budget process known as reconciliation, the measure must adhere to strict limits imposed by the top Senate rules official.

The proposed drug price regulation was the cornerstone of the Build Back Better Act, Mr. Biden’s $2.2 trillion signature plan that encompassed much of his national agenda. He cleared the House in November with only Democratic votes, but stalled a month later after Mr Manchin said he could not support such a sprawling and expensive package as inflation began to climb.

Mr. Manchin has repeatedly said that any package must focus on reducing the national debt, tackling prescription drug costs and reversing parts of the tax law that Republicans imposed in 2017. And while he opposed key elements of his party’s ambitious plans to tackle climate change, Mr Manchin showed openness to the inclusion of a package of climate and environmental taxes. clean energy in his talks with Mr. Schumer.

“Senator Manchin has long advocated for proposals that would lower prescription drug costs for seniors, and his support for this proposal has never been questioned,” said Sam Runyon, a spokeswoman. “He’s glad all 50 Democrats are on board.”

Reducing the high cost of prescription drugs remains a top priority for voters, one to which Democrats have pledged for years without success. Current Medicare drug coverage exposes many patients to high prices because the program cannot negotiate directly with drug manufacturers and because it asks beneficiaries to pay a percentage of the cost of expensive drugs with no cap. Some seniors who take expensive drugs for cancer and autoimmune diseases regularly spend $15,000 or more a year on drugs.

Mr. Manchin and Mr. Schumer have met several times in recent weeks to hammer out the details of a possible deal, which is expected to be around $1 trillion. The tax component must also win the support of Senator Kyrsten Sinema of Arizona, a centrist Democrat who has resisted her party’s proposals to revise the tax code to pay for a broad set of safety nets.

Talks centered on these remaining pieces are expected to continue in the coming days. Democrats have already shelved many of their plans to boost support for families and children in a bid to keep the overall cost of the legislation low and win support for Mr. Manchin.

They are also pushing to include an extension of the Affordable Care Act grants that were extended under the $1.9 trillion Pandemic Relief Act signed into law last year. These are due to expire at the end of the year.

The medicine package unveiled on Wednesday is broadly similar to the medicine provisions that were part of previous negotiations. But that mirrors some of the couple’s negotiations: They are now extending financial assistance to more low-income seniors, reducing their premiums, deductibles and other Medicare drug benefits.

The current program provides such assistance to seniors earning less than 135% of the federal poverty level — about $18,000 per year for an individual — and more limited assistance to recipients earning slightly more. The legislation would extend those subsidies up to 150% of the poverty line — about $20,000 a year — according to the summary.

It would also force the Department of Health and Human Services to negotiate lower Medicare prices on some prescription drugs. Previous legislation had given the department discretion to do so, but had not mandated it, and Democrats feared a future health secretary in a Republican administration might refuse.

Some provisions of the original drug bill were also removed, including one that would have limited the amount Americans could be asked to pay out of pocket for insulin each month. But a vote on a separate bipartisan insulin bill led by Senators Susan Collins, Republican of Maine, and Jeanne Shaheen, Democrat of New Hampshire, is expected in the Senate in the coming weeks, although it is not clear whether he will attract enough Republican support.

Debra DeShong, executive vice president of public affairs at drug trade group PhRMA, expressed dissatisfaction with the proposal, noting that some technical tweaks could cost Medicare beneficiaries more than they would have spent in previous versions of the bill. The industry has long opposed price regulation efforts.

“The prescription drug bill released today has gone from bad to worse for patients,” she said in a statement. “Democrats have weakened protections for patient costs included in previous versions, while doubling down on the government’s sweeping pricing policies that will threaten patient access and future innovation.”

The urgency surrounding the overall package has grown as Mr Biden’s popularity continues to decline and Democrats fear losing control of Congress.

The Supreme Court’s decision to limit the Environmental Protection Agency’s ability to tackle carbon emissions last week also intensified pressure among Democrats to pass legislation that would thwart the impact of climate change. . The proposal being discussed could include up to $300 billion in clean energy tax incentives that the House originally approved in November.

“We don’t have the help of a single Republican to be able to move forward in lowering prescription drug prices and expanding our capacity around clean energy and addressing the climate crisis,” said Senator Tina Smith, Democrat of Minnesota.

Republicans remained uniformly opposed to the domestic policy package. After applauding Mr. Manchin’s decision to pull out of the talks in December, some Republicans have watched with concern as talks with Mr. Schumer resumed in recent weeks.

Sen. Mitch McConnell of Kentucky, the Minority Leader, threatened on Thursday that Republicans would walk away from the manufacturing and technology bill, which enjoys bipartisan support, if Democrats insisted on saving climate spending and the tax package.

In a speech to the Paducah-area Kentucky Chamber of Commerce on Tuesday, McConnell criticized the legislation and warned: ‘If they bring this back, it will only make the whole thing so much worse.’

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