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 Republican U.S. President-elect Donald Trump pledged two weeks ago
to bring down drug prices, addressing an issue that could appeal to
voters in both parties. He did not say how he would accomplish this
although he previously suggested he was open to allowing importation
of cheaper medicines from overseas.
Nineteen Senate Democrats this week urged Trump to push the issue
with Republican lawmakers, many of whom have resisted government
action to rein in medication costs.
Persistently rising drug prices have imposed a heavy burden on
consumers. Many Americans cannot afford their medicines or face
increasing co-pays on prescription drugs.
The 2010 Affordable Care Act, dubbed Obamacare, enabled about 20
million Americans who previously had no medical insurance to get
coverage. It is considered outgoing Democratic President Barack
Obama's signature legislative achievement and an important
accomplishment for his party.
Republicans, who will control both the White House and in 2017,
condemn it as a government overreach. Trump and congressional
Republicans have vowed to repeal and replace it. Senate Majority
Leader Mitch McConnell has said senators will start the repeal
process shortly after Jan. 1. Trump takes office on Jan. 20.
A House of Representatives leadership aide told reporters drug
pricing was one of several areas Republicans would use to reach out
to Democrats to solicit their involvement in Obamacare replacement
legislation, along with the Medicaid insurance program for the poor,
and children's healthcare.
"We are going to try and find where the other side wants to engage,"
the aide said.
Democrats may be difficult to persuade. Democratic Senator Amy
Klobuchar of Minnesota said drug-pricing proposals might have been
part of a bipartisan healthcare reform package to address Obamacare
issues, if Republicans were not insisting on repeal first, placing
the two parties in opposite camps.
"My vision before the election was that we would have some form of
reform package, and now that's murky because of this effort to
repeal," Klobuchar said in a telephone interview.
PROCEDURAL HURDLES
Republican lawmakers have angered Democrats with their plan to use
arcane congressional budget procedures to repeal Obamacare as
quickly as possible, without having to secure any Democratic votes.
This approach would thwart procedural hurdles Democrats could pursue
under normal circumstances.
Republicans including Senator John Thune of South Dakota, a member
of his party's Senate leadership, have said they want Democrats to
work with them to replace Obamacare once it is repealed. They will
almost certainly need them.
In the 100-seat Senate, Republicans need a super-majority of 60 to
clear procedural hurdles and pass replacement legislation. With 52
Republican senators, they would need to attract at least eight
Democrats.
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"If they genuinely wanted to work with us on fixing the Affordable
Care Act, we would have that conversation before they repealed,"
Democratic Senator Chris Coons of Delaware said of the Republicans.
Americans can obtain health insurance from private insurers through
the Affordable Care Act by buying it on state or federally run
exchanges.
In 2016, costs on the individual insurance market rose. Insurers
including UnitedHealth Group Inc and Aetna Inc pulled out for 2017,
saying they were losing too much money. More insurers may drop out
for 2018, making insurance plans more expensive.
Lawmakers in both parties expressed outrage after Mylan NV raised
the price of a pair of the generic drugmaker's lifesaving EpiPen
allergy treatments to more than $600 this year from $100 in 2008.
Klobuchar has worked with Iowa Republican Senator Charles Grassley
on drug-pricing issues, introducing legislation that would help put
an end to brand-name drug companies paying generic drugmakers to
delay marketing low-cost competing medications.
She was among the Democrats who sent Trump the letter on drug costs.
They suggested five areas of cooperation: allowing the Medicare
insurance program for the elderly to negotiate prescription prices,
increasing transparency, stopping abusive pricing, encouraging
incentives for innovation, and supporting generic competition for
branded drugs.
In addition, Republican Senator Susan Collins of Maine Democratic
Senator Claire McCaskill of Missouri this week released a report
detailing drug-pricing abuses at Valeant Pharmaceuticals
International and Turing Pharmaceuticals.
Health policy expert Joe Antos of the American Enterprise Institute
think tank said Democrats may refuse to work on Obamacare
replacement legislation for some time, especially if Republicans
delay the repeal's effective date by up to three years.
"Democrats can just say, we don't have to do it now," Antos said.
Stuart Butler of the Brookings Institution think tank said it will
get harder for Democrats to stay on the sidelines after a repeal
because hospitals, insurers and Americans who may lose their
coverage will press for action.
"I think they (Democrats) will get as much political capital out of
not engaging as they can, and then I think their own constituents
will start to push them," Butler said.
(Reporting by Susan Cornwell in Washington and Caroline Humer in New
York; Editing by Will Dunham)
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