The House is set to vote Thursday on legislation meant to lower prescription drug prices and strengthen the individual health insurance exchanges, setting up a political minefield for Republicans who are torn between the two issues.
Democratic leaders’ decision to combine legislation that would make it easier to bring generic drugs to market with bills that would bolster the 2010 health care law does not damage the prospects of passage for the package of bills. But that does make it certain that most Republicans will vote against the bipartisan drug pricing legislation.
The decision to merge the bills, which Democrats say was made so that savings achieved through the drug pricing measures would pay for spending under the health insurance legislation, could open Republicans up to attacks that they voted against legislation to lower drug prices, an issue that polls show is of great concern to both Republicans and Democrats.
“These are very separate issues,” said Rep. Greg Walden, R-Ore., the ranking member on the Energy and Commerce Committee. “How we deal with bad practices in getting drugs and samples and all that to consumer and competition in the market is different than paying for more navigators and wiping out state-regulated health insurance.”
“They’re just waiting to cut the TV ads,” he added.
Rep. Mark Meadows, R-N.C., the chairman of the House Freedom Caucus, said he wasn’t concerned about the “show vote,” but said it was a missed “unique opportunity.”
“I think most people will see it as an Obamacare vote and not a prescription drug price vote,” he said, referring to the 2010 law. “At the end of the day, if we lower prescription drug prices, which I fully intend to do, the president fully intends to do, and if we’re successful in doing that, then these votes will be a minor thing.”
Democrats said both planks of the legislation would lower health care costs and protect people with preexisting conditions. They criticized Senate Majority Leader Mitch McConnell, R-Ky., for making the Senate a “legislative graveyard,” rather than addressing health care issues, a key plank of the party’s agenda ahead of the 2020 election.
“There’s been a relentless campaign of sabotage by the Trump administration to deny people health care, and thankfully the new Democratic majority in the House have taken action and passed bills to combat the Trumpcare sabotage,” Senate Minority Leader Charles E. Schumer, D-N.Y., said Wednesday. “The Republican-led Senate? No movement. Nothing.”
Rep. Frank Pallone Jr., D-N.J., who chairs the Energy and Commerce Committee, said he hoped the Senate would eventually reach a bipartisan agreement on health care, but noted that some senators reached a tentative bipartisan agreement on stabilizing the health law last year. That agreement, which would have provided funds to set up reinsurance programs, is not part of the bill the House is considering on Thursday and fell apart over issues of abortion coverage.
“Clearly, there are people in the Senate on the Republican side that would like to shore up the ACA rather than repeal it, but I don’t know what he’s going to do,” Pallone said, referring to McConnell. “So far he seems like he blocks almost everything we send him on any issue.”
Some Democrats who worked on the drug pricing bills are torn over the decision to combine them with the more partisan bills. Rep. Peter Welch of Vermont said he would have favored a show of bipartisan support for the drug pricing bills, while Rep. David Cicilline of Rhode Island said that Republicans shouldn’t oppose the insurance provisions because most say they support protections for preexisting conditions.
One part of the bill — which originally was a standalone bill — would block a Trump administration rule issued last year to expand the duration of short-term insurance plans to up to nearly one year that can be extended for up to three years.
Republicans say the plans, which don’t have to comply with all of the health law’s rules, offer more affordable choices to consumers and that states regulate the plans. Democrats say that they undermine preexisting conditions protections.
Other aspects of the bill would authorize $100 million for the navigator program that aids people signing up for insurance coverage, which the Trump administration cut by 84 percent compared to funding under the Obama administration. Another would authorize the restoration of marketing and outreach funding for the exchanges, which the Trump administration cut by 90 percent compared to the previous administration.
While the drug pricing bills advanced out of the Energy and Commerce Committee with bipartisan support last month, the insurance bills were approved along party lines.
While some House members lamented that the Senate is typically more receptive to taking up bills that came out of the House with unanimous support, drug pricing advocates in the Senate did not seem phased by the measures being paired with the health care law bills.
“I think it gives us a big boost,” said Senate Finance Chairman Charles E. Grassley, R-Iowa. “We’ll have to sort that out in conference but the main thing is to get these drug prices down and what the House is doing in regard to that is very excellent for that.”
The Finance Committee, as well as the Health, Education, Labor and Pensions Committee, are working on packages meant to lower health care costs and prescription drug prices. Both panels could mark up legislation in July.
While House Democrats plan to advance bills to strengthen the health care law, those aren’t expected to be picked up by the Republican-controlled Senate. Grassley said the only aspects of the law Senate Republicans might touch are some of the taxes levied under it, such as a 2.3 percent excise tax on medical devices.