In the previous Congress, a bipartisan compromise took shape on addressing the cost of prescription medications. In fact, in 2019, proponents were cautiously optimistic: A pair of leading senators — Oregon Democrat Ron Wyden and Iowa Republican Chuck Grassley — even received support from the Trump White House for their deal.
But it quietly withered on the vine. According to Grassley, then-Senate Majority Leader Mitch McConnell effectively sabotaged the legislation by asking other Republicans not to support it, even after it passed the House with relative ease. In the upper chamber, the bill never even reached the floor.
In the current Congress, the effort is still alive, though it faces related challenges, including the 60-vote threshold to overcome Senate Republican opposition. It was against this backdrop that Grassley made an unexpected admission yesterday. Politico reported:
Sen. Chuck Grassley (R-Iowa), who has previously negotiated a plan to lower prescription drug costs with Finance Committee Chair Ron Wyden (D-Ore.), admitted during a committee hearing it would likely be hard to pass if his own party regained control of Congress. He called on Democrats to pass it now.
At a Finance Committee hearing, the Iowa Republican said, “I think you suggested the difficulty of passing something like in a Republican Congress, so you got an opportunity to do it right now, when Democrats and Republicans can work together to accomplish this. If we want to reduce drug prices, then we need to do it now.”
Grassley was effectively admitting what many have long understood: If his party controls even one chamber of Congress after this year’s midterm elections, legislation to address the cost of medications almost certainly won’t pass. Policymakers have to act quickly, the longtime GOP senator seemed to concede, before his own party makes governing on the issue effectively impossible.
This was notable, not because Grassley was wrong. On the contrary, he was entirely correct. Rather, Capitol Hill observers simply aren’t accustomed to hearing sitting Republican lawmakers admit that their own partisan allies aren’t likely to work on an important issue.
As for what’s likely to happen next on drug prices, that’s a tough question to answer with confidence. The Democrats’ original plan was to include a relatively ambitious drug plan in their Build Back Better package, which, as you’ve probably heard, has run into a few roadblocks.
It’s possible that such a bill could still be revised — and since we’re talking about a reconciliation package, it wouldn’t need Republican support — but it’s tough to be optimistic. Even if a larger framework could satisfy Democratic Sen. Joe Manchin’s demands, Democratic Sen. Kyrsten Sinema has balked at drug-price reform efforts for months, despite having run on the issue in 2018. [Update: see below.]
Which brings us back to the Grassley/Wyden compromise. It’s less ambitious than the original provisions of the BBB plan, but if it can get some Republican backing, it’d be better than nothing.
Senate Majority Leader Chuck Schumer spoke on the floor yesterday afternoon and said, “Few things are as frustrating and debilitating as going to the pharmacy and seeing the price on your receipt go up and up and up for essential medications.” As for the road ahead, the New York Democrat added, “I expect that we will consider next steps soon on proposals already presented to my colleagues.”
Update: I heard from Sen. Sinema's office, who told me via email, "[A]fter the White House’s original Build Back Better framework excluded prescription drug reform, Senator Sinema worked with Speaker Pelosi to craft a historic Medicare drug negotiation framework. Here is our office’s statement for reference."