EDITORIAL: Lower drug costs bill is in Republicans' court now

Dec. 15--The U.S. House of Representatives has passed a bill that would give Medicare permission to negotiate the prices of 250 commonly prescribed drugs and give private insurers, if they want to take advantage of it, the right to benefit from the lower prices.

That would translate into insulin or epipen prices, for example, that would come much closer to the prices being paid by diabetics or allergy sufferers in Canada or the United Kingdom. It would address the outrage of American manufacturers and middleman companies charging Americans exorbitantly more for common lifesaving drugs than they charge patients in foreign countries.

H.R. 3 -- described by Congressman Joe Courtney, one of its three Connecticut co-sponsors, as the most significant piece of health care legislation that will pass this year -- would also cap the out-of-pocket drug expenditures for a Medicare subscriber at $2,000 per year and allow coverage of vision, hearing and dental care. It would require drug companies to rebate to Medicare any price increases that outpace the rate of inflation.

The renamed Elijah E. Cummings Lower Drug Costs Now Act would, in pocketbook terms, give consumers the relief that they consistently tell pollsters and elected officials was a top issue in how they voted in 2018 and will be again in 2020.

The bad news is that, despite the overwhelming voter appetite for lower and fairer drug prices, the provision for the secretary of Health and Human Services to negotiate on behalf of Medicare -- which the Veterans Administration already does, effectively -- has next to no chance in the Senate or with President Trump. Drug companies hate it and their political influence is formidable, with $43.6 million in campaign contributions in 2018.

In the Senate, Majority Leader Mitch McConnell, who is the single largest recipient of campaign contributions from drug companies in Congress - $479,000 in the last five years - has said he will not bring it to a vote. The president, who made Medicare negotiating power a campaign point in 2016, nonetheless says he will veto the bill if it gets to his desk. The partisanship is suffocating; in the House, the bill passed 230-192, with just two Republicans in favor.

The better but still uncertain news is that Iowa Republican Sen. Charles Grassley and Oregon Democrat Ron Wyden are promoting a bill that would include the consumer cost cap and the rebates for price increases over the rate of inflation, but would not grant Medicare negotiating rights. Uncertain because McConnell hasn't agreed to allowing a vote on the bill backed by Grassley-Widen, either.

Republicans say that lowering drug company profits could curtail research, particularly in cases of rare diseases. We question the absoluteness of that statement, given the worldwide markets for new kinds of cures and the American drive to lead the way. Under H.R.3, some of the estimated $450 billion in money not spent over 10 years with pharmaceutical companies would go for drug research at the National Institutes of Health.

We urge the Senate leadership to consider the will and the want of the people -- the will to change a price-gouging, inhumane system and the want of lifesaving care. As Connecticut Fifth District Rep. Jahana Hayes said on the House floor, she represents people in want because they cannot afford both medicine and food. The most direct way to cut costs at the user end of the system is to cut them from the top, by lowering the prices Medicare will pay for commonly used drugs with no generic competitors.

If that remains politically impossible, as it has since Medicare was forbidden by law in 2003 to negotiate, then the Senate bill, such as it is, is better than the status quo. Trickledown relief for consumers will be far less, and employer-sponsored health insurance plans will get far less respite from rising premiums than they would if private insurers could join in the negotiations benefits, but it moves policy in the right direction.

Someone will pay. The people have made their priorities clear, and they will do so again in November 2020.

The Day editorial board meets regularly with political, business and community leaders and convenes weekly to formulate editorial viewpoints. It is composed of President and Publisher Tim Dwyer, Editorial Page Editor Paul Choiniere, Managing Editor Tim Cotter, Staff Writer Julia Bergman and retired deputy managing editor Lisa McGinley. However, only the publisher and editorial page editor are responsible for developing the editorial opinions. The board operates independently from the Day newsroom.

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