House Democratic leaders on Thursday announced plans to use savings from their government drug price negotiation bill to expand Medicare benefits, increase financial assistance for low-income beneficiaries, fund community health centers, bolster research at the National Institutes of Health, combat drug shortages and fund other healthcare priorities. They said the bill will come up for a House floor vote the week of Dec. 9.
House Energy & Commerce Committee Chair Frank Pallone (D-N.J.), Ways & Means Chair Richard Neal (D-Mass.), and Education & Labor Chair Bobby Scott (D-Va.) said they expect the Elijah E. Cummings Lower Drug Costs Now Act to save around $500 billion over the next 10 years, according to guidance they received from the Congressional Budget Office. The leaders did not provide any further details about the CBO analysis.
The House bill would allocate savings from drug-pricing provisions to add vision, dental and hearing coverage to Medicare Part B. The expansion would provide coverage for dental procedures, dentures, eye exams, glasses, contact lenses and hearing aids in traditional Medicare.
The expansions have long been a priority for beneficiary advocates.
"The lack of coverage for these important health benefits leads to worse health outcomes for older Americans and could actually cause higher Medicare spending," said AARP National Volunteer President Catherine Alicia Georges at a Ways & Means Committee hearing on the drug-pricing bill in October.
Lawmakers also said bill savings would be used to expand eligibility for low-income subsidies in Medicare and financial assistance with out-of-pocket expenses. Community health centers would receive $10 billion of funding for capital improvements and capacity building. Money would also be allocated to invest in home visits to reduce maternal mortality and boost local government treatment programs to fight the opioid epidemic.
Additional savings would be directed to funding biomedical research at the National Institutes of Health and to supporting the Food and Drug Administration's efforts to mitigate drug shortages and modernize infrastructure.
Congressional Progressive Caucus Co-Chair Pramila Jayapal (D-Wash.) has said she has concerns that taxpayer-funded research at the NIH is being used to develop drugs that everyday Americans cannot afford.
"I would like to see money go into (research and development), but there have to be some very specific protections," Jayapal said on Nov. 21. "If we are the investor, then the American people should get the benefit of that investment."
Even if the Lower Drug Costs Now Act passes in the House, its prospects are grim in the upper chamber. Senate Majority Leader Mitch McConnell (R-Ky.) has said that the House bill will not come up for a vote in the Senate.
The House drug-pricing package would allow the HHS Secretary to negotiate with drug companies on the prices of a limited number of high-priced drugs with little competition. The negotiations would be bounded by an international index of drug prices in several developed countries. If drugmakers did not agree to a negotiated price, they would be taxed up to 95% of their sales.
The bill would also redesign Medicare's Part D benefit and limit seniors' spending on drugs dispensed at the pharmacy counter to $2,000 per year. Drugmakers would have to pay back the government if they raise drug prices faster than inflation.
President Donald Trump took to Twitter to deride the legislation.
"Pelosi and her Do Nothing Democrats drug pricing bill doesn't do the trick. FEWER cures! FEWER treatments! Time for the Democrats to get serious about bipartisan solutions to lowering prescription drug prices for families," Trump tweeted on Nov. 22.
The White House Council of Economic Advisers on Tuesday published a blog post decrying the bill's potential negative impact on drug development. The report extrapolated a preliminary CBO score on one provision of the Lowering Drug Costs Now Act to conclude that the bill could result in a worst-case scenario of as many as 100 fewer drugs entering the market over a decade due to reduced revenue for the pharmaceutical industry.
However, policy analysts and stakeholders who support the bill dismissed the analysis. Experts argued that reductions in revenue do not necessitate reductions in research funding; that not all new drugs are necessarily innovative; and that drug-pricing policies promoted by the Trump administration would also reduce drugmakers' revenue.
"The biggest math bogey is the impact estimate based on assumption that all of R&D expenses go into developing new drugs," Peter Bach, the director of Memorial Sloan Kettering's Center for Health Policy and Outcomes, tweeted.