A congressional effort to reach a deal to lower prescription drug prices this year seemed on a path to derailment Wednesday amid political escalation on several fronts.
House Republicans took a hard line against a major plan from House Speaker Nancy Pelosi (D-Calif.), in the first committee hearing on her proposal to authorize government negotiation of certain high-priced drugs.
Later in the afternoon, Senate Finance Committee Chair Chuck Grassley (R-Iowa) acknowledged his effort with ranking member Sen. Ron Wyden (D-Ore.) to get their embattled proposal on the Senate floor may not happen this year and could slip into early 2020 when the presidential election will overshadow congressional activity.
Grassley and Wyden planned to release the legislative text of their legislation Wednesday, a necessary step to secure more GOP co-sponsors. Grassley said he won't meet with Senate Majority Leader Mitch McConnell (R-Ky.) about bringing the bill to the floor for a vote until he has more Republicans signed on in support.
But both the Senate and House face major hurdles to any substantial deal.
The House Energy and Commerce Committee's hearing on Pelosi's plan marked the first congressional debate over a signature idea from President Donald Trump: the international price index. But Republicans avoided specific mention of the president's idea as they panned the proposal to require Medicare price negotiation using an international reference price as the ceiling.
Democratic panel leaders, on the other hand, underscored repeatedly how the speaker's proposal harnessed the White House's yet-to-be-finalized policy. Pelosi had also adopted the so-called "inflation caps" from the Grassley and Wyden legislation, which would limit Medicare's allowed annual price increases to the rate of inflation. But that has drawn sharp criticism from Grassley's GOP colleagues.
"We all need to take a deep breath, roll our sleeves up and look for the opportunities to work together," Energy and Commerce health subcommittee chair Anna Eshoo (D-Calif.) said after a barrage of Republican complaints about Pelosi's bill.
As he left the hearing, House Energy and Commerce ranking member Greg Walden (R-Ore.) declined to address Trump's international price index in detail, but noted "issues" with the rushed process between the release of Pelosi's bill and Wednesday's hearing that forestalled any serious consideration of the policy.
"If we get into the (international price index) and those issues, I want to know what the implications really are," he said.
He and other GOP members complained that the bipartisan work the committees were doing on a restructure of Medicare Part D similar to what the Senate Finance Committee proposed was effectively halted by the release of Pelosi's plan.
A source close to talks confirmed that the bipartisan work on Part D completely left out the Senate's inflation caps policy.
Meanwhile on the Senate side, Grassley dismissed the idea that the House Republicans' fight over Pelosi's bill—which McConnell and other Senate Republican leaders have panned as well—could hurt the Senate's effort. He said the fact that Trump had signaled support for the House Democratic effort last week could actually help negotiations.
"It kind of makes our bill be a moderate position between doing nothing and perhaps what Pelosi wants to do, and the president showing some sympathy for that," Grassley said.
And he didn't back down on his support for the inflation caps policy, saying only it would be "waste of time" to pass a proposal without it.
But his task hasn't necessarily gotten easier.
Sen. Pat Toomey (R-Pa.), who sits on the Finance Committee and is pushing hard against the inflation caps proposal, said he doesn't think Pelosi's aggressive proposal changes anything for his colleagues' stance on the finance bill.
"I think most Republicans don't like the idea of price controls," Toomey said.
On top of these ongoing politics, the specter of impeachment cast an additional pall over Congress this week after Pelosi formally backed an inquiry. Her support for impeachment followed revelations of Trump's communications with Ukrainian President Volodymyr Zelensky.
Still, the speaker on Wednesday morning said she hoped House Democrats could still work with Trump on drug pricing despite the impeachment push.
She said this after White House press secretary Stephanie Grisham released a statement late Tuesday saying "House Democrats have destroyed any chances of legislative progress for the people of this country by continuing to focus all their energy on partisan political attacks."
Some in the GOP happily seized on this same point. In a floor speech, Sen. John Cornyn (R-Texas) talked about the legislative effort on drug prices only to warn next that impeachment move would make "solving these big challenges facing our country nearly impossible."
Lawmakers sounding the most pessimistic notes were those who are the most reluctant about the aggressive policy options for drug prices.
"I think we're going to have to continue, even though it doesn't feel like it anymore," said Rep. Susan Brooks (R-Ind.), who thought the introduction of Pelosi's bill poses the main threat to a bipartisan effort.
Brooks said she represents manufacturers in her district and favors more moderate proposals that don't bring major regulation to pharmaceuticals.
"I think what's frustrating to us is that we really were going down a bipartisan road," she said. "It's not going to be bipartisan now, which is so unfortunate, when we thought we were making progress and getting somewhere now. People are expressing that to the administration also."
