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From the CQ Newsroom: House Passes Bill to Require Medicare Drug Price Negotiations

By Drew Armstrong, CQ Staff

January 12, 2007 -- Democrats delivered on another campaign promise Friday when the House easily passed a bill that would require the administration to negotiate Medicare drug prices.

The vote was 255–170, with two dozen Republicans supporting the measure (HR 4).

In the Speaker's Lobby after the vote, bill sponsor John D. Dingell, D-Mich., hugged and gave a small peck on the cheek to Missouri Republican Jo Ann Emerson, a prominent voice on the GOP side in support of the legislation. "You are a pleasure to work with," Dingell told her.

Hugs and kisses might be harder to come by in the Senate, where the bill awaits a much tougher path. It also faces a veto from President Bush.

The measure would alter the Medicare Part D drug benefit (PL 108-173) by requiring the secretary of Health and Human Services (HHS) to negotiate prescription drug prices. It also would bar the government from setting up a formulary or restricting access to drugs as a way of leveraging lower prices.

The 2003 law bars the government from getting involved in the negotiations by private plans that run the programs.

Opponents fired every rhetorical arrow they had in their quiver, arguing that the bill was a path to price controls, would restrict access to many drugs or simply wouldn't do anything to lower prices.

Rep. Joe L. Barton, R-Texas, called the bill a political exercise, and hoped that the Democrats' early legislative drive would sputter.

"In all likelihood it'll never come out of the Senate, so this is as far as it's going to get . . . which will be a nice, benign death."

Rep. Ron Lewis, R-Ky., summoned the specter of then first lady Hillary Rodham Clinton's failed health plan in the early 1990s as he said, "this bill is nothing but a veiled attempt at national health care."

Waving a copy of the Congressional Record, Kenny Hulshof, R-Mo., reminded Democrats that many of their ranks had voted for the original drug benefit law (PL 108-173) when it passed in 2003.

"You just can't find it in yourselves to say we got one right," he yelled across the aisle, to applause.

Pete Stark, D-Calif., quickly fired back at the former state prosecutor.

"I'd like to remind my colleague from Missouri that at least in California we require law students to read well enough to understand that the bills they wave in the air are different from the bill that we're considering today," Stark said.

Dingell made an effort to refute Republican objections to the bill as debate closed.

Citing a Congressional Budget Office report indicating that the bill would not reduce drug prices, Dingell said, "the reason is, because they know full well that this secretary probably won't negotiate on their behalf."

Dingell then promised that Democrats would hold the administration accountable if it did not lower prices. "We will give [the secretary] and the others in the administration the oversight they have lacked for six years."

Several Democrats cited the low prices obtained by the Department of Veterans Affairs (VA) as evidence that the government could indeed win lower prices than private plans negotiating on their own.

Most, however, have backed away from replicating the VA system for Medicare beneficiaries because of worries about angering voters by restricting drug access. The VA is empowered to walk away from drug price negotiations in cases where they think the price of a drug is too high, which sometimes results in leaving beneficiaries with generic or older brand drugs.

Republicans took their only shot at changing the bill with a motion to recommit that would have forbidden drug access restrictions, especially for cancer, AIDS, mental health, and neurological drugs. It also would have forbidden the negotiations to cause any increase in drug prices, for the Medicare plans or for the system run by the VA.

The motion failed, 196–229.

Mike Teitelbaum contributed to this story.

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