{"id":782967,"date":"2022-08-26T13:33:44","date_gmt":"2022-08-26T13:33:44","guid":{"rendered":"https:\/\/jacobin.com\/2022\/08\/democrats-drug-pricing-lobbyists-pharma\/"},"modified":"2022-08-26T13:33:44","modified_gmt":"2022-08-26T13:33:44","slug":"did-democrats-just-modestly-rein-in-big-pharma","status":"publish","type":"post","link":"https:\/\/radiofree.asia\/2022\/08\/26\/did-democrats-just-modestly-rein-in-big-pharma\/","title":{"rendered":"Did Democrats Just (Modestly) Rein in Big Pharma?"},"content":{"rendered":"\n \n\n\n\n

Past congressional efforts to rein in drug pricing have been undone by Big Pharma\u2019s lobbying of the executive branch. But Democrats seem to have written their recent drug pricing legislation to prevent this possibility.<\/h3>\n\n\n
\n \n
\n A little-noticed section of the Democrats\u2019 new drug pricing legislation tries to prevent drugmakers from using executive branch influence to get their way in the future. (Roberto Sorin \/ Unsplash)\n <\/figcaption> \n<\/figure>\n\n\n\n\n \n

More than two decades ago,\u00a0Senator Bernie Sanders\u2019s (I-VT) legislative obsession<\/a> provided a lesson about how a bill becomes a law \u2014 and then doesn\u2019t. It is a cautionary tale that one Democratic senator seems to have internalized and quietly acted on deep in the legislative text of the drug pricing provisions included in the recent spending bill signed by President Joe Biden.<\/p>\n

The maneuver could be a welcome twist on a Washington narrative that has long been all too common: legislative victories over powerful industries are often undone by the executive branch during the ensuing rulemaking and implementation. That is when industry lobbyists weaponize vague bill text and loopholes that they often helped write to ultimately get exactly what they want.<\/p>\n

Back in 2000, for example, after a campaign of high-profile\u00a0bus trips to Canada<\/a> and legislative arm-twisting, Sanders somehow passed a measure through a Republican Congress to let Americans buy cheaper medicines from other countries. The measure was popular and included in a must-pass spending bill, forcing pharma-friendly president Bill Clinton to sign it into law.<\/p>\n

On the surface, the measure\u2019s passage seemed like a shocking victory over drugmakers \u2014 until a few months later, when Clinton had his administration use a provision\u00a0inserted into the bill at the last minute<\/a>\u00a0to\u00a0block<\/a> the law\u2019s implementation\u00a0just before he left office.<\/p>\n

This same process has been used by corporate lobbyists to also water down Wall Street reforms after the financial crisis, prevent enforcement of\u00a0existing laws<\/a> to lower drug prices, and\u00a0block<\/a>\u00a0the closing of a tax break for private equity moguls.<\/p>\n

But here\u2019s a bit of good news: in a little-noticed section of the Democrats\u2019 new drug pricing legislation, lawmakers for once didn\u2019t pull that old bait and switch. It appears they actually took their jobs as legislators seriously and tried to prevent drugmakers from using executive branch influence to quietly get their way in the future.<\/p>\n\n \n\n \n \n \n

A Preemptive Strike Against the Rogue Secretary<\/h2>\n \n

At issue is the section of the Inflation Reduction Act that allows Medicare to begin a very small program of negotiating lower drug prices. Pharmaceutical companies spent\u00a0$142 million<\/a> on lobbying\u00a0on the matter, and that spending convinced lawmakers to water down the much-promised initiative in myriad ways. Democrats, for example, limited the provision to only cover a handful of older drugs, and\u00a0put off implementation<\/a>\u00a0until 2026.<\/p>\n

But lobbyists couldn\u2019t get Democrats to just drop the program outright. As important, Democrats included a provision that will make it harder for pharma lobbyists to kill the negotiation measure through executive action, like they did with drug importation efforts during the Clinton years.<\/p>\n

Whereas the original House\u00a0version<\/a> of the legislation could have given a future pharma-friendly Health and Human Services (HHS) secretary discretion to avoid negotiating lower drug prices for Medicare recipients, the Senate version of the bill overseen by Senator Ron Wyden (D-OR) explicitly shut down this so-called \u201crogue secretary\u201d loophole<\/a>.<\/p>\n

\u201cThe proposal would close a loophole in the House-passed bill that would have allowed a bad actor Republican secretary to refuse to negotiate or negotiate fewer than the maximum number of drugs,\u201d Senate Democrats noted in a\u00a0messaging document<\/a>\u00a0last month. \u201cThe bill now requires the Secretary to negotiate the maximum number of drugs each year, to the extent that number of drugs qualify for negotiation.\u201d<\/p>\n

The so-called Build Back Better reconciliation bill that passed the House in\u00a0November<\/a>\u00a0provided wiggle room for HHS to reduce the number of drugs negotiated by Medicare to as low as zero, saying that \u201cnot more than 10\u201d drugs would be subject to price negotiation. In their\u00a0version<\/a> of the bill, Senate Democrats fixed this issue by replacing that language and specifying that ten drugs will be subject to the price renegotiations.<\/p>\n

Removing discretion here is important, given the history: Clinton\u2019s HHS Secretary Donna Shalala killed importation right before Clinton began his new career giving\u00a0paid speeches<\/a> to corporate groups,\u00a0including<\/a>\u00a0drugmakers<\/a>.\u200b\u200b Shalala, for her part,\u00a0quickly joined<\/a>\u00a0the board of directors at the health insurance giant UnitedHealth Group.<\/p>\n

That particular rogue secretary incident wasn\u2019t some isolated occurrence: unbound by stricter legislative mandates, President Barack Obama\u2019s HHSsecretary Sylvia Burwell<\/a> and President Biden\u2019s HHS secretary Xavier Becerra<\/a>\u00a0have refused<\/a>\u00a0to use existing laws to reduce the skyrocketing price of lifesaving medicines developed at government expense.<\/p>\n\n \n \n \n

Legislators Must Actually Legislate, Especially Now<\/h2>\n \n

Of course, the language doesn\u2019t fix the shortcomings of the legislation\u2019s new Medicare drug negotiation initiative, and in preventing those negotiations from launching until 2026, lobbyists won themselves ample time to try to get the next few Congresses to repeal the program entirely.<\/p>\n

However, the preemptive strike on a future rogue secretary represents an important and exceedingly rare thing in Democratic politics: an authentic effort to make a bill do what it purports to do.<\/p>\n

The move recognizes that too often there is a chasm between a bill\u2019s stated mission and its implementation, which not only undermines legislative intent but also makes voters distrust politicians\u2019 promises that help is actually on the way.<\/p>\n

The attention to detail embodied by this provision is particularly critical right now, when the Supreme Court\u2019s conservative bloc is\u00a0trying<\/a>\u00a0to hamstring administrative agencies by preventing them from deriving regulatory and enforcement power from vague bill text.<\/p>\n

Combating that conservative crusade will require lawmakers to avoid giving industries or courts ways to evade or eviscerate those laws during implementation. Legislators will have to actually legislate \u2014 that is, they will need to write their bills to explicitly empower and compel the executive branch to take action.<\/p>\n\n \n \n \n\n \n \n

You can subscribe to David Sirota\u2019s investigative journalism project, the\u00a0Lever<\/i>,\u00a0here<\/a>.<\/p>\n\n\n\n

This post was originally published on Jacobin<\/a>. <\/p>","protected":false},"excerpt":{"rendered":"

More than two decades ago,\u00a0Senator Bernie Sanders\u2019s (I-VT) legislative obsession provided a lesson about how a bill becomes a law \u2014 and then doesn\u2019t. It is a cautionary tale that one Democratic senator seems to have internalized and quietly acted on deep in the legislative text of the drug pricing provisions included in the recent [\u2026]<\/p>\n","protected":false},"author":1777,"featured_media":0,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[],"tags":[],"_links":{"self":[{"href":"https:\/\/radiofree.asia\/wp-json\/wp\/v2\/posts\/782967"}],"collection":[{"href":"https:\/\/radiofree.asia\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/radiofree.asia\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/radiofree.asia\/wp-json\/wp\/v2\/users\/1777"}],"replies":[{"embeddable":true,"href":"https:\/\/radiofree.asia\/wp-json\/wp\/v2\/comments?post=782967"}],"version-history":[{"count":1,"href":"https:\/\/radiofree.asia\/wp-json\/wp\/v2\/posts\/782967\/revisions"}],"predecessor-version":[{"id":782969,"href":"https:\/\/radiofree.asia\/wp-json\/wp\/v2\/posts\/782967\/revisions\/782969"}],"wp:attachment":[{"href":"https:\/\/radiofree.asia\/wp-json\/wp\/v2\/media?parent=782967"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/radiofree.asia\/wp-json\/wp\/v2\/categories?post=782967"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/radiofree.asia\/wp-json\/wp\/v2\/tags?post=782967"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}