A progressive leader among House Democrats on lowering drug prices is circulating a letter calling for “necessary improvements” to Speaker Nancy Pelosi (D-Calif.) signature legislation on the topic.
The letter from Rep. Lloyd Doggett (D-Texas), obtained by The Hill, outlines changes that he says need to be made to the legislation Pelosi unveiled earlier this month, which is one of House Democrats’ top legislative priorities.
There has been tension for months as progressives have pushed Pelosi to go further in lowering drug prices in the bill.
Doggett did not explicitly threaten to vote against the legislation if changes are not made, and a spokesperson said he is focused on making improvements and that it is too early to say how he would vote.
Doggett’s position is key given that it could influence many other progressive House Democrats. Doggett is the sponsor of an alternative bill to lower drug prices that has been endorsed by the Congressional Progressive Caucus.
“After reviewing her plan, I find much to merit support but some significant limitations that require improvement,” Doggett wrote in a “Dear Colleague” letter to the 129 House Democrats who have co-sponsored his alternative drug pricing bill.
Pelosi’s bill, which congressional Republicans have attacked from the right as being “socialist,” would allow the secretary of Health and Human Services (HHS) to negotiate for lower drug prices.
But a main concern among progressives, including Doggett, is that Pelosi’s bill would require negotiation for a minimum of 25 drugs per year and a maximum of 250 rather than for all drugs. Doggett called 25 drugs a “very small” number in his letter and objected to the fact that drugs are eligible for negotiation only if they do not have any competition from generic drugs. He noted that would exclude the EpiPen, a drug at the center of outrage over its price in recent years.
Doggett also expressed concern that the bill does not go far enough to address the launch prices of new drugs arriving on the market for the first time.
Pelosi has expressed some openness to making changes. She told reporters this month that the number of drugs subject to negotiation is an “open point,” though she noted that there are concerns about the capacity of the HHS secretary to negotiate more drugs. Supporters also note the need to prioritize the most expensive drugs for negotiation.
Pelosi is hoping for the support of President Trump for her bill given his sharp rhetoric against drug companies, though that is far from assured, especially amid the impeachment inquiry into him.
“My objective is not to let the perfect get in the way of the good, but to ensure that the good we seek actually reaches those whom we serve,” Doggett wrote. “In short, more work and amendments are needed to make H.R. 3 effective in achieving our shared objective of lowering drug prices for American families.”