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Speaker Nancy Pelosi on Thursday released her long-awaited plan to curb soaring prices of prescription drugs, a political chess move that could prod the Senate to move and heat up congressional negotiations with the White House on a popular but elusive goal. Ms. Pelosi’s plan, which she laid out at a morning news conference, would allow the government to negotiate the price of insulin and as many as 250 name-brand drugs each year for Medicare beneficiaries — an idea that many Republicans hate but that President Trump embraced during his 2016 campaign. Drug companies would also have to offer the agreed-on prices to private insurers or face harsh penalties, which could give the package broader appeal with voters. (Goodnough, 9/19)

Kaiser Health News: Hill Hodgepodge: Pelosi Draws From Democrats, GOP And Trump For Drug Plan

Outlining how the HHS secretary would determine which drugs to negotiate, the plan says HHS would identify the target drugs each year with the highest aggregate cost, meaning they would take into account the price and the volume of sales. HHS would be required to negotiate the price of insulin, the proposal adds, singling out the lifesaving diabetes medication with sky-high costs that have spurred outrage at drugmakers this year. The legislation would aid negotiations by creating a maximum price called the Average International Market price. (Huetteman, 9/20)

As an enforcement mechanism under Pelosi’s plan, if a drug company refused to negotiate a lower price, the company would be hit with a 65 percent tax on the drug’s gross sales, which would escalate up to 95 percent if the company still refused to come to the table. The plan would also set a maximum price in negotiations of 120 percent of an average of the price in other countries, borrowing an idea Trump himself has proposed to lower drug prices. (Sullivan, 9/19)

The plan would limit copays for seniors covered by Medicare's "Part D" prescription drug program to $2,000. Medicare-negotiated prices would be available to other buyers, such as employer health plans. It's shaping up as a high-stakes gamble for all sides in Washington. Polls show that high drug prices have Americans worried, and regardless of party affiliation, they want Congress to act. As a candidate, President Donald Trump called for Medicare negotiations but later seemed to drop the idea. (9/19)

“I want the biggest number we can possibly get, but I don’t want to promise something that we won’t have a deliverable within the next year on,” Mrs. Pelosi said. The pharmaceutical industry denounced the proposal and said other options, such as lowering consumers’ coinsurance and increasing patient-cost transparency, are preferable. (Armour and Duehren, 9/19)

In gridlocked Washington, both Democrats and Republicans have signaled there's potential for a deal when it comes to lowering prescription drug prices. Now, there's an idea both Congressional Democrats and the White House seem to like: They want to base U.S. prices on something called an international price index. "The basic idea is to peg what the United States pays for a particular drug to the price paid in some set of other countries," says Rachel Sachs, an associate professor of law at Washington University in St. Louis who specializes in drug pricing policy. (Simmons-Duffin, 9/19)

Pelosi’s final proposal, in some ways, is more aggressive than prior concepts that had circulated among lobbyists and congressional staff this year. It abandons a proposal to use binding arbitration to settle negotiation disputes, which progressives had opposed. Prior versions also did not include an international price index, which has become an unexpected point of agreement between Trump and progressives.(Facher, 9/19)

Progressive House lawmakers are pushing for Speaker Nancy Pelosi’s (D-Calif.) bill to lower drug prices to go further. The lawmakers have not denounced the bill and praised its overall approach, but say that important changes need to be made to make it stronger before it goes to the House floor. (Sullivan, 9/19)

As Pelosi works to appease her progressive flank, she also needs to worry about the moderates in her caucus, who may see this plan as too anti-industry. Pelosi attempted to sell the plan Wednesday to Democrats’ main moderate caucuses, the Blue Dog and the New Democrat coalitions. “Everybody wants to ensure that innovation continues to happen, that cures continue to happen, everyone wants to make sure those cures are accessible and affordable for their constituents as well,” said Rep. Derek Kilmer (D-Wash.), chair of the New Democrats. “And that’s the narrow needle that needs to be thread in this conversation.” (Florko and Facher, 9/19)

Even if there is no deal with the White House, the Democrats’ bill is a baseline for future efforts to address prescription drug costs under a Democratic president and Senate. The measure would require the Health and Human Services secretary to negotiate the prices of up to 250 drugs in Medicare that do not have competitors and would impose severe financial penalties on drug companies that failed to come to an agreement. The negotiated prices would be available to all purchasers, not just Medicare beneficiaries. (Abutaleb and DeBonis, 9/19)

Democrats in 2018 seized control of the House of Representatives in large part because they convinced voters that they would be the party to protect Americans’ healthcare. But now, as the 2020 presidential campaign narrows the window for passing significant legislation and dominates headlines, rank-and-file Democratic House members have little to show on healthcare, an issue that is still top of mind for voters. (Haberkorn, 9/19)

The Pharmaceutical Research and Manufacturers of America, called PhRMA, the industry’s main trade group, opposed the plan, saying it gives “the federal government unprecedented, sweeping authority to set medicine prices in public and private markets while importing price controls from other countries that restrict access to innovative medicines.” “Speaker Pelosi’s radical plan would end the current market-based system that has made the United States the global leader in developing innovative, lifesaving treatments and cures,” PhRMA President and CEO Stephen J. Ubl said in a statement. (Lovelace, 9/19)

Senate Republicans are warning Speaker Nancy Pelosi that her much-anticipated drug pricing plan is dead and will not be considered in the Senate. In an interview, Senate Majority Leader Mitch McConnell (R-Ky.) ruled out any action on the bill, which would call for Medicare to negotiate drug prices for a minimum of 25 medicines and target drugs that cost the American health system the most. Pelosi rolled out the plan on Thursday to intense opposition from the drug industry, and McConnell. (Everett, 9/19)

But House Energy and Commerce Chair Frank Pallone (D-N.J.) said he hopes the committee process will help "convince (committee Republicans) that this is the way" to lower prices. "We do think we can get Republican support, and the president is key," Pallone said. Pallone and Ways and Means Chair Richard Neal (D-Mass.) repeatedly invoked Trump's own rhetoric lamenting that the U.S. pays far higher prices than people in other countries whose governments limit what manufacturers can charge.(Luthi, 9/19)

President Trump on Thursday broke with most Republicans on Capitol Hill on the issue of drug pricing, saying on Twitter that it was “great to see” House Speaker Nancy Pelosi introduce a bill that many GOP lawmakers derided earlier in the day as “socialist.” In the tweet, Trump also reiterated his support for an existing, bipartisan drug pricing package currently before the Senate, and encouraged lawmakers to pursue a bipartisan solution. (Facher and Florko, 9/19)

McConnell has not said if he will bring up Grassley’s legislation. Secretary of Health and Human Services Alex Azar met with Democratic lawmakers on Thursday to push for a bipartisan agreement on lowering drug prices. Azar did not give an opinion on Pelosi’s bill, saying he had just started to read it, according to lawmakers in the room. Much of the discussion centered on the Grassley-Wyden proposal, and Wyden, who was in attendance, walked through some of the details of the bill. (Sullivan, 9/19)