Health Care

Dems court conservative firebrand in Medicare drug fight

Democrats pushing to lower drug prices for seniors have found an unusual proponent in the fight: Freedom Caucus Chairman Mark Meadows.

The North Carolina Republican, a conservative firebrand and close ally of President Trump, has built a political career around efforts to shrink government and promote free markets. But he also supports the notion of empowering Medicare to negotiate pharmaceutical prices on behalf of seniors — an idea Republican leaders have devoutly rejected since they enacted the Part D drug benefit in 2003.

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Democrats have fought to grant Medicare negotiating powers for exactly as long, and some of the chief proponents of that design — most notably Reps. Elijah Cummings (D-Md.) and Peter Welch (D-Vt.) — have been in direct talks with Meadows about bringing him on to their bill. The measure currently has one Republican backer: Rep. Francis Rooney (R-Fla.).

Meadows, for his part, said he “absolutely” supports the concept, but has been sidetracked by administration efforts to rein in skyrocketing drug costs unilaterally.

“We haven’t spent as much time on that as trying to do some of the things more administratively than legislatively,” Meadows said. “My preference is legislatively.”

“Elijah and I continue to have what I’d say [are] sidebar conversations about it,” he added.

Cummings said Democrats have initially focused on laying out their preferred reforms, with eyes on getting input — and rallying support — from Republicans further down the line. Meadows, he said, is a key part of that recruitment effort.

“We wanted to get the Democratic piece first, and then we’ll try to pull in others,” Cummings said. “Hopefully he’ll be on the bill.”

“I’m gonna ask him, don’t worry,” he added. “Meadows and I have a great relationship. I’m not saying that just to say it — we do.”

The proposal has no chance of advancing in a GOP-controlled House, especially so close to the midterm elections. But Democrats — who have made drug costs a featured piece of their midterm campaign message — want to lay the groundwork for passing a Medicare negotiation bill next year if they win back the Speaker’s gavel.

Democrats made a similar promise when they won the House in 2006, and quickly passed a bill through the lower chamber. But it was blocked in the Senate — the only item on their “six for ’06” wish list that wasn’t signed into law.

They’re hoping Meadows’s endorsement will lend momentum to their proposal, which had the enthusiastic support of Trump on the 2016 campaign trail before falling out of the president’s favor more recently.

“We’re much better off having the Republicans’ help,” said Welch, lead sponsor of the Medicare negotiation bill. He was in discussions with Meadows last year about joining forces on legislation, but the talks between the two fizzled out.

“I’d love to have his help,” Welch said, adding that it’s been a while since the two of them spoke. “But you’re reminding me, so I’m gonna say, ‘Mark, time to go. Time to team up.’ ”

Meadows, hardly known for bipartisanship, has built a reputation for rallying the Freedom Caucus behind conservative policy demands, and then using that bloc of roughly 30 votes to aggravate efforts by GOP leaders to move bills through the House.

But he’s joined forces with Democrats to target the pharmaceutical industry over skyrocketing drug prices, endorsing a bill that would ensure generic manufacturers have access to samples of name-brand drugs for research purposes. He’s also been open to Medicare negotiation stretching back to at least May 2017, when he and Cummings were tentatively scheduled to discuss the matter with Trump at the White House.

That meeting was scrapped after House Republicans passed their bill to repeal ObamaCare the very same day, as scores of GOP lawmakers were bussed over to the White House to celebrate their victory with the president in the Rose Garden. Fourteen months later, Meadows said he’s ready to take another look at the Democrats’ proposals.

“We’ve been talking about drug pricing; on that particularly bill I don’t know. I’ll take a look at it and see if I can sign on,” he said.

The talks, he added, “haven’t stopped.”

“Mr. Cummings and I continue to talk, but not with any great specificity,” Meadows said.

In enacting the Medicare drug benefit in 2003, Republicans faced pressure from pharmaceutical companies and ended up including a provision barring the Department of Health and Human Services from negotiating prices directly with drug companies. Critics of that prohibition contend it prevents Medicare from tapping its bulk-buying power to lower drug costs for seniors — a ban that would be eliminated under Welch’s bill.

A similar proposal, introduced Wednesday by Rep. Lloyd Doggett (D-Texas), would also empower the federal government to negotiate drug prices, while granting Medicare additional authority to pursue generic competitors if negotiations fall through.

On the campaign trail, Trump was a fierce critic of the pharmaceutical industry, saying the companies were “getting away with murder” and vowing to “negotiate like crazy” to lower Medicare drug costs.

“We’ll save more than $300 billion a year if we properly negotiate,” he said in early 2016. “We don’t do that, we don’t negotiate.”

In May, however, his administration released its plan to lower drug costs that excluded new negotiation powers.

Democrats have taken every opportunity to point out the contradiction, and their “For the people” campaign slogan for the midterms dedicates one of just three main talking points to lowering prescription drug prices.

“The president, during the campaign, you probably remember when he said he was going to ‘negotiate like crazy’ to lower prescription drug prices,” House Minority Leader Nancy Pelosi (D-Calif.) told reporters Thursday in the Capitol. “As I’ve said to you before, ‘negotiating like crazy’ means not negotiating at all, because that’s not what happened.”

While the Democrats are scratching their heads over Trump’s reversal, they’re also emphasizing the importance of gaining the president’s support if they’re to have any chance of passing a Medicare drug bill next year.

“It was very clear that he understood very much that, A, pharma is ripping us off and, B, it’s good politics to be for lower prices,” Welch said, referring to a meeting he and Cummings had with Trump in March 2017. “So he understands it substantively and politically. It’s a mystery to me why candidate Trump isn’t showing up these days.

“If he were supportive, specifically got behind it, it would pass,” Welch added. “We need him.”