Healthcare and drug policy take center stage in Washington

Presidential campaigns only magnify an already intense debate


There are at least 26 bills, roughly evenly split between the House and Senate, already filed in the 116th Congress that point at the pharma industry. And because there is an unusual consensus among Democrats, the White House, and most Republicans, to address drug pricing and reimbursement policy, there is a strong likelihood that some of this legislation will pass. The fact that various Democrats have declared their presidential intentions (along with some Republicans who would potentially go up against President Trump), only adds gasoline to this simmering fire.

Introducing bills is, of course, merely the first step in the legislative process, and some of these bills were floating about in the previous Congress. One—the CREATES Act that would clear away the spurious practice of withholding innovator’s comparator drugs for when a generic manufacturer is attempting to win FDA approval—is likely to pass in some form; the practice is a black eye on the pharma industry and wouldn’t, itself, dramatically change overall drug pricing.

2019 legislation

According to press reports, the pharma industry (one of the powerhouses in Washington lobbying) is not sitting idly by. For years, it has fought against drug importation, and is carefully aligning itself with President Trump and his HHS Secretary, Alex Azar, in their push to change the rebate practices of pharmacy benefit managers. But the issue that is likely to garner the most headlines during presidential campaigning—various versions of “Medicare for All”—is, surprisingly, something that PhRMA and BIO finds themselves in alignment with insurance companies, hospital administrators and many medical associations: They are against it. These groups are all part of a relatively new organization, the Partnership for America’s Health Care Future, and their basic stance is: Fix what needs fixing in the Affordable Care Act, but do not expand Medicare to a wider group of covered lives.

This stance is counterintuitive, in that the pharma industry was an early supporter of ACA—whose primary purpose was to expand governmental healthcare insurance. After Sen. Bernie Sanders announced his candidacy in February, the Partnership’s executive director, Lauren Crawford Shaver, commented, “Whether you call it Medicare for All, Medicare buy-in, single-payer or a public option, when Americans learn the facts about government-run health care proposals, majorities oppose it.” In broad terms, the Partnership will argue that there’s a necessary choice between Medicare for All and private insurance, but that belief itself will be argued over.