“It isn’t a hill to die on for us,” he said in a Wednesday interview on the sidelines of the HLTH conference in Las Vegas, where he touted the president’s “non-ideological” approach to high health care costs.
Senate Democrats have said getting rid of the Part D caps would be a deal-breaker. Senate Finance Chairman Chuck Grassley has urged Republicans to get on board with the legislation or risk political consequences like being forced to take up Speaker Nancy Pelosi’s controversial drug pricing bill.
Grogan, a former Gilead lobbyist, said he is still in talks with Pelosi about her legislation, which would authorize the government to directly negotiate the cost of certain drugs. But he distanced the administration from the bill, citing budget scoring concerns and the way its provisions limiting drug prices could run afoul of the Fifth Amendment’s takings clause as well as the Eighth Amendment’s excessive fines clause.
He last spoke with Pelosi’s office about a week before a new analysis from congressional legal advisers came out this month and told them “I admire the ambition, but I don’t know how you’re going to get it through. It might be time to start thinking about [the Senate Finance bill].”
A spokesperson for Pelosi, pointing to Trump’s support for drug negotiations during the 2016 campaign, said Trump should focus on advancing the House bill.
“President Trump used to insist that we needed to ‘negotiate like crazy’ to lower prescription drug prices, and House Democrats’ legislation is the only bill that includes negotiation,” Pelosi spokesperson Henry Connelly said in a statement. “Instead of caving to Big Pharma, the Trump Administration should work with us to pass the Lower Drug Costs Now Act through the Republican-controlled Senate.”
Senate Majority Leader Mitch McConnell has not committed to bringing up the Finance Committee legislation — or other health bills passed this summer, like a HELP Committee measure, to lower health care costs — for vote.
Grogan said the White House has been talking to McConnell’s team but is also focusing on a range of members. It’s had particularly frequent conversations with Senate Finance Chairman Chuck Grassley to encourage changes that can get bipartisan backing for the measure.
Grogan said the administration separately has made significant progress on its international pricing index proposal, which would benchmark U.S. prices for certain Medicare Part B drugs to an index of lower prices paid abroad. “We’re not done, but it’s not a difficult problem to solve.” He also said an importation proposal is “very close” to release.
One plan unlikely to be resurrected by the White House is a move to eliminate rebates that drugmakers pay to pharmacy benefit managers. Lawmakers have discussed added more scaled-back versions of the plan to both the Senate and House bills.
“I have been extremely skeptical that we can get a solution,” he said, adding that players in the drug pricing chain said eliminating rebates from the system could actually make drug pricing problems worse. “But if somebody knows how to cut the Gordian knot, knows how to solve the Rubik’s cube, I can’t wait to see it.”