10 | POLITICO | THURSDAY, SEPTEMBER 19, 2019
Health subcommittee, after a
closed-door meeting on the bill.
Democrats are set to unveil the
bill Thursday, capping months of
work on what many consider the
caucus’ legislative centerpiece —
even as few outside of Pelosi’s tight
circle have seen it in full.
The frustration on the left has
been building for months, in part
aimed at one of Pelosi’s longtime
health advisers Wendell Primus,
whom one progressive leader de-
rided as “Representative Wendell”
for his dominant role in drafting the
plan.
Rep. Debbie Dingell (D-Mich.) on
Wednesday walked out of a meeting
with House Energy and Commerce
leaders, after complaining that she
had not seen key details and still
had more questions, according to
two people in the room.
In one exchange, Energy and
Commerce Chairman Frank Pal-
lone told the group of lawmakers,
“We’re going to have Democratic
consensus on this.”
Dingell replied, “I don’t think
you do have consensus,” citing
concerns from progressives, ac-
cording to two people in the room.
Afterward, some other liberal
Democrats in the room spoke up
in favor of the bill, though several
people familiar with the briefing
also questioned how invested Pal-
lone was in pushing it.
It’s a warning sign for Pelosi and
other top Democrats as they look
to notch a big legislative win by
year’s end. If the party can’t fulfill
a top campaign promise, it could
threaten the freshman Democrats
who flipped seats and delivered the
House in 2018.
“She knows where it is in the
polls,” said Rep. John Larson (D-
Conn.), who has served with Pe-
losi for 20 years in the House. “I
think anytime she sets her mind
to do something — she knows
how to work the caucus as well as
everyone.”
Other Democrats have emerged
from private briefings on the bill
this week with confidence that the
House could approve drug pricing
legislation this fall, though many
said they would reserve their final
judgment on Pelosi’s plan until de-
tails emerged.
In separate meetings with the
Blue Dog Coalition and New Demo-
crats this week, lawmakers raised
concerns with relatively technical
aspects of the legislation, rather
than major substantive issues,
according to multiple lawmakers
and aides in the room. The speaker
will meet with the Congressional
Progressive Caucus on Thursday
afternoon.
“There’s a lot of momentum
behind this,” Rep. Dan Kildee (D-
Mich.) said. “It’s big. When you get
into the details, obviously it can be
difficult.”
But the secretive process has
frustrated Democrats across the
spectrum and left both progres-
sives and otherwise supportive
centrist members skeptical of
leadership’s case for speeding the
drug plan through as soon as Octo-
ber. Some liberal lawmakers have
privately vented in recent weeks
that Pelosi was preparing to jam
them on a key priority — forcing
members to effectively pass her
favored bill or risk going home
empty-handed.
Indeed, the legislation fails to
meet a series of demands that pro-
gressives have made for months
— namely that it authorize federal
officials to directly negotiate theprice for at least 250 drugs. The
bill instead will require negotia-
tions for 25 drugs per year, with
a maximum of 250, according to
lawmakers and aides.
That provision has been one of
the biggest concerns for progres-
sives, multiple lawmakers said, and
was one of the focal points in the
Energy and Commerce Commit-
tee’s briefing on Wednesday. Pelosi
and her staff have said in response
that requiring negotiations for 250
drugs would have been nearly im-
possible to achieve.
The bill may also violate a second
requirement for liberal lawmakers
that it allow for immediate limits
on the price of newly launched
medicines.
House leadership, meanwhile,
has largely dismissed compet-
ing legislation already endorsed
by progressives that would take a
harder line with the drug industry,
worrying it would hurt innova-
tion and run into a series of legal
hurdles.
The CPC has blasted leadershipfor writing the bill in secret and
pulling back its ambitions — con-
tending that Democrats shouldn’t
“negotiate against themselves”
and water down the bill in hopes
of attracting support from Senate
Republicans or President Donald
Trump.
In a public missive sent to Pe-
losi in August, five CPC members
led by its co-chairs Mark Pocan
(D-Wis.) and Pramila Jayapal (D-
Wash.) warned the coalition may
not support legislation that fails to
meet its standards.
“Our position has not changed
a millimeter,” said Pocan, who
gave Primus the nickname. “I
don’t think anyone wants to go back
home and say we’re negotiating for
25 drugs. It’s gotta be something
more substantive.”
Moderates, however, have said
that any drug pricing bill should be
more than a statement of Demo-
cratic values. It should be some-
thing that can be signed into law.
“My worry is that it may be
something that does not attractRepublican support, which means
it’s dead on arrival in the Sen-
ate,” said Rep. Anthony Brindisi
(D-N.Y.), a freshman who won a
Trump-backed district in part by
campaigning on health care.
“There’s a sense that, although
a lot has been accomplished in the
House, a lot of it may not see the
light in Senate, so we have to re-
ally focus our attention over the
next year and a half on what can
actually get passed and signed into
law,” he added.
Top Democrats stressed that the
legislation could still change as it
winds through committee, and
they emphasized that passing a
drug negotiation bill is a must for
the caucus to be able to proclaim a
successful first year in power.
“I don’t know how anyone can go
home and say, ‘You know what, it
was so hard to do that. I can’t lower
the price of prescription drugs for
you,’” Eshoo said. “I just don’t
think that that’s a take-home item.”
Eshoo’s subcommittee is plan-
ning a legislative hearing on the bill
next Wednesday, with sessions in
the Ways and Means and Education
and Labor panels likely to follow in
the next few weeks. Top Democrats
are targeting a floor vote as soon as
the end of October.
In addition to authorizing direct
negotiation of drug prices, the bill
would allow the government to slap
a hefty tax on drugmakers that re-
fuse to cooperate.
The legislation also incorporates
a measure tying the maximum price
of drugs under negotiation to the
often lower prices that are charged
abroad.
That so-called reference pric-
ing concept — which is favored by
liberals like Sen. Bernie Sanders of
Vermont — appears aimed directly
at winning over Trump, who has
embraced a similar approach in a
sharp break with GOP orthodoxy.
The legislation also sets a first-
ever $2,000 cap on what seniors
must pay out of pocket for their
drugs under Medicare Part D, a
broadly popular move that’s be-
come a priority for Republicans
and Democrats over the past year.
“I think everybody has an ap-
petite to dig in,” said Rep. Derek
Kilmer (D-Wash.), chairman of the
New Democrat Coalition. “This is
something in red districts, purple
districts, blue districts, we all hear
about it from our constituents.”Sarah Owermohle contributed to
this report.Pelosi’s drug pricing plan is drawing liberal angst
DRUG PRICING from page 1
Sen. Lindsey Graham has become
one of President Donald Trump’s
closest allies since trashing his
candidacy in 2016. But he’s stick-
ing with his criticism of Trump’s
approach on Iran.
After Trump chastised him
this week on Twitter and in com-
ments to reporters for advocating
a hard-line approach and military
strikes on Iran in retribution for
an attack on Saudi Arabia, Gra-
ham (R-S.C.) stood firm on his
opinion that the president and
his administration is being too
soft on Iran. And he thought little
of the new sanctions Trump an-
nounced on Wednesday.
“Sanctions so far haven’t worked
and I doubt they ever will. So I think
an appropriate military response is
in order,” Graham told a pair of re-
porters on Wednesday afternoon.
The “measured response to the
drone attack, I appreciated that, I
was hoping that would give every-
body a chance to reset. So clearly,
the Iranians have taken that to be
a sign of weakness.”
Asked about Trump’s tweet re-
buking him, Graham replied: “All
I can say is, it’s not working. The
Iranians are your target audience,not me. And the Iranians decision
to attack the Saudi oil field is an act
of war by any definition.”
Trump has shrugged off sug-
gestions by Graham and Sen. Tom
Cotton (R-Ark.) to strike Iran in
retaliation for its incursions in
the Middle East and even sacked
his hawkish national security ad-
viser, John Bolton. And the beef
between Graham and Trump lin-
gered into Wednesday afternoon,
with Trump saying his reluctance
to strike back after Iran allegedly
bombed Saudi Arabia’s oil pro-
duction facilities is a “great sign
of strength.”“It’s very easy to attack, but if
you ask Lindsey, ask him how did
going into the Middle East, how did
that work out? And how did going
into Iraq work out? So we have a
disagreement on that. And you
know there’s plenty of time to do
some dastardly things,” Trump told
reporters on Wednesday.
The episode marks a rare schism
between the president and Gra-
ham, who famously did all he
could to stop Trump’s rise during
the 2016 primary before shifting
to become a golfing buddy and
close adviser once Trump became
president. The two have workedclosely over the past two years,
though Graham has occasion-
ally advocated a more muscular
military approach than Trump is
comfortable with.
Graham said on this issue the
president knows where he stands,
and warned that stalling any fur-
ther could open up the Middle East
to more attacks.
“They’re clearly not going
to stop until they pay a heavier
price,” Graham said. “The Irani-
ans decision to attack the Saudi
oil field is an act of war by any
definition. Pompeo said so. I’m
glad he did.”BY BURGESS EVERETT
Graham to Trump: ‘The Iranians are your target audience, not me’
J. SCOTT APPLEWHITE/AP
Speaker Nancy Pelosi’s ambitious drug pricing bill and its closed-door drafting process has left progressives
worried that the plan will fall well short of their expectations and that they remain cut out of the talks.