One of These Bills Could Actually Lower Prescription Drug Costs

A bill supported by Senator McSally provides minimal limits on drug prices.

The stage is set for a battle in Congress over two bills that promise to rein in the rising cost of prescription drugs, and even lawmakers with historically unclear positions on the issue are jumping into the fray.

One of the bills, the Lower Drug Costs Now Act, was approved by the House of Representatives in December 2019. Also known as H.R.3, the bill aims to lower costs by adding exceptions for price negotiations for Medicare and Medicaid and putting a maximum on how much can be charged for prescription medication.

Currently, the federal government is prohibited from negotiating prices for drugs covered by Medicare Part D.

H.R.3 would amend this law and open negotiations up for up to 250 brand-name drugs. The bill predicts that allowing negotiations would allow for prices to be fairly decided.

Additionally, H.R.3 would set a maximum limit to what can be charged for Insulin products and at least 25 other drugs. It sets the cap for costs at “120% of the average price in Australia, Canada, France, Germany, Japan, and the United Kingdom.” Both negotiated prices and price caps would apply to drugs purchased through public and private insurance.

Studies estimate that costs for some patients will be reduced by thousands of dollars. As a whole, the Congressional Budget Office estimates direct spending by the federal government on Medicare would reduce by $345 billion between 2023 and 2029.

In the Senate, Sens. Chuck Grassley, R-Iowa, and Ron Wyden, D-Oregon, are garnering support for S. 2543, the Prescription Drug Pricing Reduction Act (PDPRA). Less expansive than H.R.3., this bill also aims to reduce costs for patients using Medicare Part D, mainly through incentives for insurance companies. 

PDPRA would also cap annual out-of-pocket costs for those using Medicare Part D at $3,100. Over one million patients on this plan paid $5,100 or more in out-of-pocket last year.

Grassley’s proposal recently received a nod from President Donald Trump at his State of the Union Address. Since his address, Grassley brought in 12 additional Republican Senators to back the bill, including Arizona Senator Martha McSally.

“I was glad to be able to work with Senator McSally on several provisions in this bipartisan bill,” Grassley said in a statement. “The Prescription Drug Pricing Reduction Act would lower premiums, cap out-of-pocket expenses and rein in the skyrocketing costs of prescription medicines.”

But critics of PDPRA say it doesn’t go far enough to keep prescription drug costs down. While it limits raising prescription costs for Medicare and Medicaid to keep them from outpacing inflation, the bill stops short of curbing price hikes for those on private insurance. Senate Minority Leader Chuck Schumer, D-New York, blocked an earlier version of Grassley’s bill, calling for more wide-ranging solutions. 

Trump brought up prescription drug costs again at his campaign rally in Phoenix on Wednesday and brought McSally onstage to talk about the issue.

“Big pharma cheating and boxing out competition and jacking up the price on our seniors,” McSally told the crowd. 

However, McSally has not shown support for H.R.3, and some critics claim her relationship with pharmaceutical companies could be preventing her from championing more comprehensive solutions to lowering drug costs. Campaign finance records show McSally has received nearly $500,000 from the healthcare, pharmaceutical and insurance industries, which have come out in staunch opposition to drug price negotiations for Medicare and Medicaid.