Lowering pharmaceutical drug prices is a rare bipartisan goal in Washington, and a legislative proposal to do just that cleared the Ways and Means House committee on Tuesday. The proposed law would allow Medicare to negotiate directly with pharmaceutical companies over the price of 250 of the United States’ most costly drugs, and in turn pass on those savings to private health plans. Failure on the companies’ part to negotiate would result in them getting fined at least 65 percent of their drug’s gross sales.

The bill would save Medicare a hefty $345 billion over 10 years, according to a report from the Congressional Budget Office, a nonpartisan entity.

Last week, the legislation—including some last-minute changes that would institute a price cap on drugs with no other competitors—passed a vote out of the Energy and Commerce committee that was divided down party lines. Some Republicans have opposed the bill, saying that it will tamp down on the industry’s innovation if profit margins are limited. They have also expressed doubt that the legislation will ever make it across the finish line.

“I don’t believe that I was elected to write bills that would never go anywhere,” said Republican Michael Burgess, who sits on the Energy and Commerce Committee. “And that’s exactly where this bill is headed.”

But Speaker of the House Nancy Pelosi and other Democrats are determined to push a vote on the bill, even by the end of the month.

Does The Bill Have A Shot?

President Donald Trump had previously expressed support for the legislation. “Let’s get it done in a bipartisan way!” he tweeted as recently as September.

However, if the bill relies on the relationship between Pelosi and Trump, it may be in trouble. Last month, Pelosi announced Democrats plan to move forward on proceedings to impeach Trump. The bombshell turned the at-best tentative relationship between the politicians sour. “Nancy Pelosi needs help fast!” Trump tweeted last week. “There is either something wrong with her ‘upstairs,’ or she just plain doesn’t like our great Country [sic]. She had a total meltdown in the White House today. It was very sad to watch. Pray for her, she is a very sick person!”

Pelosi has told the press that despite what Trump tweets, his statements will have little effect on their ability to work together on lowering prescription drug costs. His outbursts are “not important, in that regard,” she said.

Some Senate Republicans have also presented themselves as a hurdle for the legislation. When the plan was announced in September, Senate Majority Leader Mitch McConnell pronounced it “dead on arrival.” But others have established themselves as allies of plans that would lower drug costs, like Senate Finance Committee chairperson Chuck Grassley.

Reflecting the bipartisan nature of the legislation, there is another prescription drug bill that does have the backing of members of both parties and the president that was proposed by the Senate Finance Committee in June. That plan also contains penalties for drug companies who raise prices faster than inflation, but stops short of granting Medicare direct bargaining power.

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