Senate bill on drug prices may not apply to people with occupational insurance

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Senate Democrats’ bill to cut prescription drug prices may not apply to millions of people who get health insurance through their jobs, Senate advisers and lobbyists have said , which alarmed employers and progressive groups.

The Democrats’ signature drug price measure, expected to be included in their next $ 3.5 trillion package, would allow the Secretary of Health and Human Services to negotiate lower drug prices, a long-standing Democratic goal . The House’s measure would apply those lower negotiated prices not only to seniors with medicare, but also to the roughly 150 million Americans who receive medicare through their employers.

But in the Senate, the push is hampered by the complicated rules of the upper house. The “Byrd rule” requires that the provisions have a sufficient impact on the federal budget. The drop in drug prices for people with private insurance does not have as direct an impact on the federal budget as the drop in prices with Medicare.

Employers and progressive groups are pushing for lower drug prices to apply to people with private insurance as well, saying all Americans, not just those with Medicare, need health care. ‘a relief.

Additionally, employer groups warn that if prices apply only to Medicare, drug companies will simply increase prices in the private insurance market, pushing them to bear the costs.

James Gelfand, senior vice president of health policy at the ERISA Industry Committee, an employers’ group, said employers would oppose the drug bill’s provisions unless lower drug prices expands to the employer market.

“If you can’t find a way to protect the private sector, then the bill could lead to explosive increases in drug prices for employers and working families,” he said.

Proponents argue that if lawmakers truly believe in extending lower drug prices to the private market, they can find a way to do it within the rules.

For example, Gelfand said an alternative his group is advocating for complying with the Byrd rule is to impose an excise tax on drug companies that set prices in the employers’ market above the negotiated rate.

However, the situation is still fluid and could change.

Chairman of the Senate Finance Committee Ron WydenRonald (Ron) Lee Wyden Business groups aim to divide Democrats on .5T spending bill Crypto debate set to resume Air attacks on fires often do nothing, expert says MORE (D-Ore.), Who is leading the Senate drug pricing effort, has expressed support in the past for extending lower prices to the employer-sponsored insurance market.

On Tuesday, when asked about the fate of the private market arrangements, an employee of the Senate finance committee said: “These policies have not yet been finalized.”

In addition to Senate rules, Wyden also pursues delicate politics as he tries to strike a balance between moderate and progressive Democrats in a 50-50 Senate – the party cannot lose a single vote on the measure.

Some Democrats, including Sen. Robert menendezRobert (Bob) MenendezOvernight Defense: Senior General Acknowledges News Missed Speed ​​Of Afghan Collapse Congress To Grill Biden Officials Over Disorderly Exit From Afghanistan GOP Senator Calls on Defense of Biden and the foreign policy team to step down MORE (DN.J.), fear of getting too tough on the pharmaceutical industry.

The Senate bill is also likely to leave out a provision allowing the prices paid on drugs in other countries to be used as a benchmark in the United States, an idea known as an “international benchmark price.” .

Instead, the bill could use a “national benchmark price”, although the details of this proposal are unclear.

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