Most Drug Price Controls Ruled OK by Parliamentarian

“The Senate parliamentarian narrowed Democrats’ plan for curbing drug prices but left it mostly unscathed Saturday, Democrats said, as party leaders prepared to start moving their sprawling economic bill through the chamber,” the AP reports.

“Elizabeth MacDonough, the chamber’s rules arbiter, said provisions must be removed that would force drugmakers to pay rebates if their prices rise above inflation for products they sell to private insurers. Pharmaceutical companies would have to pay those penalties if their prices for drugs bought by Medicare rise too high.”

Playbook: “There are two crucial policies to lower drug prices in the bill. The first is the one you hear the most about: requiring the federal government to negotiate prices for a limited number of expensive prescription drugs covered by Medicare. One of the key enforcement mechanisms for this policy is an excise tax of up to 95% on pharmaceutical companies to force them into the price negotiation regime. Republicans strongly believed this excise tax violated the strict rules of reconciliation outlined in the Byrd rule.”

“But MacDonough rejected challenges to the excise tax and declared that it can be included in the bill — though she did not explain her reasoning, at least in her written guidance, a fact that has frustrated Republicans this morning.”