Trump administration pushing new drug spending cap

Axios– November 24, 2019

The Trump administration is pushing for a monthly cap on what seniors pay out-of-pocket for drugs through Medicare’s pharmacy benefit to be added to a bipartisan drug pricing bill in the Senate, a senior administration official told Axios’ Caitlin Owens and me.

The big picture: The cost of prescription drugs is still a top priority of the administration, even amidst all of the impeachment furor — and the president could very much use a big win on the subject heading into the 2020 election.

  • Most of the administration’s major drug pricing policies have been tabled, are tied up in the courts or have yet to be implemented.

Between the lines: One unexpected side effect of impeachment is that it has dragged drug prices to the front of Trump’s mind again, the official said.

  • Trump has been talking and meeting frequently with Republican lawmakers as part of his impeachment defense strategy.
  • But, the official said, after the members discuss impeachment for a brief while with the president they usually pivot quickly and use their time with Trump to push their priorities.
  • For many of these members of Congress, lowering drug prices is one of the most urgent demands they hear from their constituents. They want to be able to run on this issue in 2020 and they’re urging Trump to lean on Senate Republicans to pass a bill.
  • Trump would not support Nancy Pelosi’s bill, so the only chance is the bill sponsored by Sens. Chuck Grassley (R-Iowa) and Ron Wyden (D-Ore.), the official said.

Details: The Grassley-Wyden bill currently caps enrollee cost-sharing in Part D at $3,100 a year beginning in 2022. The official said the administration is working with members to spread that cap out on a monthly basis.

  • “Some seniors may max out in January, and that’s a big hit. And rather than have them spend that [on a] credit card and be in debt for 12 months or even longer … they could stagger that, and it would be a great benefit for them,” the official said.
  • Grassley hinted at these changes last week, saying that the updated version of the bill “will improve the out-of-pocket cap by giving seniors and Americans with disabilities more flexibility when it comes to upfront costs.”