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Democrats Offer Plan to Cut Drug Costs, Seek Climate and Tax Deal

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WASHINGTON — Supreme Senate Democrats on Wednesday released an updated plan aimed at lowering the cost of prescription drugs, signaling progress has been made on a critical part of their bid to get some of the stalled out. President Biden’s social safety net, climate and tax bill.

Democratic leaders negotiated the drug pricing proposal primarily with West Virginia Senator Joe Manchin III, a conservative-leaning Democrat who abruptly halted discussions in December on Biden’s domestic policy bill for Mr. Biden.

They released the plan this week in a bid to pave the way for a slashed tax and climate spending package they hope to push through the Senate this month over the Republican opposition. It would be paid in part by the prescription drug proposal that is expected to save the government tens of billions of dollars in the coming years.

Under the new measure, Medicare would be allowed to directly regulate the prices of prescription drugs for the first time. It would cap the cash amount Medicare patients can be asked to pay for prescription drugs to $2,000 a year, limit the amount drug companies can raise prices each year, and make more vaccines free for those patients, according to a draft presented on Wednesday.

Its release marked the most substantial progress in months toward reviving parts of Biden’s multi-trillion dollar plan, following a meticulous series of closed-door talks in which leading Democrats have worked to accommodate the preferences of the government. Mr Manchin and other centrists in the Senate.

Since Republicans are expected to uniformly oppose it, it would need the support of every Democrat to move forward in the evenly divided Senate under special budget rules that could protect it from a filibuster.

New York Democrat and Majority Leader Senator Chuck Schumer has privately expressed a desire to vote on such a bill by the end of this month. Some aides and lawmakers remain skeptical that Democrats could rally behind one less than six months before the midterm elections, amid lingering concerns about rising inflation.

Ahead of a planned recess in August, Democrats are also juggling a tight time frame to pass sweeping manufacturing and technology legislation designed to increase U.S. competitiveness with China and reduce public pressure to respond to the Supreme Court’s decision to overturn Roe. v. to nullify Wade, the landmark case that granted constitutional right to abortion.

In an effort to remove procedural hurdles and clear the way for swift action if a broader deal can be reached, top Democrats on Wednesday asked the Senate MP to review the updated version of the drug price plan, according to a official who is familiar with the private discussions they made public on condition of anonymity. Since Democrats plan to take advantage of the accelerated budget process known as reconciliation, the measure must meet strict limits imposed by the Senate’s top official.

The drug price regulation proposal was a cornerstone of the Build Back Better Act, Mr. Biden’s signature $2.2 trillion plan that encapsulated much of his domestic agenda. It vacated the House in November with only Democratic votes, but stalled a month later after Mr Manchin stated he could not support such a comprehensive and expensive package as inflation began to rise.

Mr. Manchin has repeatedly said that any package should focus on reducing the national debt, tackling the cost of prescription drugs and undoing parts of the tax law Republicans broke in 2017. And while opposing key elements of his party’s ambitious plans to tackle climate change, Mr Manchin has expressed in his talks with Mr Schumer that he is open to the inclusion of a climate and clean energy tax package. .

“Senator Manchin has long advocated proposals that would lower the cost of prescription drugs for seniors, and his support for this proposal has never been questioned,” said Sam Runyon, a spokeswoman. “He’s happy that all 50 Democrats agree.”

Reducing the high cost of prescription drugs remains a top priority for voters, a priority Democrats have sworn unsuccessfully for years. The current Medicare drug benefit exposes many patients to high prices because the program cannot negotiate directly with drug manufacturers and because it asks beneficiaries to pay a percentage of the cost of expensive drugs with no cap. Some seniors who take expensive drugs for cancer and autoimmune diseases regularly spend $15,000 or more a year on drugs.

Mr. Manchin and Mr. Schumer have met repeatedly in recent weeks to work out the details of a potential deal, which is likely to be around $1 trillion. The tax component must also gain the support of Arizona Senator Kyrsten Sinema, a centrist Democrat who has opposed her party’s proposals to revise the tax law to pay for a broad safety net package.

Talks about those remaining pieces are expected to continue in the coming days. Democrats have already shelved many of their plans to increase support for families and children in order to keep the overall cost of the legislation low and attract Mr Manchin’s support.

They are also pushing for an extension of the Affordable Care Act grants expanded under the $1.9 trillion pandemic emergency law enacted last year. They expire at the end of this year.

The drug package unveiled on Wednesday is broadly similar to drug provisions that were part of previous negotiations. But it reflects part of the pair’s negotiations: It is now extending financial aid to more low-income seniors, lowering their premiums, deductibles and other payments in Medicare drug benefit.

The current program offers such assistance to seniors earning less than 135 percent of the federal poverty level — about $18,000 per year for an individual — and more limited assistance to beneficiaries who earn slightly more. The legislation would expand those subsidies to 150 percent of the poverty line — about $20,000 a year — according to the executive summary.

It would also require the Department of Health and Human Services to negotiate lower Medicare prices on certain prescription drugs. Previous legislation had given the department discretion to do so, but not mandatory, and Democrats were concerned that a prospective health secretary in a Republican administration would refuse to do so.

Certain provisions of the original drug bill were also scrapped, including one that would have limited the amount Americans could pay out of pocket for insulin each month. But a vote on a separate bipartisan insulin bill led by Senators Maine Republican Susan Collins and New Hampshire Democrat Jeanne Shaheen is expected in the Senate in the coming weeks, though it’s unclear if it will gain enough Republican support.

Debra DeShong, the executive vice president of public affairs at drug trafficking group PhRMA, expressed displeasure with the proposal, noting that some technical adjustments could cost Medicare beneficiaries more than they would have spent under previous drafts of the bill. The industry has long resisted attempts to regulate prices.

“The bill for prescription drugs released today went from bad to worse for patients,” she said in a statement. “Democrats weakened protections for patient costs included in previous versions, while doubling down on sweeping government pricing policies that jeopardize patient access and future innovations.”

The urgency surrounding the overall package has increased as Mr Biden’s popularity continues to decline and Democrats fear losing control of Congress.

The Supreme Court’s decision to limit the Environmental Protection Agency’s ability to tackle carbon emissions last week also increased pressure among Democrats to pass legislation that would counter the impact of climate change. The pending proposal could include up to $300 billion in clean energy tax incentives that the House initially approved in November.

“We don’t have the help of a single Republican to continue cutting prescription drug prices and expanding our capacity around clean energy and tackling the climate crisis,” said Minnesota Democrat Senator Tina Smith.

Republicans have remained unanimously opposed to the domestic policy package. After applauding Manchin’s decision to suspend talks in December, some Republicans have watched with alarm as the West Virginian resumed talks with Schumer in recent weeks.

Senator Mitch McConnell of Kentucky, the minority leader, threatened Thursday that Republicans would walk away from the bipartisan manufacturing and technology bill if Democrats insisted on saving climate spending and the tax package.

In a speech at the Paducah Area Chamber of Commerce in Kentucky on Tuesday, Mr. McConnell denounced the legislation, warning, “If they bring that back, it will only make this all significantly worse.”

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