Returning from a two-week recess, House Democrats are entering a key phase in their drive to overhaul prescription drug costs, including requiring the government to negotiate prices with manufacturers.

House Majority Leader Steny Hoyer, D-Md., last week said a vote by the end of the month on a drug pricing bill is possible. But that timeline is likely to slip as four committees will have to vote on portions of the bill before Democratic leaders can meld a final draft.

Lawmakers late last week received a preliminary economic analysis from the Congressional Budget Office (CBO), finding that their legislation would lower government spending by $354 billion over seven years, primarily due to the provision on government negotiation. But the CBO report also warned the legislation would reduce manufacturers’ investment in research, leading to 15 fewer new drugs being marketed.

House Republicans immediately howled about both the legislative process and the bill’s projected impact on innovation. But because of House rules, which hand the majority party near-total control of the legislative process, GOP lawmakers have few tools to slow down or shape the final bill.

Last month, subcommittees for the Energy and Commerce Committee and Education and Labor Committee held hearings on the bill, and the panels could vote on the bill as soon as this week. The Ways and Means Committee is holding a hearing Thursday on the legislation.

Despite the action in the House, forwarding drug pricing legislation to the White House for President Donald Trump’s signature remains a long shot. Liberal lawmakers in the House are pressuring Speaker Nancy Pelosi, D-Calif., that the bill doesn’t go far enough to bring down drug prices, but the opposite political dynamic is in play in the Senate.

Rank-and-file Republican senators remain concerned that legislation approved in July by the Senate Finance Committee would harm innovation and give government too big a hand in drug development. Senate Republicans lack unity to bring that legislation to the floor for a vote. Moreover, the House and Senate bills take such radically different approaches that reconciling them would be a difficult task.

Trump had been expected to cajole Senate Republicans into acting this month on drug pricing legislation, but that was before the House’s impeachment inquiry became more energized. Now it’s not clear that Trump would put pressure on senators to act on legislation that currently divides the GOP when he may soon need their votes to block his impeachment.

Finance Committee Chairman Chuck Grassley, R-Iowa, said his bill is key to Republicans maintaining their Senate majority – but he also acknowledged a vote on drug pricing legislation likely won’t come before 2020.

The most likely scenario for drug pricing legislation remains that discrete provisions – such as ensuring generics have access to brand drugs, even those under safety protocols; or addressing “pay for delay” agreements between brand and generic manufacturers – are added to year-end budget legislation, which will likely include a series of extensions for expiring federal healthcare programs.


A House Homeland subcommittee will hold a hearing Thursday on bioterrorism defense and preparation.

Witnesses include Dr. Asha George, executive director of the Bipartisan Commission on Biodefense; Dr. Umair A. Shah, executive director of Public Health in Harris County, Texas; and Dr. Jennifer Rakeman, director of the Public Health Laboratory at the New York City Department of Health and Mental Hygiene.

At a June hearing on antimicrobial resistance, shortly after President Donald Trump signed the Pandemic and All-Hazards Preparedness and Advancing Innovation Act, Dr. George stated, “The nation is not prepared for biological outbreaks, bioterrorist attacks, biological warfare, or accidental releases with catastrophic consequences.”


The Senate Aging Committee will hold a hearing Wednesday on efforts to reduce the incidence of senior citizens falling, which led to millions of emergency room visits last year.

The Senate last month approved a resolution from committee leaders Sens. Susan Collins, R-Maine, and Bob Casey, D-Pa., marking Sept. 23 as National Falls Prevention Awareness Day.

Collins and Casey said that in 2018, about 3 million older adults were treated in emergency rooms after falling. The senators requested information on falls prevention from the Food and Drug Administration, Centers for Medicare and Medicare Services, Housing and Urban Development Department, and the Veterans Affairs Department.

At the hearing, the committee plans to release its report on reducing the risk of falls and fall-related injuries.