Conservatives are growing increasingly uneasy with the Trump administration’s new drug pricing policy.
President Trump is desperately seeking an elusive political win in his efforts to lower prescription drug costs, but he faces a hard sell to conservative groups and GOP lawmakers as he touts ideas traditionally favored by Democrats and presidential candidate Sen. Bernie Sanders (I-Vt.).
In a rare break with Trump, conservatives are now pushing back against key administration policies and accusing the president of supporting what they call Sanders-style socialism.
The president has embraced importing drugs from Canada, as well as an international pricing policy that would bar Medicare from paying more than other countries for prescription drugs.
The moves are designed to co-opt Democratic talking points and position Trump as a populist champion of the free market.
Trump has made lowering drug prices a top priority of his presidency, but he has suffered some high-profile setbacks in recent weeks.
Drug importation and the international pricing caps proposal are the only remaining policies remaining that the White House can use to make a splash heading into 2020.
Trump has frequently railed against “global freeloading” and said he doesn’t think it’s fair that the U.S. subsidizes research and development in other countries.
Last year he went to the Department of Health and Human Services (HHS) and announced the plan to cap U.S. payments for expensive drugs, over the objections of some White House advisers.
Those objections later spread to include conservative groups.
Facebook ads this year from FreedomWorks, a conservative advocacy group, urged people to tell HHS Secretary Alex Azar to oppose “socialist-style price controls.”
Another ad warned the administration against “importing socialist European drug prices in America.”
Separately, a website sponsored by the American Conservative Union rails against the administration’s pricing index, calling it an experiment “directly out of the Bernie Sanders and Hillary Clinton government health care takeover playbook.”
In the GOP-controlled Senate, a bill backed by the administration is facing Republican opposition over a provision that would impose a limit on drug price increases in Medicare’s Part D prescription drug program.
The legislation would force drug companies to pay money back to the government if their prices rise faster than inflation.
The Senate Finance Committee approved the measure late last month in a 19-9 vote — all Democrats voted for it, and all nine “no” votes came from Republicans. Some GOP senators said they were concerned because they think the Medicare Part D provision violates traditional free-market principles.
The bill faces long odds of making it to the Senate floor without substantial changes.
“I’m not comfortable with putting price controls on drugs,” Sen. Pat Toomey (R-Pa.), a member of the Finance Committee, told The Hill.
Toomey offered an amendment to strip out the provision, which failed on a tie vote of 14-14. All but two Republicans voted for his amendment.
Aside from capping drug payments, Trump has also softened his stance on importing drugs from Canada. The administration last week announced a proposal that would set the groundwork for states or wholesalers to launch pilot programs to safely import drugs.
Shipping in drugs from abroad has long been a goal of progressives like Sanders, but has also won the support of libertarian-leaning conservatives like GOP Sens. Rand Paul (Ky.), Ted Cruz (Texas) and Mike Lee (Utah).
But with Trump looking for a win on drug pricing, political analysts and health experts argue he doesn’t necessarily care about gaining the support of conservatives.
“This is the administration throwing down a wild card,” said health care consultant Alex Shekhdar, founder of Sycamore Creek Healthcare Advisors. “In order to win in 2020, they need to take into consideration independents and anyone else who thinks drug prices are an issue.”
Joe Antos, a health care expert at the conservative American Enterprise Institute, said it doesn’t matter if the policies Trump is embracing are traditionally Democratic ones.
“Just because Democrats endorsed it in the past, doesn’t mean Trump can’t take ownership and call it his idea. He might not call them Republican ideas, but he’ll call them Donald Trump ideas,” Antos said.
But some GOP senators cautioned against letting Democrats play too much of a role.
After the Finance Committee advanced the drug-pricing bill, Chairman Chuck Grassley (R-Iowa) told reporters that Republicans don’t want Trump negotiating with Speaker Nancy Pelosi (D-Calif.).
A competing bill from House Democrats is far more sweeping than the Senate’s, and includes direct Medicare negotiation on drug prices.
“It seems to me that the Grassley-Wyden approach is a very moderate approach to what could come out,” Grassley said, referring to the bill backed by him and Sen. Ron Wyden (Ore.), the ranking Democrat on the Finance Committee.
But a stalled bill could still work to Trump’s advantage, according to Antos, who said the president doesn’t necessarily need to lower drug prices, he just needs to convince the public he is trying.
In that sense, Antos argued, Republicans haven’t offered anything better, and they will eventually support whatever the administration does.
“Republicans don’t have any alternative ideas,” Antos said. “Trump has full control of Republicans in Congress, so there’s just not going to be any response other than going along with what comes along.”