Democrats brace for insulin fight on Inflation Reduction Act (The Senate parliamentarian again)

[Celerity]

Democrats want to cap the price of insulin to $35

https://www.independent.co.uk/news/world/americas/us-politics/democrats-insulin-inflation-reduction-act-b2139876.html



Democrats are bracing for a fight to include capping the price of insulin on their climate and health care bill as they prepare for a long night of votes on Saturday. They included a provision to cap the price of insulin in their legislation known as the Inflation Reduction Act, which Senate Majority Leader Chuck Schumer and Senator Joe Manchin negotiated together. The legislation would cap out-of-pocket costs for insulin to $35.

But Senate Parliamentarian Elizabeth MacDonough issued a guidance against a provision that would cause drug companies to rebate Medicare if it raised the price of drugs higher than inflation. Democrats hope to pass the bill through a process called budget reconciliation, which would allow them to pass it with a simple majority. Should the bill pass through this process, it would allow them to avoid a Republican filibuster, since Democrats only have 50 Senate seats with Vice President Kamala Harris serving as the tie breaker.

The Senate Parliamentarian must determine if aspects of the legislation are germane to the budget or are an “extraneous matter.” If she rules that a part of the legislation does not relate to the budget, Democrats will have a vote on the amendment during the “vote-a-rama,” wherein a series of amendments are voted for the bill.

The presiding officer could ignore the parliamentarian and decide it complies with rules about budget reconciliation, but that would require 60 votes for the amendment to pass that way, as Roll Call reported. Senator Raphael Warnock of Georgia, who is up for re-election this year, has made capping the cost of insulin a signature issue in his campaign against Republican Herschel Walker.

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related:


Democrats plan to challenge parliamentarian on insulin cap

https://thehill.com/homenews/senate/3591084-democrats-plan-to-challenge-parliamentarian-on-insulin-cap/

Senate Democrats say they plan to challenge a ruling by the parliamentarian striking a proposal sponsored by Sen. Raphael Warnock (D-Ga.) to cap insulin prices from the Inflation Reduction Act, according to a Democrat familiar with the plan.

As of now, Warnock’s proposal to cap out-of-pocket insulin costs at $35 a month is in the bill, but the parliamentarian is expected to rule on the Senate floor that it does not comply with the Byrd rule, which prohibits policymaking in budget reconciliation bills that have a tangential impact on spending and revenue.

But Democrats plan to challenge the parliamentarian’s ruling on the floor, which means they would need 60 votes to waive an objection to keeping the insulin provision in the bill.

Any effort to overturn the parliamentarian is not likely to get 10 Republican votes, but it will put Republicans on the record as opposing a $35 monthly cap on patients’ insulin costs, which Democrats can use as political ammo in the midterm elections.

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[OnDoutside]

1. Is there any indication what the cost could be, I'd not $35 ?

[Celerity]

2. I do not know, sorry, perhaps they can work something out. I so hope so.

[OnDoutside]

8. Hopefully. At least getting Republicans on the record would be

something.

[crickets]

3. What does this mean?

As of now, Warnock’s proposal to cap out-of-pocket insulin costs at $35 a month is in the bill, but the parliamentarian is expected to rule on the Senate floor that it does not comply with the Byrd rule, which prohibits policymaking in budget reconciliation bills that have a tangential impact on spending and revenue.

What makes this particular part of the bill "policymaking" as opposed to the rest of it? Reading the Byrd Rule did not help, but I admit it's likely my reading comprehension that's at fault there.

I'm confused.

Independent articles linked, no paywall:
https://archive.ph/wip/IvXDm - Democrats brace for insulin fight on Inflation Reduction Act
https://archive.ph/wip/Tg4hK - Senate parliamentarian kills key part of Democrats’ prescription drug plan...

[Celerity]

6. Perhaps this article may help, it lays out a public versus private insurance rationale for exclusion

by the parliamentarian


Drug-Price Bill Pruned in Senate in Partial Industry Win

Medicare to be allowed to negotiate drug prices for first time
Commercial market excluded from inflation cap on drugs

https://www.bloomberg.com/news/articles/2022-08-06/democrats-drug-price-plan-is-trimmed-by-senate-parliamentarian

https://archive.ph/Lil0M

Medicare was cleared to negotiate drug prices for the first time by the Senate’s top rules official, though the Democrats’ proposal intended to cap price increases for prescription drugs in the commercial market was blocked. A separate provision capping out-of-pocket costs for insulin at $35 per month for those with private insurance also was blocked, according to a person familiar with the matter. Democrats were still waiting for a decision on whether the limit could be applied under Medicare. The rulings are a partial victory for drug makers, who could try to make up their lost profits in Medicare on private insurers. The Senate parliamentarian, Elizabeth MacDonough, ruled that most of the drug-price bill is eligible for a fast-track budget process whereby Democrats, who have a narrow majority in the chamber, can pass legislation without the threat of a Republican filibuster.

The drug price provisions are part of a budget bill that the Senate plans to begin debating later Saturday, representing a slimmed-down version of President Joe Biden’s multi-trillion dollar domestic agenda. “Democrats have received extremely good news: for the first time, Medicare will finally be allowed to negotiate prescription drug prices, seniors will have free vaccines and their costs capped, and much more,” Senate Majority Leader Chuck Schumer said in a statement. Yet the Senate rules official disallowed some provisions meant to stop drug companies from raising prices at a rate faster than inflation. The inflation rebate is allowed to be applied to Medicare prices, but not in the commercial market according to two people familiar with the ruling. The ruling on the inflation price penalty suggests the Senate official is likely to strike the cap in the private market as not closely related to the federal budget.

snip

Democrats originally designed the bill to require drug makers to pay the government revenue earned from raising the price of their products at more than the US inflation rate, calculated by units sold in both Medicare and commercial markets. Now, the legislation will not count commercial markets, which cover roughly 180 million Americans. MacDonough found that under Senate rules the inflation provisions of the bill were not primarily budgetary in nature. The bill would still allow Medicare to negotiate the prices for drugs it provides under Part B and Part D for the first time, would apply a tax to companies failing to comply with the negotiated price and apply a $2,000 cap on annual out-of-pocket expenses for people enrolled in Medicare Part D. Those parts were approved, Schumer said.

Limiting the inflation rebates to just Medicare means that drug makers can still annually raise prices for the two-thirds of Americans younger than 65 who have private health insurance. It will also limit some of the savings from the drug pricing provisions of the legislation, although how much is unclear. Under Senate rules designed by late West Virginia Senator Robert Byrd, provisions must be fiscal in nature rather than primarily regulatory in order to qualify for the fast-track budget reconciliation process.

snip

[crickets]

7. That does help. Thank you.

Though it is depressing. I'm glad Medicare is able to negotiate; it's a good start. Sadly, drug companies will likely raise prices in the commercial market to make up the difference. If we can just hang on to the House and get a few more seats in the Senate in November, more action can be taken next time around.

[Kingofalldems]

4. When is the vote?

[Celerity]

5. the vote for what? There are so many moving parts, what with the vote-a-rama, etc

[PortTack]

9. Fine..can't cap insulin. We need a bigger program like CA..just manufacturer it