ShareThis Page
Pelosi works her health care strategy from the ground up | TribLIVE.com
Politics/Election

Pelosi works her health care strategy from the ground up

The Associated Press
| Tuesday, January 22, 2019 1:25 p.m
664521_web1_664521-6d250a9f062e417287cab215395cd806

WASHINGTON — House Speaker Nancy Pelosi is laying out her strategy on health care and first up is improvements to “Obamacare” and legislation to lower prescription drug costs. “Medicare for all” will get hearings.

Pelosi and President Donald Trump have been sounding similar themes about the need to address the high drug costs. But her plans to broaden financial help for health insurance through the Affordable Care Act are unlikely to find takers among Republicans.

Either way, Democrats believe voters gave them a mandate on health care in the midterm elections that returned the House to their control.

Pushing her agenda, Pelosi is working from the ground up through major House committees. Her relationships with powerful chairmen and subcommittee chairs stretch back years. She’s “playing chess on three boards at once,” said Jim McDermott, a former Democratic congressman from Washington state, who predicts Pelosi’s most difficult challenge will be “herding new members” impatient for sweeping changes.

Responding to written questions from The Associated Press, Pelosi called the ACA “a pillar of health and financial security,” comparing it to Medicare, Medicaid and Social Security. “Democrats have the opportunity not only to reverse the years of Republicans’ health care sabotage, but to update and improve the Affordable Care Act to further lower families’ premiums and out-of-pocket costs, and expand coverage.”

Legislation from Energy and Commerce Chairman Frank Pallone, D-N.J., Ways and Means Chairman Richard Neal, D-Mass., and Workforce and Education Chairman Bobby Scott, D-Va., would broaden the number of people who can get financial assistance with their premiums under the Obama health law, and undo the “family glitch” that prevents some from qualifying for subsidies. It would also restore the HealthCare.gov advertising budget slashed by Trump and block some of his administration’s health insurance alternatives.

Those issues are separate from legal questions raised by ongoing Republican litigation to overturn the health law. The Democratic-led House has voted to intervene in the court case to defend the law.

The 2010 health law belonged as much to Pelosi as to former President Barack Obama, said McDermott. “She’s taking ‘Obamacare’ and very carefully figuring out where you have to support it,” he said.

The House ACA package has little chance as a stand-alone bill. But parts of it could become bargaining chips when Congress considers major budget legislation.

On prescription drugs, Trump and the Democrats are occupying some of the same rhetorical territory, an unusual circumstance that could bring about unexpected results.

Both say Americans shouldn’t have to keep paying more for medications than consumers in other economically advanced countries where governments regulate prices.

The Trump administration has designed an experiment to apply international pricing to Medicare “Part B” drugs administered in doctors’ offices.

Pelosi wants to expand price relief to retail pharmacy drugs that seniors purchase through Medicare’s “Part D” prescription drug benefit, a much bigger move. A bill introduced by leading Democrats would authorize Medicare to negotiate directly with drug companies using international prices as a fallback.

“President Trump said he’d ‘negotiate like crazy’ to bring down Medicare prescription drug prices, and since the midterm election he’s spoken about working with Democrats,” Pelosi wrote to AP. “We have an opportunity to enact the tough legislative negotiating authority needed to actually lower prescription drug prices for consumers.”

One of the top Senate Republicans on health care says he’s not inclined to do that. Finance Committee Chairman Chuck Grassley of Iowa says having private insurers negotiate with drug companies has worked.

“Part D is the only federal program I’ve been involved with that has come in under budget,” said Grassley. “If it’s working, don’t mess with it.”

Nonetheless, former Health and Human Services Secretary Mike Leavitt, a Republican, said Medicare is “a good example of places where the administration might surprise.”

“Prescription drug pricing is in a category where both the president and the Democrats have made a commitment,” Leavitt added. “There will be a lot of division, but in the end there is a very good chance they will find a way that they can both claim victory.”

But the biggest health care idea among Democrats is “Medicare for all,” and on that, Pelosi is cautious. To those on the left “M4A” means a government-run health care system that would cover every American. That would require major tax increases and a big expansion of government.

Pelosi has tapped two committees, Budget and Rules, to handle “Medicare for all.” Health care legislation doesn’t usually originate in either of them.

Says Pelosi: “We’re going to have hearings.”

Categories: News | Politics Election
TribLIVE commenting policy

You are solely responsible for your comments and by using TribLive.com you agree to our Terms of Service.

We moderate comments. Our goal is to provide substantive commentary for a general readership. By screening submissions, we provide a space where readers can share intelligent and informed commentary that enhances the quality of our news and information.

While most comments will be posted if they are on-topic and not abusive, moderating decisions are subjective. We will make them as carefully and consistently as we can. Because of the volume of reader comments, we cannot review individual moderation decisions with readers.

We value thoughtful comments representing a range of views that make their point quickly and politely. We make an effort to protect discussions from repeated comments either by the same reader or different readers

We follow the same standards for taste as the daily newspaper. A few things we won't tolerate: personal attacks, obscenity, vulgarity, profanity (including expletives and letters followed by dashes), commercial promotion, impersonations, incoherence, proselytizing and SHOUTING. Don't include URLs to Web sites.

We do not edit comments. They are either approved or deleted. We reserve the right to edit a comment that is quoted or excerpted in an article. In this case, we may fix spelling and punctuation.

We welcome strong opinions and criticism of our work, but we don't want comments to become bogged down with discussions of our policies and we will moderate accordingly.

We appreciate it when readers and people quoted in articles or blog posts point out errors of fact or emphasis and will investigate all assertions. But these suggestions should be sent via e-mail. To avoid distracting other readers, we won't publish comments that suggest a correction. Instead, corrections will be made in a blog post or in an article.