A draft plan from House Speaker Nancy Pelosi leaked Tuesday would overhaul how Medicare pays for prescription drugs, by negotiating prices for costly medications, curbing annual price hikes, and limiting what seniors pay out of their own pockets.
With President Donald Trump highly interested in a deal on prescription drugs, the ambitious plan appeared be Pelosi laying down a marker that represents what House Democrats would want to see happen.
Pelosi's office wasn't commenting directly on the leaked proposal, but spokesman Henry Connelly said she's working with leading Democrats "to develop the boldest, toughest possible bill to lower prescription drug prices for all Americans." The plan would also make Medicare's negotiated prices available to people with private insurance.
The California Democrat has been in discussions with the White House for months about potential actions to curb drug costs, but the outlook remains uncertain. Empowering Medicare to negotiate prices is a nonstarter for most Republicans, even if Trump in the past backed the idea. In the Senate, a bipartisan group of lawmakers is advancing a bill that stops short of allowing Medicare to negotiate but incorporates other major ideas in Pelosi's plan.
The leaked draft "would please a majority of Democrats in the House, (but) it is clearly not designed to appeal to Republicans or to the Senate," said John Rother, president of the National Coalition on Health Care, an umbrella group that represents a broad cross-section of consumer and health care industry organizations. "This plan gives the Democrats a strong message platform going into the election year."
Pelosi plans to unveil a bill that Democrats can take to the House floor, but in an evolving situation, it's unclear how closely it will track with the leaked draft. Major provisions of the draft plan include:
— Authorizing Medicare to negotiate prices for the 250 costliest drugs. That includes pharmacy drugs under the popular "Part D" prescription benefit, along with "Part B" medications dispensed in doctors' offices. The maximum price would be determined using a blend of international prices, an idea similar to what the Trump administration has proposed for drugs administered in doctors' offices. Insulin prices would be subject to negotiations. Drug companies that balk at making a deal would face steep fines.
— Requiring drugmakers to pay rebates to Medicare if they hike their prices beyond increases in inflation. Pelosi's inflation rebates resemble a bipartisan idea from Sens. Chuck Grassley, R-Iowa, and Ron Wyden, D-Ore. Their bill has already cleared a key Senate committee, but a date for floor consideration has not been set. It has Trump's support.
— Limiting what seniors pay out of pocket for their medications each year. Currently there is no limit on drug copays, and the advent of drugs costing hundreds of thousands of dollars a year has left some seniors saddled with bills that rival a mortgage payment. An out-of-pocket limit is also part of the Grassley-Wyden bill, and the idea has support from the Trump administration.
TOKYO (AP) — The American envoy to the United Nations called Friday for countries armed with atomic weapons to pursue nuclear disarmament as she visited the atomic bomb museum in Nagasaki, Japan.
Linda Thomas-Greenfield, who became the first U.S. cabinet member to visit Nagasaki, stressed the importance of dialogue and diplomacy amid a growing nuclear threat in the region.
“We must continue to work together to create an environment for nuclear disarmament. We must continue to prevent the spread of nuclear weapons in every corner of the world,” she said after a tour of the atomic bomb museum.
“For those of us who already have those weapons, we must pursue arms control. We can and must work to ensure that Nagasaki is the last place to ever experience the horror of nuclear weapons,” she added, standing in front of colorful hanging origami cranes, a symbol of peace.
The United States dropped the world’s first atomic bomb on Hiroshima on Aug. 6, 1945, destroying the city and killing 140,000 people. A second attack three days later on Nagasaki killed 70,000 more people. Japan surrendered on Aug. 15, ending World War II and its nearly half-century of aggression in Asia.
Nagasaki Gov. Kengo Oishi said in a statement that he believed Thomas-Greenfield's visit and her first-person experience at the museum “will be a strong message in promoting momentum of nuclear disarmament for the international society at a time the world faces a severe environment surrounding atomic weapons.”
Oishi said he conveyed to the ambassador the increasingly important role of Nagasaki and Hiroshima in emphasizing the need of nuclear disarmament.
Thomas-Greenfield's visit to Japan comes on the heels of Prime Minister Fumio Kishida's official visit to the United States last week and is aimed at deepening Washington's trilateral ties with Tokyo and Seoul. During her visit to South Korea earlier this week, she held talks with South Korean officials, met with defectors from North Korea and visited the demilitarized zone.
The ambassador said the United States is looking into setting up a new mechanism for monitoring North Korea's nuclear weapons program. Russia and China have thwarted U.S.-led efforts to step up U.N. sanctions on North Korea over its ballistic missile testing since 2022, underscoring a deepening divide between permanent Security Council members over Russia’s war on Ukraine.
She said it would be “optimal” to launch the new system next month, though it is uncertain if that is possible.
The U.N. Security Council established a committee to monitor sanctions, and the mandate for its panel of experts to investigate violations had been renewed for 14 years until last month, when Russia vetoed another renewal.
In its most recent report, the panel of experts said it is investigating 58 suspected North Korean cyberattacks between 2017 and 2023 valued at approximately $3 billion, with the money reportedly being used to help fund its weapons development.
The United States, Japan and South Korea have been deepening security ties amid growing tension in the region from North Korea and China.
U.S. Ambassador to United Nations Linda Thomas-Greenfield, left, and Japan's Prime Minister Fumio Kishida, right, shake hands during a meeting Friday, April 19, 2024, at prime minister's office in Tokyo. (AP Photo/Eugene Hoshiko, Pool)
U.S. Ambassador to United Nations Linda Thomas-Greenfield, left, and Japan's Prime Minister Fumio Kishida, right, shake hands during a meeting Friday, April 19, 2024, at prime minister's office in Tokyo. (AP Photo/Eugene Hoshiko, Pool)
U.S. Ambassador to United Nations Linda Thomas-Greenfield, right, speaks to Rahm Emanuel, U.S. Ambassador to Japan, second right, as they wait for a meeting with Japan's Prime Minister Fumio Kishida Friday, April 19, 2024, at prime minister's office in Tokyo. (AP Photo/Eugene Hoshiko, Pool)
U.S. Ambassador to United Nations Linda Thomas-Greenfield, left, and Rahm Emanuel, U.S. Ambassador to Japan, right, walk to meet Japan's Prime Minister Fumio Kishida Friday, April 19, 2024, at prime minister's office in Tokyo. (AP Photo/Eugene Hoshiko, Pool)
U.S. Ambassador to United Nations Linda Thomas-Greenfield, left, and Japan's Prime Minister Fumio Kishida, right, talk prior to a meeting Friday, April 19, 2024, at prime minister's office in Tokyo. (AP Photo/Eugene Hoshiko, Pool)
U.S. Ambassador to United Nations Linda Thomas-Greenfield, left, and Japan's Prime Minister Fumio Kishida, right, prepare to talk during a meeting Friday, April 19, 2024, at prime minister's office in Tokyo. (AP Photo/Eugene Hoshiko, Pool)
