House Speaker Nancy Pelosi unveiled legislation this week that would give the federal government sweeping new authority to regulate and lower the cost of prescription drugs. Senate Majority Leader Mitch McConnell, R-Ky., declared the bill dead on arrival and told Politico it amounts to "socialist price controls."
In an exclusive interview with NPR, Pelosi suggested McConnell was in "the pocket of the pharmaceutical industry" and noted that President Trump shares her view that negotiating drug prices is good policy. "As the president said in the course of his run for office and since: 'We're going to negotiate like crazy. We're going to negotiate like crazy.' So perhaps Mitch is talking about the president, as well."
The speaker distanced herself from the central health care policies of two leading candidates for the 2020 Democratic nomination for president.
Sens. Bernie Sanders of Vermont and Elizabeth Warren of Massachusetts are advocating for eliminating private insurers in favor of a government-run health care system for all. Asked if she believed that was the right direction for her party to take on health care, Pelosi was succinct: "No, I do not."
The speaker is leading her party's efforts in Congress on prescription drugs. On that front she said that if she and the president can cut a deal, Trump will be able to get the votes necessary to pass the bill. "If the president says he supports a path similar to this, you will see some of the Republicans come around," she said.
Most Republicans and the drug lobby oppose the House bill, and McConnell's "socialist" line of attack echoes the broader argument Republicans are trying to make against the Democratic Party ahead of the 2020 elections. Pelosi pushed back on this line of attack, noting that the government in some cases already directly negotiates drug prices.
For instance, she noted the Department of Veterans Affairs is legally allowed to negotiate drug costs, but Medicare is not. "We are not intervening in the free market. We believe in the free market," Pelosi said. "But we do not believe that the free market should have the exploitation of consumers in our country with the support of the government by banning the ability for the secretary [of health and human services] to negotiate for lower prices."
Pelosi emphasized that health care was the leading issue in the last election. Pressed on what Democrats should do instead of "Medicare for All," Pelosi said she supports expanding the Affordable Care Act to include a public option that can compete with the private market. The speaker was a chief architect of the health care law.
Former Vice President Joe Biden is campaigning on a similar policy. Democrats tried and failed to include a public option in the original version of Obamacare. "We believe that the path of the Affordable Care Act is the way to go," Pelosi said.
Pelosi praised the Democrats who are advocating for Medicare for All and said she shares the goal of universal coverage, but it's not the practical way to get it done. "Again I salute them, and if that's what they believe, God bless them for that, but that is I think not the practical path to getting something done."
ARI SHAPIRO, HOST:
Speaker of the House Nancy Pelosi says she is going to transform the way prescription drugs are paid for in this country. This week she unveiled a sweeping plan aimed at drastically reducing how much Americans pay for their drugs. Among other things, the legislation calls for the federal government to negotiate the price of as many as 250 drugs each year. It also says the costs should be tied to those on the international market, where prices are lower.
This morning, NPR congressional correspondent Susan Davis and I went to the speaker's office for an interview. She greeted us after she had rushed up from the House floor.
(SOUNDBITE OF ARCHIVED RECORDING)
NANCY PELOSI: It's very hard to get off the floor. The members...
SHAPIRO: Thank you so much for making time. Ari Shapiro.
PELOSI: Hi, Ari.
SHAPIRO: Good to see you.
PELOSI: Nice to see you.
SUSAN DAVIS, BYLINE: Susan Davis. Good to see you.
SHAPIRO: Susan Davis began our conversation by asking about the Senate majority leader's reaction to the speaker's plan.
(SOUNDBITE OF ARCHIVED RECORDING)
DAVIS: Senate Majority Leader Mitch McConnell called it, in his word, a socialist price control bill. There is a competing bipartisan Senate bill. Do you see this as the start of a negotiation between two chambers that's going to find a middle ground? Or is this Democrats laying down a marker to say this is what we believe in, and this is what we're going to fight for in 2020?
PELOSI: Well, if Mitch McConnell is in the pocket of the pharmaceutical industry, I don't want to characterize any of his comments that he says about our interest in helping America's working families. He may not have noticed, but in the last election, the health care issue, the cost of prescription drugs, was foremost for families. And whether they were Democrats, Republicans or Independents or no interest in politics whatsoever - God bless them - the American people have spoken on this subject. They're making terrible sacrifices in their lives.
This is about their health security, but it's also about their financial health because the cost of prescription drugs is just prohibitive for them to meet the needs of their families.
SHAPIRO: Madam Speaker, Republicans overwhelmingly oppose this plan based on free market principles. But President Trump has expressed on Twitter an interest in finding a bipartisan solution. There have been instances before, whether it's immigration or infrastructure, where it looks like you and the president are on the same page. And they've never produced results. Do you think this time will be different?
PELOSI: I hope so. The president says he wants to do this. But let me just say that this is not any pioneering work in the free market. The Veterans Affairs Committee - VA has always had the ability - for a long time - had the ability to negotiate for lower prescription drug prices for the VA. We are not intervening in the free market. We believe in the free market, but we do not believe that the free market should have the exploitation of consumers in our country with the support of the government by banning the ability for the secretary to negotiate for lower prices.
SHAPIRO: If I could ask a related health care question, right now, two of the three leading Democratic presidential candidates would like to do away with private health insurance and leave it entirely in the hands of the government. Do you think that's the right direction for your party to take?
PELOSI: No, I do not.
DAVIS: What do you think is the right direction?
PELOSI: The Affordable Care Act. This is complicated to put together health care for as many Americans as possible. Our goal for all of us, including those presidential candidates, is to have health care for all Americans - affordable, accessible, quality health care for all Americans. We believe that the path of the Affordable Care Act is the way to go.
So I do believe that if you want to have whatever they're calling their plan - Medicare for All, whatever it is - the path to it is the Affordable Care Act. But we might take that path to something that enables people to have Medicare if they wish or their private insurance if they wish. And I salute them. And if that's what they believe, God bless them for that. But that is, I think, not the practical path to getting something done.
And again, I say to them, all of these issues - single payer and all that - I have those signs in my basement from 30 years ago. I'm with you as an advocate. But as a member of Congress needing to get results for the American people, let's take a path that takes us quickest and best and strongest to affordable care for all Americans.
DAVIS: And that is, in your view, the public option, just to be clear.
PELOSI: Having it as an option. It isn't the public - a public option is an option. It's not the path that - you can have your private insurance, or you can have a public option if you wish.
AUDIE CORNISH, HOST:
Now elsewhere in the program, we hear Speaker Pelosi's reaction to news of a whistleblower complaint about President Trump's communications with a foreign leader and the ongoing standoff between the director of national intelligence and Congress.
(SOUNDBITE OF ARCHIVED RECORDING)
PELOSI: What is a fact is the law. And the law says the director of national intelligence shall convey the whistleblower information to the intelligence committees in the Congress. And right now, they are breaking the law.
(SOUNDBITE OF MUSIC) Transcript provided by NPR, Copyright NPR.