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No Surprise: Jim Jordan’s Abysmal Health Care Record Is One of the Many Reasons He’s A Radical Choice for Speaker of the House

With the Speakerless House GOP desperately searching for an alternative, Freedom Caucus founder and Judiciary Chair Jim Jordan (R-OH) has thrown his hat in the ring. Just like Kevin McCarthy, Jim Jordan has a long history of fighting to raise health care costs and rip away critical protections from the American people. Jim Jordan is completely out of step with the American people on health care. 

Since taking office in 2007, Jordan has been a key part of GOP efforts to repeal the Affordable Care Act and rip away protections for 135 million Americans with pre-existing conditions. Fellow Republicans called him a “legislative terrorist” for helping orchestrate the 2013 government shutdown over defunding the Affordable Care Act. He’s supported cuts to Medicare and Social Security, threatening the health and well-being of our nation’s seniors, and supports a nationwide abortion ban. On top of his abysmal health care record in his first decade in Congress, Jordan spent the last two years fighting legislation to lower drug costs in order to keep Big Pharma’s profits high. Under Rep. Jordan’s leadership, Republicans will undoubtedly return to their radical agenda of attacking people with pre-existing conditions, repealing the Affordable Care Act, slashing Medicare, and hiking drug and health insurance costs.

Jim Jordan’s record is clear: he has always supported higher prices for prescription drugs and higher premiums for people who buy health insurance on their own. Jordan opposed the Inflation Reduction Act and has a history of siding with the drug industry and health insurance companies. He’s tried to slash the Affordable Care Act & Medicaid, which seniors, communities of color, and people with disabilities count on. If Jordan got his way, drug companies would make even more record-breaking profits but working people would pay more for health care.

If Jim Jordan got his way:

  • Medicare would be banned from negotiating lower prices for prescription drugs
  • Insulin prices would not have been capped at $35/month for seniors
  • Seniors would have to pay more than $2,000 a year out-of-pocket for prescriptions.
  • Drug companies would be able to once again raise prices faster than the rate of inflation without penalty.
  • Health care coverage for about 23 million people would have been eliminated by 2026
  • People with pre-existing conditions could again be denied coverage or charged higher prices
  • …. and so much more 

THE DETAILS: Jim Jordan Voted For Higher Premiums And Prescription Drug Costs

2021: Jim Jordan, And Every Republican In Congress, Voted Against The Inflation Reduction Act. Jordan joined every Republican in Congress in voting against the Inflation Reduction Act, which “requires the Centers for Medicare & Medicaid Services (CMS) to negotiate the prices of certain prescription drugs under Medicare beginning in 2026,” and “requires drug manufacturers to issue rebates to the CMS for brand-name drugs without generic equivalents under Medicare medical services that cost $100 or more per year per individual and for which prices increase faster than inflation.” [HR 5376, 8/12/21

  • Jordan Has Ties To Drug Industry Special Interests. Jordan has significant ties to the pharmaceutical and drug manufacturing industry, having pocketed just over $28,908 from the industry during the 2022 midterm election cycle. Big drug companies fiercely lobbied against the Inflation Reduction Act, which included provisions allowing the Department of Health and Human Services to negotiate prescription drug prices for Medicare.

What The Inflation Reduction Act Means For America:

2021: Jim Jordan, And Every Republican In Congress, Voted Against the American Rescue Plan. Jordan joined every Republican in Congress in voting against the American Rescue Plan, which “provide[d] health insurance premium assistance for individuals who become eligible for, and elect to enroll in, the COBRA (Consolidated Omnibus Budget Reconciliation Act) continuation coverage program,” increased the rate of “the refundable tax credit for coverage under qualified health plan”, and “ma[de] individuals who received unemployment compensation in 2021 eligible for cost-sharing subsidies for health care expenses under qualified health insurance plans.” [HR 1319, 3/10/21

What The American Rescue Plan Meant For America:

  • Saved families an average of $2,400 a year on their health insurance premiums.
  • Ensured all Americans never pay more than 8.5 percent of their household incomes towards an ACA Marketplace premium.
  • Eliminated premiums for people earning up to 150 percent of the federal poverty level who buy their coverage on the ACA Marketplace.
  • Extended the premium tax credit to 3.1 million Americans.

2019: Jim Jordan Voted Against HR 3. Jordan joined all but two House Republicans in voting against the Elijah Cummings Lower Drug Costs Now Act (HR 3), which would have lowered the cost of prescription drug prices by “empowering the federal government to negotiate prices with pharmaceutical manufacturers.” HR 3 would have required the Department of Health and Human Services to negotiate maximum prices for insulin, new and existing single-source brand-name drugs without generics, the top drugs expensed through Medicare and Medicare Advantage, and would have set price ceilings at 120% of the average price in similar countries or 85% of the price for domestic manufacturers.

What HR 3 Meant For America:

Jim Jordan Opposes The ACA And Its Protections For 1 in 2 Americans With Pre-Existing Conditions

Jim Jordan Has Opposed The Affordable Care Act Since Its Inception. Since taking office in 2007, Jim Jordan has been a relentless opponent of the Affordable Care Act, including voting against initial passage of the law and sponsoring at least 10 attempts to repeal or substantially alter the law.

2017: Jim Jordan Voted For Trump’s Disastrous ACA Replacement. In 2017, Jim Jordan was part of the frantic Republican attempt to repeal the Affordable Care Act and rip away health coverage and protections for pre-existing conditions for millions of Americans, voting for the passage of the American Health Care Act. [HR 1628, Roll Call Vote #256, 5/4/17

 What Did AHCA Mean for America?

  • Approximately 1 in 2 people in America with pre-existing conditions would have lost protections for coverage.
  • 23 million people would have lost coverage under this bill by 2026
  • The nonpartisan Congressional Budget Office found that the American Health Care Act would have raised premiums by 20 percent.
  • The negative economic impact of the American Health Care Act would have caused 1.8 million people to lose their jobs by 2022.

2015: Jim Jordan Voted For A Total Repeal Of The ACA. Jordan voted for HR 596, an act “to repeal the Patient Protection and Affordable Care Act and health care-related provisions in the Health Care and Education Reconciliation Act of 2010.” The bill also ordered House committees to develop a replacement that would “provide people with pre-existing conditions access to affordable health coverage,” but provided no specifics. [HR 596, Roll Call Vote #58, 2/3/15

2013: Jim Jordan Staged A Government Shutdown In An Attempt to Defund the Affordable Care Act. In October 2013, the federal government ground to a halt for over two weeks after the Republican-led House of Representatives demanded that legislation to continue funding the government include provisions defunding the Affordable Care Act. Jordan was an “architect” of the 2013 shutdown, and fellow Republicans have blamed him and his far-right allies for leading the shutdown fight. Then-Speaker John Boehner later called Jordan a “legislative terrorist” for his brinkmanship, stating: “I just never saw a guy who spent more time tearing things apart — never building anything, never putting anything together.”

2010: Jim Jordan Voted Against the ACA. Jordan voted against HR 3590, also known as the Patient Protection and Affordable Care Act, in March 2010. [HR 2590, Roll Call Vote #165, 3/21/10

Jim Jordan Voted To Slash Medicare, Medicaid, and Social Security

2023: Jim Jordan and the Far-Right Freedom Caucus Released A Budget Proposal With Deep Cuts To Medicaid Enrollment. In March, the far-right Freedom Caucus – which Jordan founded in 2015 – proposed a budget plan that will cut over $3 trillion in non-defense spending, taking aim specifically at health care programs like Medicaid. One of the major restructuring of the program would be the institution of strict work requirements in order to access Medicaid. All research on the subject shows that work requirements reduce dramatically the number of people who can access Medicaid. Almost two-thirds, or 62 percent, of those who would lose their Medicaid coverage as a result of work requirements are women and disproportionately women of color. Also, even though the Freedom Caucus is claiming this is an attempt to cut spending to needless bureaucracy, time and time again Medicaid work requirements end up costing more money to implement and maintain than traditional Medicaid or Medicaid Expansion. Georgia’s new Medicaid work requirements require the state to develop “expensive administrative processes,” estimated to cost upwards of $270 million annually to implement, nearly 3 times more than Medicaid Expansion would cost.

2017: Jim Jordan Voted To Cut Medicare By $473 Billion. Jordan voted for the FY 2018 budget resolution, which included $473 billion in cuts to Medicare over 10 years. [H Con Res 71, Vote #557, 10/5/17; Vox, 10/26/17

2017: Jim Jordan Voted To Slash $1.3 Trillion From Medicaid. Jordan voted for the FY 2018 budget resolution, which cut funding for non-Medicare health programs, most notably Medicaid, by 1.3 trillion, a 20 percent cut over the course of 10 years, increasing to a 29.3 percent cut by 2027. [H Con Res 71, Vote #557, 10/5/17; Vox, 10/26/17

2017: Jim Jordan Voted For AHCA, Which Cut $880 Billion From Medicaid. Jordan voted for AHCA, which included $880 billion in cuts to Medicaid. [HR 1628, Roll Call Vote #256, 5/4/17] 

  • Vox Called AHCA A “Sneaky” Reversal Of The Medicaid Expansion. “Medicaid, a government program that simply compensates health care providers at stingy rates, is much cheaper than private insurance. So the ACA’s authors chose to expand it to cover all families with incomes below 138 percent of the poverty line, rather than shelling out the money it would have cost to have the government pay for them to buy private insurance. The AHCA reverses this expansion. But to avoid the criticism that the law throws poor children off their health insurance, it reverses it in a somewhat sneaky way. Rather than taking Medicaid away from families who have it, it simply caps new enrollments in Medicaid so no new poor families can sign up. But the way this cap works, you can’t get back on Medicaid if you go off of it. So a poor family that gets a raise and becomes non-poor for a year will lose access to Medicaid permanently.” [Vox, 5/9/17]

TOMORROW: Senator Stabenow and Rep. Schakowsky Join Protect Our Care to Discuss New Benefits at the Start of Medicare Open Enrollment

***MEDIA ADVISORY FOR TUESDAY, OCTOBER 17 AT 3:30 PM ET***

Protect Our Care Is Launching Medicare Autumn to Spread the Word That Medicare Is Better Than Ever Thanks to the Inflation Reduction Act

Washington, D.C. — On Tuesday, October 17, at 3:30 PM ET, U.S. Senator Debbie Stabenow (D-MI) and U.S. Representative Jan Schakowsky (D-IL-09) will join Protect Our Care to kick off Medicare Autumn. This campaign coincides with Medicare Open Enrollment and includes nationwide events, a multi-state tour, and themed weeks. Panelists will discuss how the 2024 open enrollment period will bring new benefits to 65 million people on Medicare. Over the next several weeks, 65 million people will go to select their Medicare plans, and they will see new benefits that could save them thousands of dollars on their prescription drug costs. Signed into law by President Biden last year, the Inflation Reduction Act introduced $35 caps on monthly insulin copays, free shingles and other recommended vaccinations, protections from drug company price hikes, and $2,000 out-of-pocket caps on prescription drugs beginning in 2025. 

Critically, the law also gives Medicare the power to negotiate lower drug prices. Right now, the Biden administration is in the process of lowering prices for the first round of prescription drugs under the Medicare Drug Price Negotiation Program, and those prices will take effect in 2026. This new program will lower prices for some of the highest-priced prescription drugs on the market used to treat conditions like diabetes, heart failure, blood clots, and autoimmune disorders.

PRESS CALL

WHO:
U.S. Senator Debbie Stabenow (D-MI)
U.S. Representative Jan Schakowsky (D-IL-09)
Linda Hamacher, patient storyteller (MI)
Dawn LaGuerre, patient storyteller (NY)
Leslie Dach, Chair of Protect Our Care

WHAT: Virtual Press Conference 

WHERE: Register for the Event Here

WHEN: Tuesday, October 17, 2023 at 3:30 PM

PRESS CALL: Senator Stabenow and Rep. Schakowsky Join Protect Our Care to Discuss New Benefits at the Start of Medicare Open Enrollment

***MEDIA ADVISORY FOR TUESDAY, OCTOBER 17 AT 3:30 PM ET***

Washington, D.C. — On Tuesday, October 17, at 3:30 PM ET, U.S. Senator Debbie Stabenow (D-MI) and U.S. Representative Jan Schakowsky (D-IL-09) will join Protect Our Care to discuss how the 2024 open enrollment period will bring new benefits to 65 million people on Medicare. Over the next several weeks, 65 million people will go to select their Medicare plans, and they will see new benefits that could save them thousands of dollars on their prescription drug costs. Signed into law by President Biden last year, the Inflation Reduction Act introduced $35 caps on monthly insulin copays, free shingles and other recommended vaccinations, protections from drug company price hikes, and $2,000 out-of-pocket caps on prescription drugs beginning in 2025. 

Critically, the law also gives Medicare the power to negotiate lower drug prices. Right now, the Biden administration is in the process of lowering prices for the first round of prescription drugs under the Medicare Drug Price Negotiation Program, and those prices will take effect in 2026. This new program will lower prices for some of the highest-priced prescription drugs on the market used to treat conditions like diabetes, heart failure, blood clots, and autoimmune disorders.

PRESS CALL

WHO:
U.S. Senator Debbie Stabenow (D-MI)
U.S. Representative Jan Schakowsky (D-IL-09)
Linda Hamacher, patient storyteller (MI)
Dawn LaGuerre, patient storyteller (NY)
Leslie Dach, Chair of Protect Our Care

WHAT: Virtual Press Conference 

WHERE: Register for the Event Here

WHEN: Tuesday, October 17, 2023 at 3:30 PM

Medicare is Better Than Ever As Open Enrollment Begins

Seniors Will Save in 2024 Thanks to the Inflation Reduction Act: Lower Drug Costs, Monthly Insulin Cap, and Free Vaccines 

Washington, D.C. — Sunday, October 15, is the beginning of Medicare open enrollment and 65 million Americans will sign up for 2024 coverage. As seniors select their plans, they will see new benefits that could save them thousands of dollars on their vaccines and prescription drug costs. Signed into law by President Biden last year without a single Republican vote, the Inflation Reduction Act delivered $35 caps on insulin, free shingles and other recommended vaccinations, protections from drug company price hikes greater than inflation, and beginning in 2025, a maximum $2,000 out-of-pocket cap on prescription drugs no matter how expensive those drugs are. 

Critically, the law also gives Medicare the power to negotiate lower drug prices. Right now, the Biden administration is in the process of lowering prices for the first round of prescription drugs under the Medicare Drug Price Negotiation Program, and those prices will be decided in 2025  and take effect in 2026. This new program will lower prices for some of the highest-priced prescription drugs on the market used to treat conditions like diabetes, heart failure, blood clots, and autoimmune disorders, and in turn lower out-of-pocket and Medicare premiums. In response, Protect Our Care Chair Leslie Dach issued the following statement: 

“As seniors enroll in their 2024 Medicare plans, they will see new benefits that could save them thousands of dollars on their vaccine and prescription drug costs, with even more savings in the years ahead. Not only will the Inflation Reduction Act save people money at the pharmacy counter, but it will touch everyone on Medicare through lower premium costs. This relief is long-overdue for seniors who are sick and tired of cutting their pills in half and paying up to four times more for their prescriptions than people in other countries so that big drug companies can fuel their massive profits. The contrast couldn’t be clearer – Democrats are standing up to big drug companies, Republicans in Congress are working overtime to rip away all of these new savings and raise costs for seniors across America.” 

Sen. Tammy Baldwin and Advocates to Discuss President Biden’s Latest Action to Lower Costs for Wisconsinites

***MEDIA ADVISORY FOR TUESDAY, OCTOBER 10TH at 10:45 AM CT***

The Biden Administration Announced the First 10 Drugs That Wisconsinites Will Save Money on Thanks to the Inflation Reduction Act 

WAUKESHA, WIOn Tuesday, October 10th at 10:45 am CT, Protect Our Care Wisconsin will join Senator Tammy Baldwin and advocates, to discuss how Medicare negotiations will lower prescription drug costs for Wisconsinites. Sen. Baldwin will visit the Waukesha Free Clinic to highlight the recent announcement of the first ten drugs selected for Medicare price negotiation under the Baldwin-backed Inflation Reduction Act. Last week, all 10 drug companies announced they entered into agreements with Medicare to negotiate lower drug prices. 

This event comes as Republicans and drug companies attack the Inflation Reduction Act by trying to derail health care policies that will bring down costs. Big drug companies are suing the federal government to protect their massive profits by halting the measure passed in the Inflation Reduction Act that empowers Medicare to negotiate drug prices while Republicans are attempting to repeal it. President Biden and Democrats in Congress are already working to expand these cost savings to more Americans, no matter what age they are or how they get their health insurance. The Biden administration is laser-focused on making medications affordable for families and ending the era of drug companies’ unchecked power and greed.

WHO: ​​
Tammy Baldwin, U.S. Senator
Amy Vega, Executive Director, Waukesha Free Clinic
Dr. Jim Brandes, Board Secretary, Director of Carroll’s Physician Assistant Program
Dr. Elizabeth Davies, Board President, Family Medicine Physician with ProHealth Care
Michael Egly, Director of Program Services, The Free Pantry Waukesha
Lynn Carey, Medicare storyteller 

WHAT:  Tour and Press Conference 

WHEN: Tuesday, October 10 at 10:45 AM CT

WHERE: Waukesha Free Clinic, 237 Wisconsin Ave, Waukesha, WI 53186

###

HEADLINES: Drug Companies Agree To Negotiate Lower Prices with Medicare “To Give Seniors The Best Possible Deal”

President Biden announced this week that all the pharmaceutical companies whose prescription drugs were part of the first round of high-cost drugs selected for negotiation announced they entered into agreements with Medicare to begin the process. This new program will lower prices for some of the most expensive prescription drugs on the market used to treat conditions like diabetes, heart failure, blood clots, and autoimmune disorders – conditions that disproportionately impact women, communities of color, and people in rural areas. Together, these drugs are taken by nearly 9 million people on Medicare, account for about 20 percent of annual Medicare Part D spending, and have made a combined $493 billion in global revenue. Read more about the first 10 drugs here.

This is a historic milestone in lowering drug prices through finally empowering Medicare to negotiate on behalf of seniors, which was enacted as part of the Inflation Reduction Act championed by President Biden and Democrats in Congress. Negotiating lower prices is overwhelmingly popular across the country, yet big drug companies are suing the federal government to protect their massive profits by halting the program while Republicans are attempting to repeal it. Read more about the lawsuits here

COVERAGE

The Messenger: Biden’s Campaign is Boasting About Lowering Prescription Drug Prices. Republican Opposition Has Given Them an Opening. “Republican presidential candidates quickly and roundly slammed the act, and, by extension, the moves on prescription drugs, giving the Biden campaign an opening for clear contrast. […] Despite the overwhelming Republican opposition, Democrats are confident focusing on this policy will help Biden in 2024, especially given inflation and rising costs are consistently a top concern. […] ‘For decades people have been concerned about the cost of prescription drugs, and for decades politicians have talked about it, but Joe Biden actually got it done and it’s a great issue to campaign on and not just among seniors,’ [Democratic strategist Eddie] Vale said. ‘And to make matters even worse Republicans are actively talking about wanting to repeal the law if they win and take away the government’s right to negotiate lower prices for people.’” [The Messenger, 10/4/23

AP News: Biden Says That All 10 Drugs Targeted For The First Medicare Price Negotiations Will Participate. “President Joe Biden announced Tuesday that the manufacturers of all of the first 10 prescription drugs selected for Medicare’s first price negotiations have agreed to participate, clearing the way for talks that could lower their costs in coming years and give him a potential political win heading into next year’s election. […] ‘For many Americans, the cost of one drug is the difference between life and death, dignity and dependence, hope and fear,’ Biden said in the video, ‘And that’s why we’ll continue to fight to lower health care costs and we will not stop until we finish the job.’” [Associated Press, 10/3/23]

BioSpace: Ten Companies Register to Participate in Medicare Drug Price Negotiation Program. “All 10 pharmaceutical companies whose products were selected for the first round of Medicare drug price negotiations have agreed to participate in the talks, the Department of Health and Human Services announced Tuesday. […] With all 10 companies’ participation confirmed, the Centers for Medicare and Medicaid Services (CMS) can now move forward with the negotiation process, which will take place throughout the remainder of this year and into 2024, according to Tuesday’s HHS announcement. This fall, CMS will hold listening sessions with patients, beneficiaries, consumer advocacy organizations, caregivers and other stakeholders. CMS will also meet with the pharmaceutical companies to discuss previous submissions that the agency will consider in determining a maximum fair price. CMS will then make its initial offer for the selected pharmaceutical products, providing the companies with a ‘concise justification’ for the maximum fair price.” [BioSpace, 10/4/23]

Bloomberg Law: All Drugmakers Enter Medicare Drug Price Talks Amid Lawsuits. “Each of the drugmakers selected for the first cycle of Medicare’s drug price negotiation have entered agreements with the agency, the companies told Bloomberg Law. […] Despite all drugmakers agreeing to negotiate, nine drugmakers and industry groups have filed legal challenges seeking to topple the drug price negotiations. The lawsuits argue that the provisions unconstitutionally force companies to lower prices for their products and discourage innovation. The CMS next will host a series of patient-focused listening sessions beginning Oct. 30 on the 10 selected drugs. The sessions are meant to provide patients, beneficiaries, caregivers, consumer and patient organizations, and other interested parties the chance to share input relevant to drugs selected for the first cycle of negotiations. ” [Bloomberg Law, 10/2/23]

CNBC: Drugmakers Opt In To Medicare Drug Price Negotiations – Here’s What Happens Next. “All drugmakers of the first 10 medicines selected for Medicare drug price negotiations have agreed to participate in the talks, even after many of them sued to halt the process last month. […] ‘Today I can announce that the manufacturers of ten drugs are coming to the negotiating table to lower prices,’ President Joe Biden said in a video on X, formerly known as Twitter. ‘They’re taking steps to participate in the negotiating program so we can give seniors the best possible deal.’ Biden’s Inflation Reduction Act, which passed last year, empowered Medicare to negotiate drug prices for the first time in the program’s six-decade history. The lengthy negotiation process won’t end until August 2024, with reduced prices going into effect in January 2026.” [CNBC, 10/2/23]

CNN: Drugmakers Agree To Negotiate Prices In Medicare Even As They Sue To Stop The Program. “The White House heralded the manufacturers’ participation in the program, which was authorized by the Inflation Reduction Act, which Democrats pushed through Congress last year. ‘For decades, Big Pharma fought to block Medicare from directly negotiating lower drug prices for seniors and other Medicare beneficiaries, while nearly three in ten Americans struggle to afford their medications because of cost,’ the White House said in a fact sheet. ‘President Biden and Congressional Democrats finally beat Big Pharma and allowed Medicare to directly negotiate lower drug prices by passing the Inflation Reduction Act – despite zero Republicans voting in favor of the bill.’ But the drug industry is continuing to try to halt the negotiation process. Manufacturers and industry groups have filed multiple lawsuits in federal courts across the US.” [CNN, 10/3/23]

The Hill: Biden’s Drug Price Negotiation Plan Nets Win. “The Biden administration took a victory lap Tuesday as the White House confirmed all 10 manufacturers of the first drugs selected for Medicare price negotiations will be participating in the program. This comes despite the fact that many of the companies are currently suing the administration in an effort to halt the process. For outside observers, it wasn’t a surprise. Despite the lawsuits and threats, drug companies want to sell their products in the Medicare marketplace. They could either play ball with the administration and negotiate a price, or they could leave. Allowing Medicare to negotiate the price of prescription drugs is politically very popular — a September AP/NORC poll found 76 percent of Americans favor the policy, and that includes a majorities [sic] of Republicans and Democrats.” [The Hill, 10/3/23]

NBC News: Drugmakers Agree To Negotiate Drug Prices With Government, White House Says. “Major drug companies including Johnson & Johnson, Merck and Bristol Myers Squibb have committed to participate in Medicare drug price negotiations with the federal government, the Biden administration said Tuesday. The move is a positive step for people on Medicare, although there are still lawsuits from drug companies fighting the price negotiations. […] In June, Merck announced a lawsuit against the federal government over the negotiation provision. Other drugmakers, including Johnson & Johnson, have since filed similar suits. The companies say allowing Medicare to negotiate prices would lead to lower profits, causing drugmakers to reduce spending in research and development.” [NBC News, 10/3/23]

The New York Times: Drug Makers Agree to Negotiate With Medicare on Prices of 10 Medications. “Politically, Mr. Biden has used the drug negotiation provision in the law as a way of demonstrating his willingness to fight against big corporate interests on behalf of Americans who are struggling with high prices. Last month at an event in Maryland, the president boasted about his achievements. ‘I, along with your senators in Congress, have been trying for our whole careers to take on Big Pharma,’ he said, saying the companies had long tried to intimidate lawmakers by spending hundreds of millions of dollars on lobbyists. ‘But guess what? It happened. We finally won.’ The White House has also used the issue to focus on the differences between Democrats and Republicans. ‘Not a single solitary Republican voted for that,’ Mr. Biden said in Maryland. ‘And now — and now they want to repeal it.’” [The New York Times, 10/3/23]

NPR: Drugmakers Will Negotiate With Medicare On Price. But They’re Suing, Too. “For the first time, Medicare is beginning to negotiate the prices of prescription drugs. Despite a pack of industry lawsuits to keep the negotiations from happening, the drugmakers say they are coming to the bargaining table anyway. […] The drugs included blockbuster blood thinners Xarelto and Eliquis, as well as drugs for arthritis, cancer, diabetes and heart failure. Although more than a third of the companies that make drugs on the list have sued the federal government, all the companies have signed agreements saying they will negotiate.” [NPR, 10/4/23]

Truthout: All Manufacturers of 10 Drugs Set for Medicare Negotiation Agree to Participate. “On Tuesday, the Biden administration announced that all prescription drug manufacturers representing the 10 medications selected for negotiation through Medicare under a newly enacted policy have agreed to take part in the process, which should formally begin early next year. […] More medications will be negotiated in the future, the administration said, and around 60 medications will be part of the program over the next four years. […] Most Americans support the government having the ability to negotiate the costs of medication; a recent poll found that 76 percent back the idea, while only 6 percent said they opposed it.” [Truthout, 10/3/23]

Big Drug Companies Are in Court to Stop Medicare Negotiation and Protect Their Sky-High Profits

Drug Companies are Putting Greed Before Patients Once Again, Filing a Series of Meritless Lawsuits 

Over the past few months, drug company giants including Merck, Bristol Myers Squibb, Johnson & Johnson-owned Janssen Pharmaceuticals, Boehringer Ingelheim, AstraZeneca, Novartis, and Novo Nordisk as well as mega lobbying groups PhRMA (of which Amgen, Johnson & Johnson and others are members) and the US Chamber of Commerce (which represents AbbVie as a member), have filed meritless lawsuits against the federal government in an effort to stop Medicare from negotiating for lower prescription drug prices — the most popular provision of the Inflation Reduction Act. 

In late September, a Trump-appointed federal district judge in Ohio rejected the Chambers of Commerce’s request for a preliminary injunction to stop the negotiation program before it started and ordered for an amended complaint to be filed, rejecting the Chambers’ claim that negotiation violates their due process rights under the Constitution.

Since the enactment of the Negotiation Program, drug companies have announced massive, above-expectation profits while arguing that negotiation is “tantamount to extortion” and will “upend…pharmaceutical innovation.” They’re just trying to protect their massive profits. While they rake in billions, U.S. drug prices are up to four times higher than prices in other high-income countries, leading patients in America to cut pills and skip doses to make ends meet.

Medicare drug price negotiation is projected to lower costs for seniors and save taxpayers tens of billions of dollars, but big drug companies are eager to protect their outsized prices and profits. Drug companies that manufacture drugs likely to be eligible for negotiation now or in the near future typically exploit the patent system to keep competitor drugs off the market, spend tens of millions on lobbying, and increase their list prices at rates that far exceed inflation.

What’s At Stake? 

These lawsuits seek to end Medicare’s new ability to negotiate lower prescription drug prices for Medicare beneficiaries. If the big drug companies get their way, patients will pay more so the drug companies can make more money:

  • GONE: Medicare’s power to negotiate lower prices for the most popular and expensive prescription drugs. Under the Inflation Reduction Act, Medicare is set to begin negotiating prices for 10 of the top 50 most expensive Part D drugs in 2026, adding another 15 drugs in 2027 and 2028, and another 20 in 2029 and subsequent years.
  • GONE: $98.6 billion in Medicare savings over the next decade from the drug negotiation program, which translates into savings for patients and taxpayers.
  • GONE: Lower Part D premiums and lower out-of-pocket drug costs for certain Medicare beneficiaries who rely on qualifying drugs.

Who Is Behind These Lawsuits? 

The plaintiffs are strategically filing these junk lawsuits in a variety of different federal court jurisdictions. Merck & Co. filed in the District Court for the District of Columbia, Bristol Myers Squibb and Janssen Pharmaceuticals, Inc., owned by Johnson & Johnson, filed in the District of New Jersey Trenton Vicinage, PhRMA et al. filed in the Western District of Texas, and the US Chamber of Commerce et al. filed in the Southern District of Ohio Western Division. Boehringer Ingelheim filed in the District of Connecticut, AstraZeneca filed in the District of Delaware, and Novartis & Novo Nordisk filed separately in the District of New Jersey.

The Plaintiffs

Merck. Merck sells Januvia, a Type 2 diabetes drug that has been selected for negotiation. Januvia has been on the market without competition for 17 years and has grossed Merck $49.9 billion in sales since its launch. Medicare has spent nearly $28 billion on the drug since 2010, spending an average of $4,343 per beneficiary as of 2021. Patients in countries like Australia paid around 87 percent less – all while Merck CEO Robert Davis raked in $13.72 million.

Bristol Myers Squibb. Bristol Myers Squibb (BMS) is motivated to block the negotiation program because its blockbuster drug Eliquis, a highly profitable blood thinner that can be as much as 78 percent cheaper overseas, has been selected for negotiation. In 2021 alone, Medicare spent over $12.5 billion on the blood clot drug, which is taken by over three million Medicare beneficiaries. BMS also believes their cancer drug Opdivo is likely to qualify for negotiation; Medicare spent approximately $1.6 billion on Opdivo in 2021.

The Pharmaceutical Research And Manufacturers Of America (PhRMA). PhRMA represents many of the largest pharmaceutical companies in the country, including drug giants Pfizer, Amgen, Eli Lilly & Company, and Johnson & Johnson, as well as Merck and Bristol Myers Squibb, and has lobbied fiercely against lowering drug prices for decades. The pharmaceutical industry outspent every other industry on lobbying in 2022, with PhRMA spending over $29 million on lobbying and tens of millions more on false and misleading ads trying to defeat the Inflation Reduction Act’s provisions to lower drug costs in Congress.

Other plaintiffs receive direct financial support from PhRMA and have deep PhRMA connections. The National Infusion Center Association and the Global Colon Cancer Association are also joining PhRMA’s lawsuit — both of which have aligned with PhRMA in previous lawsuits to protect big drug companies’ ability to charge sky-high drug prices. The National Infusion Center Association received $120,000 from PhRMA in 2019, while the Global Colon Cancer Association got at least $50,000 and has spent years lobbying against a myriad of efforts to lower prescription drug prices ranging from importation to cancer drug pricing regulations. The Global Colon Cancer Association is led by a number of “corporate members” from pharmaceutical and biotech companies represented by PhRMA.

The U.S. Chamber of Commerce, and the Michigan, Ohio, and Dayton Area Chambers. As STAT concluded, “There aren’t many groups more well-funded than the pharmaceutical industry on Capitol Hill — there are two, to be precise — and the Chamber is one of them. The Chamber has spent $29.6 million lobbying so far this year, nearly double the $15.2 million spent by the brand drug industry lobby PhRMA, according to a list compiled by OpenSecrets.” 

In late September, a federal district court judge dealt a major blow to the plaintiffs, rejecting the Chamber of Commerce’s motion for a preliminary injunction that sought to block the implementation of the Medicare drug negotiation program and suggesting he would reevaluate whether the Chamber in fact had standing to bring the case following limited discovery, an amended complaint, and the government’s renewed motion to dismiss. The judge ruled, “Because the Court, at this early juncture in the litigation, cannot tell with certainty whether or not Plaintiffs have standing to raise each of their claims, they necessarily cannot have a strong likelihood of success on the merits of their due process claim.”

Janssen Pharmaceuticals, Inc., owned by Johnson & Johnson. Johnson & Johnson’s Janssen sells Imbruvica, a leukemia drug that was selected for negotiation and has grossed the company $22.33 billion since 2013. The drug, which costs around 58 percent less in other high-income countries like France, cost Medicare $3.15 billion in 2021 alone. Johnson & Johnson’s top-selling blood clot and stroke drug, Xarelto, was also chosen for negotiation; Medicare spent $5.23 billion on Xarelto in 2021 alone.

Boehringer Ingelheim. Boehringer Ingelheim is a Germany-based drug company that sells Jardiance, a type 2 diabetes drug that Boehringer shares with Eli Lilly & Co that was selected for negotiation and has grossed the companies approximately $18.5 billion (in 2023 USD) and cost Medicare over $3.7 billion in 2021 alone. Patients in other high-income countries like Canada pay around 81 percent less, and the drug has seen a 63 percent increase in list price since launch. Boehringer Ingelheim also manufactures a top-selling asthma and chronic obstructive pulmonary disease drug, Spiriva, which Medicare spent over $1 billion on in 2021 alone.

AstraZeneca. AstraZeneca is a UK-based multinational drug company that sells Farxiga, a diabetes, heart failure, and kidney disease drug that was selected for negotiation and has cost Medicare $3.4 billion as of 2021. AstraZeneca has made more than $17.7 billion in global revenue and has spent $33.8 million on lobbying since launching the drug. Patients in other high-income countries like Australia pay around 88 percent less, and the drug has seen a 130 percent increase in list price since launch.

Novartis. Novartis is a Swiss drug company that sells Entresto, a critical drug used to fight heart failure that was selected for negotiation and has grossed the company over $17 billion in global sales. Entresto has cost Medicare more than $4.5 billion since launch, while patients in other high-income countries like Australia pay around 62 percent less for the same drug.

Novo Nordisk. Novo Nordisk is a Danish drug company that sells Fiasp, a diabetes drug also known as NovoLog that has cost Medicare more than $24.8 billion through 2021. Meanwhile, Novo Nordisk has initiated at least $33 billion in stock buybacks while bringing in around $38.6 billion in global sales and spending more than $132 million on lobbying since launching the drug.

BONUS: Astellas Pharma was so eager to protect their profits that they preemptively filed suit in the Northern District of Illinois Eastern Division and withdrew after the Biden administration announced the first ten drugs up for negotiation – a slate that did not include Xtandi, Astellas’ blockbuster drug used to treat prostate cancer.

Why The Plaintiffs’ Legal Arguments Are Wrong

The plaintiffs assert several sweeping claims, including under the First Amendment, the Fifth Amendment, and the Eighth Amendment across the lawsuits, but experts agree that these meritless arguments are merely an attempt to maintain the status quo where drug companies can protect their massive profits by charging whatever they want at the expense of patients and taxpayers.

Plaintiffs’ First Argument: First, the drug companies argue that the Takings Clause of the Fifth Amendment requires the federal government to pay “just compensation” if it takes “property” for public use – Merck argues that the negotiation process is akin to a ‘forced seizure.’ BMS argues that the Fifth Amendment requires the government to pay “just compensation” if it takes “property” for public use, and that obtaining drugs at what BMS characterizes as a “unilaterally dictated discount” is no different from outright seizure of a portion of a pharmaceutical company’s inventory. Relatedly, the companies argue that it is unconstitutional for a manufacturer to have to exit the Medicare and Medicaid programs for all of its products in order to avoid selling one of its products at a negotiated price.

Why The Plaintiffs Are Wrong: The Negotiation Program in no way requires drug companies to sell selected drugs to Medicare at a specified price, nor is it an “unilaterally dictated” program. First and foremost, Medicare is, and always has been, a voluntary program. Drug manufacturers – like physicians, hospitals, clinical labs, insurers, and other health care industry stakeholders – choose to participate in Medicare on a voluntary basis. If a manufacturer of a selected drug does not want to negotiate the price of a selected drug or cannot come to an agreement on a negotiated price, the manufacturer can withdraw from participation, just as they could have done at any point since the law has been debated and enacted. Setting Medicare program requirements that include negotiating the price of certain drug products is already standard in Medicare; program requirements apply broadly to other participants in the Medicare program. For example, hospitals that participate in Medicare can’t choose to deny certain services to Medicare patients because they think Medicare doesn’t pay them enough. Rather, if they participate in Medicare they must provide all offered services to Medicare beneficiaries. 

Companies do not have any kind of property right to participate in a voluntary program and dictate the prices they pay. The notion that participating in market negotiation in a voluntary program somehow violates a company’s constitutional right is nonsensical. The Act lets companies decide whether they wish to participate or not–and leaves it to companies to decide which path makes the most economic sense for them. So far, the courts have found this claim dubious. As a federal judge in Ohio’s Southern District ruled in the Chambers of Commerce case, “The law established in the Sixth Circuit and beyond is clear: participation in Medicare, no matter how vital it may be to a business model, is a completely voluntary choice…Thus, the Program’s eventual “maximum fair price” cannot be considered confiscatory because pharmaceutical manufacturers who do not wish to participate in the Program have the ability—practical or not—to opt out of Medicare entirely.” 

Simply put, drug companies want to continue the status quo of having their greed unchecked by setting their own prices for their drugs and having Medicare be required to pay those prices. For too long, the industry has been able to exert its unparalleled power and deprive Americans of affordable drugs. The only reason they did not have to negotiate sooner is that Republicans included a provision in 2003 amendments to Medicare preventing negotiation in a concession to the powerful drug industry.

Pharma Plaintiffs’ Second Argument: Second, the drug companies make a desperate attempt to distort the First Amendment by arguing that they are being forced to use language they disagree with to describe the Negotiation Program. Merck argues that they shouldn’t have to sign an “agreement” to “negotiate” a “maximum fair price” because it betrays their belief that the negotiation program is not a legitimate negotiation. Likewise, BMS argues that the negotiation process set out by the Inflation Reduction Act violates the First Amendment’s mandate that the government cannot conscript businesses to “parrot its preferred political messaging,” and plaintiffs in US Chamber of Commerce et al. also argue that the program violates the First Amendment by compelling drug companies to characterize the program as a negotiation process.

Why The Plaintiffs Are Wrong: The Negotiation Program does not force drug companies to enter into agreements against their will; participation in Medicare is completely voluntary and the plaintiffs are attempting to stretch First Amendment doctrine beyond belief. As a federal district judge ruled in the Chambers of Commerce case, “As there is no constitutional right (or requirement) to engage in business with the government, the consequences of that participation cannot be considered a constitutional violation. Because Plaintiffs are not legally compelled to participate in the Program— or in Medicare generally—they have not shown a strong likelihood of success on the merits of their due process claim.” PhRMA itself lost a First Amendment challenge to California’s drug pricing legislation in 2021, and the Supreme Court has previously explained that the government may attach certain conditions and language to funding and programs without violating the First Amendment, even where private actors disagree with those conditions and language. 

Plaintiffs’ Third Argument: Plaintiffs for both PhRMA et al. and US Chamber of Commerce et al. argue that the drug price negotiation program violates the Eighth Amendment’s excessive fines clause because they claim the act imposes an excise tax on companies that choose not to enter into the negotiation process by refusing to submit statutorily required information to facilitate the negotiation process.

Why The Plaintiffs Are Wrong: The Supreme Court has famously ruled that Congress has broad and far-reaching authority to tax. While the Eighth Amendment protects against “punitive” or “grossly disproportionate” taxes, the excise tax levied for refusing to comply with the Negotiation Program is neither a compulsory tax nor punitive. Drug companies can avoid the tax by complying with the Negotiation Program or simply exiting the Medicare and Medicaid programs. In fact, there are several provisions in the Tax Code that impose extremely large excise tax assessments, some even more than 100% of the amount involved.  

Plaintiffs’ Fourth Argument: The drug companies argue that the IRA gives the Department of Health and Human Services (HHS) overly broad, unconstrained authority to negotiate prescription drug prices. This, they argue, “flouts bedrock principles of separation of powers and nondelegation, [and] exceeds Congress’s enumerated powers…” Additionally, by barring judicial review of some drug-price-negotiation items and allowing HHS to implement the program through guidance rather than rulemaking, they argue that the IRA provides no avenue for checking HHS’s authority.

Why The Plaintiffs Are Wrong: There is a long-standing precedent for Congress delegating authority to negotiate lower prescription drug prices. Since 1992, the Department of Veterans Affairs (VA) has been able to negotiate prescription drug prices. The VA pays approximately 54 percent less for drugs than Medicare. Congress barring judicial review or administrative rulemaking is not a novel concept; There are at least 190 instances in federal code where Congress has barred judicial review. The Medicare statute already bars judicial review of reimbursement rate payments in at least 25 instances. 

Plaintiffs’ Fifth Argument: The plaintiffs argue that the program violates the Fifth Amendment’s Due Process Clause because it allows HHS to impose “confiscatory” negotiated prices without providing adequate procedural protections through “administrative and judicial review.” They characterize the negotiation program as an arbitrary price control mechanism and argue that they have a constitutionally protected right “to be free from [such] price controls.” By barring notice-and-comment rulemaking and judicial review, they argue, the IRA deprives big drug companies of “an opportunity to be heard” in determining drug prices. They argue this is a violation of their due process rights.

Why the Plaintiffs Are Wrong:

The IRA is not a price control statute. These are private companies, with enormous market power because they are the sole manufacturer of drugs that Americans depend on. The IRA merely empowers HHS to negotiate–rather than blindly accept a price dictated by a drug company–the prices Medicare pays for a limited number of specified drugs. The IRA does not set the market rate for drug prices. It establishes a mechanism by which drug manufacturers and the federal government mutually participate in a regulated market-driven process. 

Even assuming the IRA was a price control statute, as the drug manufacturers wrongly characterize it, the Constitution does not shield businesses from lawful price regulation. For doctors choosing to participate in the program, Medicare determines what doctors can be paid for services provided to patients (rates substantially lower than commercial market rates). All levels of government – federal, state, and local – have laws that affect prices in some form. These run the gamut, including areas such as real estate leases, utilities, insurance, wages, and so forth. And these laws have been upheld against constitutional challenges.

What Happens Next

  • October 13: U.S. Chamber of Commerce’s amended complaint is due in Chambers of Commerce v. Becerra.
  • September 20: Astellas filing due
  • October 16: The federal government’s cross-filings are due in Bristol Myers Squibb v. Becerra and Janssen v. Becerra
  • October 19: Merck’s reply filing is due
  • October 23: Amicus briefs are due in Bristol Myers Squibb v. Becerra and Janssen v. Becerra
  • October 27: The federal government’s renewed motion to dismiss is due in Dayton Area Chamber of Commerce v. Becerra.
  • November 10: Bristol Myers Squibb’ & Janssen’s reply filings are due
  • November 21: Merck’s reply filing is due
  • December 1: The federal government’s reply filing is due in Bristol Myers Squibb v. Becerra
  • December 6: The federal government’s summary judgment motion is due in Boehringer Ingelheim v. Becerra
  • December 8: Bristol Myers Squibb’ & Janssen’s reply filings are due
  • December 13: Amicus briefs are due in Boehringer Ingelheim v. Becerra
  • January 12: Boehringer Ingelheim’s reply filing is due
  • February 12: The federal government’s reply filing is due in Boehringer Ingelheim v. Becerra

Here’s What Legal & Health Experts Have Said About The Cases

Amici

  • Nine Nationally Recognized Health Care Experts, Including Three Former Medicare Administrators: “Ensuring Prescription Drug Price Affordability Is Essential To The Financial Stability Of The Medicare Program.” “The Amici, nationally recognized experts in healthcare, healthcare finance, and Medicare, submit this brief to explain: that ensuring prescription drug price affordability is essential to the financial stability of the Medicare program; that the authority conferred on CMS by the DPNP to negotiate drug prices for the Medicare program is consistent with the authority that Congress has given CMS to limit excessive prices of other Medicare services; that this authority is also consistent with that given to other agencies to limit drug prices in other federal government programs; and, finally, that the courts have uniformly rejected challenges to the federal authority to limit prices for drugs and services paid by federal healthcare programs.” [Merck & Co. Inc. v. Becerra et al., Amicus Curiae Brief, 9/18/23]
  • Seven Top Economists & Health Care Policy Scholars: Drug Companies Present “An Overly Simplistic And Misleading Account Of The Prescription-Drug Market.” A group of seven top health care policy scholars and economists hailing from Harvard, Yale, Johns Hopkins, Boston University, and Georgetown wrote: “This brief shows how Merck’s contention reflects an overly simplistic and misleading account of the prescription-drug market. […] [The Inflation Reduction Act] gives Medicare the authority to negotiate prices for drugs that have been on the market for at least 9-13 years. By doing so, it provides consumers a negotiating agent with enough clout to counter the pharmaceutical monopolist’s excessive prices. The law now gives consumers a negotiating agent that has enough clout to counter the pharmaceutical monopolist in establishing a price. The harm to true innovation is negligible because any drug eligible for negotiation will almost certainly have already recuperated its investment many times over. […] [C]ontrary to Merck’s contention, the Inflation Reduction Act pushes the drug market’s dynamics closer to competitive equilibrium, not further away.” [Merck & Co. Inc. v. Becerra et al., Amicus Curiae Brief, 9/18/23]
  • Protect Our Care, Public Citizen, Patients for Affordable Drugs Now, Doctors for America and Families USA: Without Negotiation, Big Drug Companies Set Prices By “To Maximize Profit.” “Merck’s theory is built on the faulty premise that the price that Merck charges absent negotiation is necessarily the “fair market” price. “Fair market value” is the price determined by a willing buyer and a willing seller. Drug companies, however, set prices for brand-name prescription drugs under monopolistic conditions. In a monopoly system where a seller has an exclusive product, the sales price—absent negotiation— is not set by the “fair market value,” but by the seller’s effort to maximize profit. Indeed, Merck charges different amounts to different buyers and in different countries. Because Merck’s Takings Clause argument claim fails to take into account the dynamics that inform pricing in the market for brand-name prescription drugs, Merck’s assertion that the price negotiated under the IRA program results in an unconstitutional taking fails.” [Merck & Co. Inc. v. Becerra et al., Amicus Curiae Brief, 9/13/23]
  • American Public Health Association and Three Top Public Health Professional Organizations: “Doctors And Their Patients Do Not Support Untrammeled Price Increases By Drug Manufacturers.” “[T]he Inflation Reduction Act’s (IRA) Drug Price Negotiation Program…is vital to maintaining and strengthening patient care and the Medicare program. Contrary to what drug companies have argued, doctors and their patients do not support untrammeled price increases by drug manufacturers.” [Merck & Co. Inc. v. Becerra et al., Amicus Curiae Brief, 9/18/23]
  • AARP and the AARP Foundation: “Many Older People Simply Do Not Have The Resources To Pay For Exorbitant And Escalating Drug Prices.” “Ever-escalating drug prices have hit older people particularly hard, forcing millions of them to make devastating decisions because they cannot afford the medication they need. More than 50 million people are enrolled in Medicare Part D, the federal government’s voluntary prescription drug benefit program for Medicare beneficiaries. On average, they take between four and five prescriptions per month and have a median annual income of just under $30,000. The vast majority have chronic conditions that require lifelong treatment. Many older people simply do not have the resources to pay for exorbitant and escalating drug prices. As a result, they are forced to choose between paying for their prescribed medication or paying for basic life essentials such as food, housing, or heat. Some older people skip doses, split doses, or forego filling their prescriptions altogether to make ends meet. Others sell everything they own and drain their resources because the price of their medication is beyond their reach.” [Merck & Co. Inc. v. Becerra et al., Amicus Curiae Brief, 9/18/23]
  • Fourteen U.S. Senators: Big Drug Companies Are Working “To Accomplish Through Judicial Action What It Could Not Through The Legislative Process.” A group of fourteen U.S. Senators – including Sens. Amy Klobuchar (D-MN), Peter Welch (D-VT), Tammy Baldwin (D-WI), Richard Blumenthal (D-CT), Sherrod Brown (D-OH), Catherine Cortez-Masto (D-NV), Richard J. Durbin (D-IL), John Fetterman (D-PA), John Hickenlooper (D-CO), Jacky Rosen (D-NV), Jeanne Shaheen (D-NH), Debbie Stabenow (D-MI), Chris Van Hollen (D-MD), and Elizabeth Warren (D-MA) – wrote, “Merck and its allies in the pharmaceutical industry tried to prevent this legislative result. Merck now attempts to accomplish through judicial action what it could not through the legislative process. […] As a matter of constitutional law, that position is baseless, as the government’s opposition and cross-motion for summary judgment ably explain. […] Congress improves laws all the time, and it has the right and indeed the duty to do so. The Program takes nothing from Merck: not its drugs and not its patents. And the Program likewise does not coerce Merck to do or say anything: like every other market participant, it may sell its products at a price the buyer thinks is fair, or it may not.” [Merck & Co. Inc. v. Becerra et al., Amicus Curiae Brief, 9/19/23]

Legal Experts

  • Suhasini Ravi, ​​Zachary Baron and Andrew Twinamatsiko, researchers at the O’Neill Institute for National and Global Health Law at the Georgetown University Law Center: “[T[he stakes of these lawsuits are considerable. The outcome of these cases will likely substantially affect prescription-drug accessibility and affordability. The pharmaceutical industry’s attempts to prevent the implementation of the negotiation program could fundamentally reshape the government’s authority to manage the Medicare program and would impede decades-long advocacy and legislative efforts to curb ever-increasing prescription drug prices.” [Health Affairs, “Amicus Briefs In Merck Lawsuit Defend Constitutionality Of Medicare Drug Price Negotiation Program,” 9/29/23]
  • Nicholas Bagley, Professor at the University of Michigan School of Law: “Merck doesn’t have a constitutional right to sell its drugs to the government at the price that it sets. That’d be nuts. […] both of these claims look very, very weak. […] That’s not an unconstitutional condition. That’s just bargaining.” [X (Thread), 6/6/23]
  • Zachary Baron and Andrew Twinamatsiko, associate directors of the O’Neill Institute for National and Global Health Law at the Georgetown University Law Center: “That lawsuits are ultimately brought says nothing about any actual legal infirmity with the IRA or the Medicare Drug Negotiation program. In fact, as discussed briefly below, a number of the potential claims that the pharma industry and their allies may pursue largely track other unsuccessful industry challenges and would likely face substantial legal headwinds. If successful, such lawsuits would have broader implications beyond just Medicare or prescription drugs. Rather, the success of these challenges could result in new legal doctrines that would severely restrict federal regulatory authority in the health care arena.” [Health Affairs Forefront, 6/7/23]
  • Michael Cannon, director of health policy studies at the Cato Institute: “Is this actual coercion? Is it a takings in violation of the Fifth Amendment, as Merck alleges? No. Merck is rent-seeking—and hoping its use of the right shibboleths will trick conservative and libertarian legal scholars into rallying to the company’s cause. […] In case we needed more evidence that Merck is just rent-seeking—that is, attempting to gouge taxpayers—the company describes the prices it currently receives from Medicare as reflecting ‘fair market value’ and Medicare’s current drug‐​pricing rules as ‘a free‐​market approach based on market‐​driven prices.’ Troy describes what Medicare pays as a ‘market price.’” [The Cato Institute, 6/9/23]
  • Robin Feldman, professor of intellectual property and health law at the University of California College of the Law in San Francisco: “Applying the takings clause to patents would be like the shot heard round the world — it would be an extraordinary shift and the companies will have a heavy lift to convince the courts that those words apply to patents.” [CNBC, 6/20/23]

Physicians and Health Care Experts

  • Erik Gordon, Clinical Professor at the University of Michigan’s Ross School of Business: “[There are] better odds that Elizabeth Holmes wins Medtech Innovator of the Year than that Merck wins its lawsuit.” [STAT, 6/6/23]
  • Ameet Sarpatwari, Assistant Professor of Medicine at Harvard Medical School: “What Merck argues is ‘coercion’ is actually the establishment of a freer, more rational marketplace [that will address a crucial root cause of high drug prices].” [New York Times, 6/6/23]
  • Jonathan Reiner, Professor Of Medicine & Surgery at the George Washington University School of Medicine & Health Services: “Merck made $14.5 billion in profits last year.” [Twitter, 6/7/23]

Health Care Organizations and Advocates

  • Larry Levitt, Executive Vice President for Health Policy at KFF: “While the drug companies that make the 10 drugs subject to negotiation are expected to start engaging with the government, the industry is publicly attacking the program and has filed a slew of lawsuits to block the government from carrying it out. […] [A]s the cases now wind their way through the lower courts, the pharmaceutical industry may not win in the court of public opinion. According to KFF polling, 81 percent of the American public favors negotiation of drug prices in Medicare, with support spanning the political spectrum, so it’s no surprise that Democrats see this as a winning political issue in the 2024 election. […] The more the pharmaceutical industry does to attack drug price negotiation, the more the public will become aware of the most noteworthy health reform initiative since passage of the Affordable Care Act more than a decade ago.” [The New York Times (Opinion), 9/6/23]
  • Richard Fiesta, Executive Director of the Alliance for Retired Americans: “Merck’s ridiculous lawsuit is the equivalent of a toddler throwing a temper tantrum. Americans pay the highest prices in the world for prescription drugs and too many seniors must choose between putting food on the table and paying for their medicine. That is because corporations like Merck have been allowed to charge taxpayers whatever they want for their drugs.” [The Alliance for Retired Americans Press Release, 6/6/23]
  • Emily Gee, senior vice president for Inclusive Growth at the Center for American Progress: “This lawsuit is an insult to millions of patients in America who have been forced to ration their medications or forgo prescriptions altogether because of Big Pharma’s greed. For decades, Big Pharma has exploited its monopoly power to rip off hardworking Americans by charging prices in the United States that no other country in the world will agree to pay for the exact same drugs. President Joe Biden’s targeted law to lower drug prices puts an end to the most egregious excesses in the pharma industry; incentivizes drugmakers to actually invest in innovative therapies; and will lower drug prices for millions of seniors with cancer and diabetes, among other common conditions. The courts should reject this and similar lawsuits that appear to be nothing more than a ransom note for millions of Americans who need access to lifesaving medications they otherwise cannot afford.” [Center for American Progress, 6/21/23]
  • Margarida Jorge, Head of Lower Drug Prices Now: “This is nothing but a political stunt motivated by the same shameless greed that we’re used to seeing from drug corporations that have made decades of inflated profits at the expense of patients’ health and taxpayers’ hard-earned money. […] It’s time for big drug corporations like Merck to give up their monopoly control over prices and negotiate fair prices for the medicines we need.” [Lower Drug Prices Now Press Release, 6/6/23]
  • David Mitchell, Founder of Patients For Affordable Drugs Now: “Merck’s bogus lawsuit bemoans Medicare’s negotiation authority as ‘tantamount to extortion’ – but the truth is, Big Pharma companies like Merck are the ones who have been extorting patients for years, forcing them to pay unjustified prices or sacrifice their health. […] We believe that courts will see Merck’s lawsuit for what it is: a meritless attempt to maintain its ability to unilaterally set prices that are untethered to quality at the expense of patients. The truth is, implementation of Medicare negotiation is a desperately needed, long-awaited rebalancing of our drug price system that will help millions of patients obtain the medications they need at prices they can afford while ensuring continued innovation.” [Patients For Affordable Drugs Now Press Release, 6/6/23]
  • Tricia Neuman, Senior Vice President at the Kaiser Family Foundation: “It’s no surprise that drug companies have been gearing up to challenge #Medicare price negotiations in the courts, but a little surprising to see a lawsuit before CMS announces the names of the 10 drugs included on the list.” [Twitter, 6/6/23]
  • Max Richtman, President & CEO of the National Committee to Preserve Social Security and Medicare: “Merck’s decision to sue the federal government today demonstrates that there is no bottom to Big Pharma’s greed and the corporate culture of putting profits before people. With its lawsuit, Merck has made it clear that one of the nation’s most profitable drugmakers wants seniors to continue paying sky-high prices for their vital medications. (Merck made $14.5 billion in profits last year.) […] Merck’s constitutional arguments are spurious at best; the Veterans Administration has been successfully negotiating prices with Big Pharma for years. Drugmakers can still remain profitable while abiding by the Inflation Reduction Act, which was a long-awaited and landmark piece of legislation to protect seniors from industry price gouging.” [National Committee to Preserve Social Security and Medicare Press Release, 6/6/23]
  • Bill Sweeney, Senior Vice President at AARP: “Seniors and taxpayers are tired of being the piggy bank for the profits of big drug companies. Lawsuits like this are simply an attempt to keep high profits by gouging America’s seniors.” [CNBC, 6/6/23]
  • Robert Weissman, President of Public Citizen: “Merck is claiming the U.S. Constitution requires the U.S. government and people to be suckers. That’s not true. This lawsuit is a desperate attempt by the industry to beat back popular legislation that would curtail Big Pharma’s ability to price gouge Medicare and secure monopoly profits. Full stop. While Big Pharma’s litigation gambit plays out, it is critical that the federal government continue its preparation for price negotiations. Delay in the commencement of long-overdue negotiations will result in billions of dollars in excess costs for taxpayers and consumers” [Public Citizen Press Release, 6/6/23]

Drug Companies Enter Medicare Negotiation Agreements With CMS, Kickstarting Process to Lower Prices for Seniors Nationwide

Washington, D.C. — All 10 drug companies announced they entered into agreements with Medicare to negotiate lower drug prices. Some of these drugs are the most expensive in the U.S., with patients on Medicare paying an average of $6,500 per year out-of-pocket. Together, these drugs are responsible for about 20 percent of Part D spending and have made a combined $493 billion in global revenue.

This is a historic milestone in lowering drug prices through finally empowering Medicare to negotiate on behalf of seniors, which was enacted as part of the Inflation Reduction Act championed by President Biden and Democrats in Congress. This comes as some of these big drug companies are suing in the courts to try to stop Medicare from negotiating lower drug prices in order to protect their outrageous profits. In response, Protect Our Care Chair Leslie Dach issued the following statement:

“After years of a broken system where drug companies get to pull the strings and charge whatever they want for lifesaving medications, seniors will get some long-overdue relief. Thanks to the leadership of President Biden and Democrats in Congress, negotiations are finally underway. This first round of prescription drugs are some of the most expensive on the market and have lacked competition for years. It’s time for their prices to be affordable to patients. Even as drug companies try to go to court to stop the negotiation process, it is clear that the Biden administration is not backing down to make prescription drugs affordable for everyone.” 

Background 

Companies with drugs that have entered into negotiation agreements are:

  1. AstraZeneca, which manufactures Farxiga to treat diabetes, heart failure, and kidney disease
  2. Boehringer Ingelheim, which manufactures Jardiance to treat diabetes
  3. Bristol Myers Squibb, which manufactures Eliquis to treat blood clots
  4. Merck, which manufactures Januvia to treat diabetes
  5. Amgen, which manufactures Enbrel to treat rheumatoid arthritis, psoriasis, and psoriatic arthritis
  6. Novartis, which manufactures Entresto to treat heart failure 
  7. Novo Nordisk, which manufactures Fiasp/NovoLog to treat diabetes
  8. Pharmacyclics, owned by Abbvie, which manufactures Imbruvica to treat leukemia and lymphoma 
  9. Johnson & Johnson, which manufacturers Stelara to treat psoriasis, psoriatic arthritis, Crohn’s disease, and ulcerative colitis
  10. Janssen Pharmaceuticals, owned by Johnson & Johnson, which manufactures Xarelto to treat blood clots 

Read more about these high-cost drugs here.

BREAKING: Trump-Appointed Judge Denies Request for a Preliminary Injunction to Block Medicare from Negotiating Lower Drug Prices

Washington, DC — Today, a federal judge in Ohio denied the Chambers of Commerce’s request for a nationwide preliminary injunction in one of the cases that seeks to stop Medicare from negotiating lower drug prices for millions of seniors. This ruling allows Medicare to continue the process of negotiating lower drug prices as scheduled.

The Chambers’ case is one of eight meritless lawsuits seeking to overturn the Negotiation Program, which is overwhelmingly popular among voters of all parties across the country, to protect drug companies’ outrageous profits. While drug companies rake in billions and force seniors to skip doses of life-saving medicines, they charge up to four times more in the U.S. than in other countries. Read more about the lawsuits brought by big drug companies and their allies here. 

In response, Protect Our Care Chair Leslie Dach issued the following statement: 

“This decision means that greed lost and hard-working Americans won. All these lawsuits are meritless and driven by nothing more than corporate greed. Seniors shouldn’t be forced to cut pills and skip doses of lifesaving medications while the drug companies rake in outrageous profits. For now, Judge Newman’s decision means that Medicare can move forward and negotiate with drug companies to make prescription drugs more affordable for millions, but we must remain vigilant. The drug companies will continue using every tool in their arsenal in all of these cases so that they can continue to charge whatever they want.”

GOP Pushes Legislation to Give Tax Breaks to the Wealthy While Undermining Affordable Health Care

Washington, DC — Yesterday, Republicans on the House Ways and Means Committee once again considered legislation to promote the use of health savings accounts (HSA), which overwhelmingly benefit high-income people while worsening racial and ethnic inequities in health care. This legislation incentivizes the expansion of HSAs through tax breaks, which would cost taxpayers more than $70 billion to reward the highest-paid workers. This comes as Republicans are working to repeal the Inflation Reduction Act, raise prescription drug prices, and throw millions off of Medicaid. In response, Leslie Dach issued the following statement: 

“Republicans are putting their priorities on full display: doling out more tax breaks to the wealthy while threatening to shut down the government. Republicans could join the Democrats to focus on making prescription drugs more affordable, expanding affordable health care, or fighting the maternal mortality crisis, but instead they are working to line the pockets of the wealthiest Americans while exacerbating harmful racial inequities in our health care system. Time and again, Republicans prove they are all in on their war on health care with no signs of letting up.” 

Background

HSAs Make Health Care Less Accessible And Affordable. Republican efforts to promote the use of HSAs directly undermines the ACA’s goals to make quality health care more accessible and affordable for all Americans. The promotion of employer-sponsored high-deductible health plans that use HSAs increases the cost of health care for employees and continues the difficult decisions low-income working families have to make between putting food on the table or paying for medical care. 

HSAs Benefit The Wealthy. HSAs largely benefit high-income individuals. Contributions to HSAs are not taxed, which helps wealthy people decrease their taxable income and avoid paying their fair share. These contributions can also be invested in stocks and bonds to accrue tax-free earnings that carry over year to year — further exacerbating the wealth gap.

HSAs Do Not Make Care More Affordable for Low-Income Individuals. HSAs do not benefit low-income individuals as they often do not have the ability to contribute to HSAs and need to use their available income to pay for medical bills and care upfront. Nearly 70 percent of adults under 200 percent of the poverty line would not have been able to pay a $1,000 medical bill within 30 days in 2022, let alone contribute to a HSA. Low-income individuals also do not benefit as much from tax-free earnings as high-income individuals due to the lower amount of tax deductions from being in a lower income tax bracket. Employers who offer high deductible health plans, where HSAs are necessary, typically contribute little to nothing to their employees’ HSAs. 

HSAs Exacerbate Racial And Ethnic Inequities In Health Care. Black and Latino people with private insurance are half as likely to have HSAs as white and Asian people. Per the Center on Budget and Policy Priorities: “Against a backdrop of long-standing racial disparities in wealth — a typical white family in 2019 had eight times the wealth of a typical Black family and five times the wealth of a typical Latino family — HSAs provide preferential tax treatment that is disproportionately out of reach for people of color.”

HSAs Cost The Government Billions. HSAs will cost the government $182 billion between 2023 and 2032. Meanwhile, the cost of President Biden’s plan for permanently closing the Medicaid coverage gap or permanently extending marketplace coverage premium tax credits over the next 10 years would cost roughly the same amount at $200 billion and $183 billion respectively. Unlike the bills to expand HSAs, Medicaid expansion and marketplace premium tax credits would allow millions of uninsured individuals to gain quality coverage.