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Democrats are counting on the drug policy proposal, which could deliver budget savings of up to $ 700 billion over a decade, to help pay for their other health policy priorities, including proposals to extend the Affordable Care Act, Medicaid and Medicare benefits.

Yarmuth noted that the leadership has given grassroots Democrats a fairly long leash so far, but this period of tolerance is drawing to a close.

Still, hold-outs maintain their concerns about the Bill’s impact on the creation of new drugs are sincere and the lobbying campaign has yet to sway them, forcing Democrats to consider less tasty backup plans.

Peters, one of Congress’ largest recipients of pharmaceutical industry donations, told POLITICO he was proposing to fellow moderates and senators like Kyrsten Sinema the alternative and narrower drug price bill he unveiled last week, and maintains his opposition to the Democrats’ more aggressive version .

“I think it would devastate American science, and we’re trying to make that point,” he said. “I hope [forcing a vote on the drug bill] is not the plan because I clearly expressed my position.

But persistent opposition could open Peters and his allies to accusations that they are endangering much of President Joe Biden’s national agenda and Democrats’ control over Congress, and vulnerable members of the House of Districts. violets plan to support this case.

“We are the ones who will determine if we are in the majority and we are very committed to it,” said Rep. Colin Allred (D-Texas), a member of the Pelosi leadership circle which represents a swing district. “We are also the ones who receive the attack ads. So if we’re still willing to do it, we think anyone else should be able to do it.

Senior Democrats and their aides stressed that negotiations are ongoing and many things, including the drug pricing bill, could still change in the coming days as the entire bill threatens to fail. collapse under the weight of competing demands from progressives and moderates on both sides of Capitol Hill. . But the current plan, they said, is to come up with something close to the drug negotiation bill that has already been passed twice by the House.

While Nancy Pelosi warned members in a letter to Dear Colleague Monday night that the overall size of the bill may have to shrink due to ongoing negotiations with the Senate, they are still counting on drug policy to increase the size of the bill. money to pay for other priorities such as coverage of dental, vision and hearing benefits for the elderly, the extension of Medicaid for low-income people in the Red States, and the sustainability of Obamacare grants.

“The plan is to put HR.3 in the Build Back Better Act and then we’ll start working with the membership,” said Rep. Raul Ruiz, who heads the Hispanic caucus. “We’ll have to whip it up and I think once it’s included in the bigger bill it’s more likely to pass.”

Although Peters, Schrader and Rice blocked the bill from moving forward in the Energy and Trade Committee last week, identical language was removed from the Ways and Means Committee, paving the way for its inclusion in the larger package. Yet the leaders are still making a risky bet, given that they can only lose three Democratic votes on the floor.

“We have to work with the few members who have reservations or we won’t be successful,” warned Rep. Peter Welch (D-Vt.), Who is taking the lead in lobbying for the drug bill. “It’s still in the bill, but we continue to have our work cut out for it.”

Leaders from the White House, House and Senate and outside advocacy groups are also joining the fight, working to reduce reluctance as the party struggles to bolster a package of health policy changes without GOP votes.

Groups like Indivisible, Protect Our Care, Our Revolution and AARP are stepping up their lobbying campaigns – urging voters to flood the offices of recalcitrant appeals, run ads attacking them, and picket outside their headquarters. district. At a rally led by Senator Bernie Sanders on Tuesday, activists made life-size puppets with the faces of Peters, Schrader and Rice outside the DC offices of the pharmaceutical industry’s leading lobby group. The goal? Make sure all three lawmakers vote the other way if the full bill gets to the House.

A senior Democratic official said leaders hope this external pressure “increases the price of obstructing drug price negotiations.”

But Peters said all the internal and external pressure he has received over the past week has not made a difference for him.

“The amount of vitriol that my district office is taking has been really tough, and I’m sorry for my staff,” he said. “But I still think my stance is right and my job is to do what I think is the right thing.”

In a letter to her constituents over the weekend, Rice presented a similar case, saying her “no” vote was “not an easy decision to make, but I think it was the right decision.” She also said the global $ 3.5 trillion package was not “fiscally responsible”, although the drug provision she opposes saves rather than costs the government money, and doesn’t did not explain why she voted for the other elements of the bill.

Yet House leaders have projected confidence that recalcitrant members will line up to avoid reneging on their campaign pledges.

“We promised the American people in 2018 that we would work to reduce the high cost of life-saving prescription drugs,” Representative Hakeem Jeffries (DN.Y.), chair of the House Democratic Caucus, told POLITICO.

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