October 17,2019

Grassley on the Need to Lower Prescription Drug Costs

Grassley on the Need to Lower Prescription Drug Costs
Prepared Remarks by U.S. Senator Chuck Grassley of Iowa
Chairman, Senate Finance Committee
Senate Floor
Thursday, October 17, 2019
I come to the floor today to speak about lowering the cost of prescription drugs for America’s seniors.
I’ve spoken on this topic many times before. In one of my previous speeches, I said that we were delivering on the promises of the last three elections, in a bipartisan manner to help seniors who had waited far too long for relief.
That speech was more than fifteen years ago.
We’ve been here before.
In 2003, I was leading the last piece of bipartisan entitlement reform, the creation of the Medicare Part D program in the Medicare Modernization Act of 2003.
And now, here we are again, on the cusp of meaningful, bipartisan action.
This action would fulfill the promises that I, many of my colleagues and the administration made to the American people. 
I want to remind my colleagues that history does not have to repeat itself – hopefully this will help avoid the gridlock that delayed us from delivering Medicare Part D nearly two decades ago.

As we all know, the Medicare Modernization Act was signed into law in November of 2003 but the process of creating Part D began long before then.
In fact, Congress was voting on versions of what would become prescription drug coverage as early as 1988.
Suggestions for how to help seniors afford prescription drugs came from every corner throughout the next decade.
Yet the proposals weren’t enacted so we failed to bring any kind of comprehensive change to Medicare.
Under President Clinton, prescription drug pricing reform gained national attention.
As part of the Balanced Budget Act of 1997, Congress created the National Bipartisan Commission on the Future of Medicare.
After a year’s worth of research, the Commission voted on three recommendations in 1999, including a prescription drug benefit.
However, the recommendations failed to receive the mandated super-majority of member votes, so no formal recommendations were ever submitted to Congress.
Facing mounting pressure from the public to act in anticipation of the 2000 election, all of the major presidential candidates presented plans.
President Bush had suggested a new federal subsidy to help low-income beneficiaries purchase drug coverage through private insurers.
Vice President Al Gore proposed a new voluntary benefit within Medicare to protect chronically ill or low-income beneficiaries against catastrophic expenses.
And yet, we still couldn’t reach a compromise.
The country was united behind Medicare reforms but Congress was divided on how, or even if, it should act.

In the Finance Committee, former Chairman Bill Roth had proposed two plans to committee members, in the hopes that consensus could be reached.
The first plan worked to fundamentally change the Medicare program.
The proposal included a universal drug benefit for the Medicare program, with several major contracting reforms.
The reforms would have permitted pharmacy benefit managers, insurers and other qualified firms to compete to manage the government drug benefit in a cost effective way.
Chairman Roth also proposed a scaled back plan which would extend prescription drug coverage to low-income seniors and, on the state level, to those seniors facing catastrophic levels of spending.
This second piece of legislation was meant to be a backstop, a short-term bipartisan band-aid on a gaping wound while negotiations continued to find a longer-term solution.
But despite support from then President Bill Clinton and Majority Leader Trent Lott, compromise was elusive and the Finance Committee did not act before the November elections.
In the 2000 election, we lost five Republican Senate incumbents.
The American people were disappointed in our lack of action, and it showed.
We marched on to find a path forward but building consensus was not easy.
Between 2000 and 2003, we held countless member meetings and hearings on the status of Medicare and how we could come to an agreement to add Part D and bring Medicare into the 21st century.
The gridlock seemed inescapable.
In 2002, the budget allowed for three hundred and fifty billion dollars to reform the Medicare program.
Partisan discord led to three separate proposals being sent to the Senate from House Republicans that were subsequently voted down.   
When I re-took the gavel as chair of the Finance Committee after the 2002 elections, I promised legislation that would address  seniors’ concerns and be bipartisan so that it would pass an almost evenly split Senate.
In the Finance Committee, we went through the important and wide-ranging process of creating what eventually became the Medicare Modernization Act.
I worked across the aisle, across the Capitol and down Pennsylvania Avenue to make sure that the prescription drug and Medicare improvement bill struck the right balance, spending the money allocated to us by President Bush in a fair and equitable way.
A lot had changed in the practice of medicine since Medicare had been signed into law in 1965 and we needed to recognize that.
My friend Senator Baucus and I were able to thoughtfully pull together a package that Medicare by closing a big coverage gap, and doing that in the right way.
The Part D marketplace offered consumers better choice, better coverage and better value.
And it was about time.
I said in 2003, “We all know seniors don’t want politics, they want prescription drugs” and that holds true today.
It’s important to note that just like in the 2000 election, the country took notice.
But, this time it was for our accomplishments, and Republicans gained 4 Senate seats in the 2004 election.

I’m now standing here again, more than fifteen years later, to make that same point.
It might seem like déjà vu.
America’s seniors don’t care about party politics any more now than they did in 2003. What they care about is having access to affordable medications. 
I’m once again leading a bipartisan effort to enact much needed entitlement reform and once again some of my colleagues on both sides of the aisle are resisting compromise.
Once again, medicine has changed since the last entitlement reform that I led.
Scientific advances have led to many new and more effective treatments.
However, they are often accompanied by high costs.
This means that prescription drug prices have skyrocketed and Americans want Congress to act now so they can afford their lifesaving medications.
Our seniors deserve better than the over five year delay in action we put them through last time.

Congress has been here before.
I personally have been here before.
I have watched the opportunity to help patients slip away.

Now, just like then, Americans want action on entitlement reform.

Now, just like then, the President supports action.
Now, just like then, numerous proposals were floated and ultimately fell short of the finish line.
We have another opportunity to deliver meaningful reforms to help the Part D program adapt to new innovation in the health care world.
The Prescription Drug Pricing Reduction Act of 2019 builds on the successful program we created in 2003.
It will lower beneficiary premiums by $6 billion and lower out of pocket costs by $25 billion.
The bill will implement an out of pocket cap, eliminate excess payments, cap taxpayer subsidies and permanently repeal the donut hole.
It uses market forces to incentivize manufacturers to lower list prices and report more accurate calculations of their rebate obligations.
In short, this is the right bill at the right time. 
We should seize this opportunity to support actions that Americans need now, not five or ten years from now. 
I ask that my colleagues join Senator Wyden and me in our bipartisan effort to lower the cost of prescription drugs.