Senate Parliamentarian Sides With Big Pharma On Drug Price Controls In Private Insurance Market (Updated)

The Associated Press reports, Senate rules referee weakens Dem drug plan in economic bill:

The Senate parliamentarian on Saturday dealt a blow to Democrats’ plan for curbing drug prices but left the rest of their sprawling economic bill largely intact as party leaders prepared for first votes on a package containing many of President Joe Biden’s top domestic goals.

Elizabeth MacDonough, the chamber’s nonpartisan rules arbiter, said lawmakers must remove language imposing hefty penalties on drugmakers that boost their prices beyond inflation in the private insurance market. Those were the bill’s chief pricing protections for the roughly 180 million people whose health coverage comes from private insurance, either through work or bought on their own.

Other major provisions were left intact, including giving Medicare the power to negotiate what it pays for pharmaceuticals for its 64 million elderly recipients, a longtime goal for Democrats. Penalties on manufacturers for exceeding inflation would apply to drugs sold to Medicare, and there is a $2,000 annual out-of-pocket cap on drug costs and free vaccines for Medicare beneficiaries.

Her rulings came as Democrats planned to begin Senate votes Saturday on their wide-ranging package addressing climate change, energy, health care costs, taxes and even deficit reduction. Party leaders have said they believe they have the unity they will need to move the legislation through the 50-50 Senate, with Vice President Kamala Harris’ tiebreaking vote and over solid Republican opposition.

“This is a major win for the American people,” Senate Majority Leader Chuck Schumer, D-N.Y., said of the bill, which both parties are using in their election-year campaigns to assign blame for the worst period of inflation in four decades. “And a sad commentary on the Republican Party, as they actively fight provisions that lower costs for the American family.”

Dropping penalties on drugmakers reduces incentives on pharmaceutical companies to restrain what they charge, increasing costs for patients.

Erasing that language will cut the $288 billion in 10-year savings that the Democrats’ overall drug curbs were estimated to generate — a reduction of perhaps tens of billions of dollars, analysts have said.

Schumer said MacDonough’s decision about the price cap for private insurance was “one unfortunate ruling.” But he said the surviving drug pricing language represented “a major victory for the American people” and that the overall bill “remains largely intact.”

The parliamentarian also signed off on a fee on excess emissions of methane, a powerful greenhouse gas contributor, from oil and gas drilling. She also let stand environmental grants to minority communities and other initiatives for reducing carbon emissions, said Senate Environment and Public Works Committee Chairman Thomas Carper, D-Del.

She approved a provision requiring union-scale wages to be paid if energy efficiency projects are to qualify for tax credits, and another that would limit electric vehicle tax credits to those cars and trucks assembled in the United States.

The overall measure faces unanimous Republican opposition. But assuming Democrats fight off a nonstop “vote-a-rama” of amendments — many designed by Republicans to derail the measure — they should be able to muscle the measure through the Senate.

House passage could come when that chamber returns briefly from recess on Friday.

“What will vote-a-rama be like. It will be like hell,” Sen. Lindsey Graham of South Carolina, the top Republican on the Senate Budget Committee, said Friday of the approaching GOP amendments.

Why does anyone even care what this sniveling Coup Plotter traitor has to say? If this Trump fluffer has something to say, let him say it under oath before the grand jury in Georgia. Fuck him.

Democrats are using special procedures that would let them pass the measure without having to reach the 60-vote majority that legislation often needs in the Senate.

It is the parliamentarian’s job to decide whether parts of legislation must be dropped for violating those rules, which include a requirement that provisions be chiefly aimed at affecting the federal budget, not imposing new policy.

UPDATE: The fate of the price cap on insulin will be decided on the Senate floor, as Republicans are expected to ask for a parliamentarian ruling. Chuck Schumer wants to dare Republicans to vote against a popular $35 insulin cap:

.Senate Majority Leader Chuck Schumer wants to dare Senate Republicans to knock out a popular $35 monthly cap on insulin prices from the party’s big bill under consideration[.]

The $35 limit on insulin co-pays is one of the most popular elements of the legislation that Democrats want to pass using budget reconciliation. That maneuver allows Senate Democrats to sidestep GOP resistance and approve certain bills with only a simple majority vote if they all stay united.

But the insulin cap has always been at risk of falling out of the bill since it may not comply with its strict procedural rules. The process is overseen by the Senate parliamentarian, who gave the green light to most of the Democratic legislation’s climate, health, and tax provisions overnight.

The fate of the insulin cap remains formally up in the air. But one of the people familiar said that the parliamentarian sustained a GOP objection to it during the “Byrd Bath,” meaning the top official didn’t believe it complied with reconciliation’s rules.

The $35 insulin cap is still in the Inflation Reduction Act for now. If the parliamentarian strikes out the provision, Senate Democrats can still keep it in and force Republicans to raise a “point of order” to take it out. That would set the stage for a recorded vote to overrule the parliamentarian at a 60 vote threshold.

NEW, IMPORTANT – INSULIN CAP: The fate of the insulin price cap in the reconciliation bill will be determined in real time, on the Senate floor, per multiple sources involved.

— Lisa Desjardins (@LisaDNews) August 6, 2022

Democrats do have this option:

The Congressional Research Service wrote the following about the Parliamentarian:

“As a staff official, neither parliamentarian is empowered to make decisions that are binding on the House or Senate. The parliamentarians and their deputies/assistants only offer advice that the presiding Representative or Senator may accept or reject; individual Members may appeal rulings.”

The parliamentarian advises who’s sitting in the chair (the President of the Senate), she doesn’t rule.

Can the Senate overrule the Parliamentarian’s recommendation?

According to Casey Burgat, the Director of the Legislative Affairs Program at George Washington University,he believes it’s possible the Senate could overrule the recommendation with a simple majority, by using the so-called ‘nuclear option.’ He explained the logic of such a move in the following way:

“Dems nuked the filibuster (against the Parliamentarians recommendation of past precedent) in 2013 with a simple majority; GOP did the same on SCOTUS nominees in 2017. Neither had 60 votes. To change the standing rules of the Senate, you need a 2/3rds supermajority. This isn’t that, this is overruling a nonbinding ruling from the parliamentarian. It establishes a new precedent by overruling a point of order… Yes, it would be controversial. Yes, it would break from precedent. In fact, it would establish a new one, by definition. But parliamentarians have been ignored in the past (though, very rare).”

According to Wikipedia: The most recent example of a Vice President (as President of the Senate) overruling the parliamentarian was Nelson Rockefeller in 1975. That ruling was extremely controversial, to such an extent that the leaders of both parties immediately met and agreed that they did not want this precedent to stand, so the next week the Senate altered the rule under consideration via standard procedure.

We live in unprecedented times. We have one of our major political parties committed to the overthow of American democracy and seeking to establish a White Christian Nationalist theocratic autocracy under permanent Republican rule. We shouldn’t be too concerned about a Senate precedent of allowing an unelected and unaccountable employee of the Senate making the final determination on legislation,  on which the Senate can vote and decide for itself.