Pharma Deal Shuts Down Senate Health Care Debate

The White House, aided by Sen. Tom Carper (D-Del.), is working hard to crush an amendment being pushed by Sen. Byron Dorgan (D-N.D.) to allow for the reimportation of pharmaceutical drugs from Canada, Senate sources tell the Huffington Post.

As a result, the Senate health care debate has come to a standstill: Carper has placed a "hold" on Dorgan's amendment and in response, Dorgan tells HuffPost, he'll object to any other amendments being considered before he gets a vote on his.

Sen. Olympia Snowe (R-Maine) is a lead co-sponsor of Dorgan's amendment. She said she's confident that, as of now, they have the votes they need. "I think that's why we're not having this vote," she said, smiling. The amendment has the support of a number of other Republicans , including Sens. John McCain (Ariz.), Charles Grassley (Iowa), John Thune (S.D.) and David Vitter (La.).

Opponents of the amendment worry that many more Republicans may join the amendment not because they agree with it, but because they want to put the health care bill in jeopardy.

So the White House and the drug makers are trying to persuade as many Democrats as they can to oppose the amendment despite their previous support for it.

"I don't think that's going to get my vote," Sen. Jay Rockefeller (D-W.Va.) said when HuffPost asked about the reimportation amendment. He said that even though he is a supporter of reimportation, he is concerned that if it passes it could blow everything up.

"I'm not messing around with anything without 60 votes. Nothing," he said. "And I'm a co-sponsor of the amendment."

The dispute within the Democratic caucus is becoming personal. "Of course, with Dorgan, it's all about Dorgan," a senior Democratic aide told HuffPost, complaining that Dorgan was willing to blow up health care reform for his own glory.

Within a decade, reimportation would save consumers roughly $80 billion and the federal government $19 billion, according to the Congressional Budget Office. But that would mean $100 billion more in lost revenue than the powerful Pharmaceutical Research and Manufacturers of America (PhRMA) lobby agreed to bear-- in exchange for being supportive of the overall health reform effort.

Earlier this year, the administration struck a deal with PhRMA and the Senate Finance Committee limiting the industry's hit to $80 billion over ten years. The deal has never been officially confirmed, but the Huffington Post reported at the time that the White House agreed to oppose re-importation. The Senate Finance Committee bill, as well as the merged bill sent to the floor by Majority Leader Harry Reid (D-Nev.), stuck to that deal.

Along with its pledge of support, PhRMA offered to spend $150 million on ads backing reform. Most of that money stands ready to be used to kill reform, should it come to that. A Democratic aide said that the threat of PhRMA ads is being used by opponents of Dorgan's amendment as a reason to sink it.

Similarly, if Republicans end up providing the winning margin for the importation amendment, a source involved in the negotiations said the drug makers will come after the GOP "with a vengeance -- and not just on health care."

Grassley, a longtime supporter of reimportation, said that the amendment is running into trouble "[b]ecause of the PhRMA agreement with the White House. This thing can pass and they don't want egg on their face with PhRMA. And I understand there's going to be a side-by-side [alternative amendment] and it's probably one of these issues where it will obfuscate the issue, but that not one single pill will get into this country if that side-by-side is adopted."

Thune, another co-sponsor of the amendment, said he was unsure how many fellow Republicans would come along. "It remains to be seen. Everybody's close to the vest on this and I think that's why the Dems don't want it voted on. They don't know how many votes their side has to deliver to defeat it. They've got a lot of people on their side that would normally vote for it," said Thune.

Did he think some Republicans would vote for it just to cause mischief, HuffPost asked.

"It's possible," he said.

Sen. Roger Wicker (R-Miss.) agreed it was a possibility, adding, "And some members of the Democratic leadership might vote against it even though they love the idea, because they've been so cozy with their new-found friends in PhRMA."

Wicker said he has yet to decide how he'll vote. "I've frankly been all over the map on that issue, so I'm being courted heavily," he said.

There's no certainty that PhRMA would walk away from the entire bill if the amendment passed, because it contains a basket of other goodies the industry won from the White House - not to mention about 30 million newly-insured consumers. "Who knows what people are going to do? It's hard to predict what's going to happen," Sen. Max Baucus (D-Mont.), chairman of the Finance Committee, said Friday.

Asked about the state of the amendment, he said: "Limbo."

The lobby is fighting the amendment as hard as it can, along with Carper, the senator from Delaware, which is home to a range of pharmaceutical interests.

Dorgan said that Carper's hold is unusual. "When somebody comes in and says, 'Let's have a vote,' it's generally, by consent, let's schedule a vote for 2:15," he said.

The hold causes problems for Dorgan and buys time for the amendment's opponents. "You can only beat a hold though after you file a cloture petition and wait two days and the cloture petition ripens and you get your vote," said Dorgan. "As a result of that [hold], I have also objected to them doing other business until I get my vote."

Ken Johnson, PhRMA's vice president, tells HuffPost the industry opposes the amendment for three principal reasons. First, he said, the Food and Drug Administration can't guarantee the safety of reimported drugs. Second, he says, it would cut into drug makers' profits - money it needs for research. And third, he says, the uncertainty around the origin of reimported drugs could tarnish the pharmaceutical brand, as people wonder about the authenticity of the drugs in their medicine cabinet.

Carper asked the FDA for its opinion on Dorgan's amendment and the administration wrote back on December 9 that it opposed it.

Publicly, President Obama continues to support reimportation, as he did during the campaign.

"The President supports reimportation of safe and effective drugs. He made that clear in his FY 2010 budget, which included $5 million to enable the FDA to begin developing policy options," reads a statement from the White House. "The Food and Drug Administration has raised safety concerns about the current proposal and will continue exploring policy options to create a pathway to importing safe and effective drugs."

UPDATE: "We're not whipping against the Dorgan amendment. Those rumors just aren't true," says a White House aide in an e-mail. The aide says that the White House has taken no position on the amendment.

Ryan Grim is the author of This Is Your Country On Drugs: The Secret History of Getting High in America