Tom Williams/CQ Roll Call via AP Images
Rep. Kathleen Rice in 2018
In a constituent letter, Rep. Kathleen Rice (D-NY) gave her most extensive reasoning for voting against a part of the $3.5 trillion reconciliation bill in the House Energy and Commerce Committee that would allow Medicare to negotiate with pharmaceutical companies for lower drug prices. She claims that she opposed the measure because the overall bill “has no chance to become a law,” although that didn’t stop her from voting for almost every other part of the same bill in the committee.
The letter, dated Friday, came in response to a constituent who expressed disappointment with Rice’s vote on the drug pricing reform. Her vote, along with that of two other Democrats (California’s Scott Peters and Oregon’s Kurt Schrader) blocked that measure from advancing out of the Energy and Commerce Committee. The House Ways and Means Committee passed a similar measure as part of their portion of the reconciliation bill, known as the Build Back Better Act, so the reform can still be added to the bill. But it sends a strong signal for three House Democrats to oppose it, and threatens passage of the final bill on the House floor, and with it President Biden’s agenda.
Rice begins her response to the constituent by saying, “please know that I support the goals” of the drug pricing reform, which has been voted on in the House before as H.R. 3, the Elijah E. Cummings Lower Drug Costs Now Act. In fact, Rice acknowledges, she has voted for H.R. 3 twice before, and she agrees that “allowing Medicare to negotiate drug prices is the best way to reign in [sic] price gouging pharmaceutical companies.”
However, Rice continues, she had previously voted for H.R. 3 as a standalone bill. This time, she writes, “the H.R. 3 drug pricing language was being used as a tool to offset the cost of a $3.5 trillion reconciliation bill. That bill has no chance to become law, as Democrats in the Senate have stated that a bill with such a price tag will not have the votes to pass in their chamber. That is why I did not support the inclusion of H.R. 3.”
If this is her reasoning, then every other subtitle of the legislation that the Energy and Commerce Committee voted on should have also drawn a no vote from Rice.
In a metaphysical sense, there’s no guarantee that anything in the House will pass the Senate in its exact form, and therefore an extension of Rice’s logic should have her voting no on everything that comes before her. But her contention here is that the Build Back Better Act cannot pass the Senate in its current form, and therefore she had to vote no on the drug pricing reform.
If this is her reasoning, then every other subtitle of the legislation that the Energy and Commerce Committee voted on should have also drawn a no vote from Rice. After all, the $3.5 trillion price tag is seen by Democrats like Sen. Joe Manchin (D-WV) as too high. Everything that the committee passed is unlikely to survive in precisely the way that the committee passed it.
So did Rice consistently vote no on all other parts of the reconciliation bill in committee? No. As a markup action sheet produced by the committee shows, Rice voted for every single subtitle of the legislation (including this one and this one and this one and this one and this one), except for the drug pricing reform and the measure to extend Medicare coverage for dental, vision, and hearing. The Medicare expansion, despite Rice’s no vote, still had enough support to advance out of committee. (Rice also voted with her Democratic colleagues on every single partisan amendment in the markup.)
The Medicare coverage expansion is nominally tied to the drug pricing reform, because the savings from the latter is intended to “fund” the former, although in the context of a $3.5 trillion bill, it’s a bit rudimentary to legitimately say that anything funds anything else. Nevertheless, Rice’s complaint was that the whole bill won’t become law, not just the drug pricing/Medicare piece. So why did she vote for everything else in the bill?
Rep. Rice’s office has not yet responded to a request for comment.
Left unsaid in the letter is that the pharmaceutical industry would see lower profits as a result of their biggest customer (Medicare) finally being allowed to negotiate prices, and their powerful lobbyists can always find votes to prevent those profits from being cut. We cannot say definitively that Rice obliged the industry’s request in the committee, but we can certainly infer it.
Elsewhere in the letter, Rice stressed her commitment to fiscal responsibility, and that “moving to advance a $3.5 trillion package, with several outstanding questions about how it will be paid for, would break that promise.” But she did move to advance the package on all of its spending items. The only part that she blocked was the drug pricing reform, which would make the package, well, more fiscally responsible, since it creates budget savings of up to $700 billion over 10 years, in addition to reducing the price of prescription drugs for all Medicare patients and those with commercial insurance.
Rice frames this as a difficult decision but the right one to make “to ensure the Build Back Better Act is ultimately enacted and helps as many people as possible.” In fact, voting down the drug pricing reform threatens the bill’s passage, because that $700 billion in savings is unlikely to be found elsewhere, and Democrats with the ability to stop the bill have demanded that all the spending should be offset.
Finally, Rice concludes that she will continue to work with colleagues on “advancing a prescription drug proposal, measures to strengthen the Affordable Care Act, and a final reconciliation package.” Of course, Rice weakened the possibility of a reconciliation package becoming law with her vote. But there’s also a more subtle point being made here.
Rice mentioned the Affordable Care Act by name. There’s been a running argument among Democrats on how to deal with health care in the Build Back Better Act. Some want to permanently expand subsidies for the ACA exchanges (which the American Rescue Plan instituted through 2022) and provide coverage for poor people in states that haven’t expanded Medicaid under the ACA. Others want to do that and also expand Medicare, either through hearing/vision/dental coverage or by lowering the eligibility age.
By name-checking the ACA, as well as her vote against hearing, vision and dental in Medicare in committee, Rice is weighing in on that debate on the side of just strengthening the ACA. There may ultimately be a reckoning on that as the Build Back Better Act moves through Congress.
