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HHS Secretary Alex Azar. Photo: Sarah Silbiger/CQ Roll Call via Getty Images

Health and Human Services Secretary Alex Azar said today that the Trump administration's plan for lowering drug costs relies on expanded price negotiations — just not the kind Democrats have called for in the past, and which President Trump seemed to embrace during the campaign.

The catch: The administration's plan would pull more drugs into an existing system of price negotiations within Medicare. But it’s not clear how many drugs would be affected or how much of that shift the administration could make on its own, without help from Congress.

Between the lines: Some early reaction to the White House’s drug-pricing plan — including from Democrats pooh-poohing it — has focused on the fact that it does not call for Medicare to directly negotiate what it will pay for prescription drugs.

The other side: “These are big moves, this is harnessing Medicare, this is negotiation,” Azar told reporters today.

  • He dismissed direct government negotiations as “trite, gimmicky, political proposals.”

How it works: Instead, the administration wants to move some drugs from Medicare Part B into Medicare Part D.

  • Part B covers drug administered by a doctor; it pays a fixed rate for those services.
  • Part D covers drugs you take yourself; it relies on privately administered insurance plans, which negotiate discounts off of drugs’ sticker prices.
  • So, moving some drugs from Part B to Part D would expose them to price negotiations from which they’re currently shielded.

The big questions: Azar said the administration is still figuring out which drugs to move into Part D.

  • It’s also not clear how aggressively HHS could move on its own. Azar said he could move at least some drugs from Part B to Part D, using his authority to conduct payment experiments. But the administration has also asked Congress for express authority to make such moves.

Go deeper

Updated 14 mins ago - Politics & Policy

Harris breaks tie as Senate proceeds with lengthy debate on COVID relief bill

Photo: Caroline Brehman/CQ-Roll Call, Inc via Getty Images)

The Senate on Thursday voted 51-50 — with Vice President Kamala Harris breaking the tie — to proceed to debate on President Biden's $1.9 trillion coronavirus rescue package, likely setting up a final vote this weekend.

The state of play: Sen. Ron Johnson (R-Wis.) forced Senate clerks to read the entire 628-page bill on the floor, which took nearly 11 hours and lasted until 2:05 a.m. Friday. The Senate then adjourned and is expected to reconvene at 9 a.m. to debate the bill before considering amendments.

1 hour ago - Health

Cuomo advisers reportedly altered July COVID-19 nursing homes report

New York Gov. Andrew Cuomo. Photo: Seth Wenig/AFP via Getty Images

New York Gov. Andrew Cuomo's advisers successfully pushed state health officials to exclude certain data on the number of COVID-19 nursing home deaths from a July report, the Wall Street Journal reported late Thursday.

Why it matters: The changes resulted in a "significant undercount of the death toll attributed to the state’s most vulnerable population," the WSJ wrote.

Ro Khanna wary of Biden approach on Middle East

Rep. Ro Khanna. Photo: Cody Glenn/Sportsfile for Web Summit via Getty Images

An outspoken progressive Democrat is wary of President Biden’s approach to the Middle East, arguing it’s like “conceding defeat of the aspiration” to win a Nobel Peace Prize.

Why it matters: A number of members of Biden’s own party dislike his Middle East strategy, as his administration signals the region is no longer the priority it was for President Obama and his predecessors.