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A pharmacist fills a prescription. Photo: Jeffrey Greenberg / UIG via Getty Images

Lobbyists with the pharmacy benefit management industry met with federal officials last month, warning that Medicare Part D premiums will rise by 22% in 2019 if the government pursues an idea that would lower what Medicare patients pay for medications at the pharmacy counter.

Why it matters: PBMs and other companies that sell Medicare drug plans dislike the proposal, which would require them to apply rebates and fees at the point of sale as a way to make drugs cheaper, and a final ruling is expected soon.

The details: The meeting took place on Feb. 28, according to public records. Pharmaceutical Care Management Association CEO Mark Merritt and several other lobbyists affiliated with the PBM trade group attended.

Federal officials at the meeting included Joe Grogan, director of health programs at the White House's Office of Management and Budget, and numerous people with the Centers for Medicare & Medicaid Services, the agency that proposed the policy in November.

Merritt said in an interview the meeting was "mostly on issues where we had common ground," like opioid prescribing. But he and others voiced their opposition to point-of-sale rebates and reminded officials that President Trump's own budget said the measure would raise costs by $42 billion over the next decade.

Between the lines: The rebate proposal is only in an information-gathering phase, and independent analyses suggest it would in fact lead to higher Medicare premiums. But the Trump administration is hunting for any ways to ease drug costs, and the rebate idea would be an easy way for people to feel relief when they pick up their prescriptions.

Go deeper: Inside a drug pricing contract.

Go deeper

Updated 25 mins ago - Politics & Policy

In photos: The Biden and Harris inauguration

President Biden and first lady Jill Biden watch a fireworks show on the National Mall from the Truman Balcony at the White House on Wednesday night. Photo: Chip Somodevilla/Getty Images

President Biden signed his first executive orders into law from the Oval Office on Wednesday evening after walking in a brief inaugural parade to the White House with First Lady Jill Biden and members of their family. He was inaugurated with Vice President Kamala Harris at the U.S. Capitol on Wednesday morning.

Why it matters: Many of Biden's day one actions immediately reverse key Trump administration policies, including rejoining the Paris Agreement and the World Health Organization, launching a racial equity initiative and reversing the Muslim travel ban.

Republicans pledge to set aside differences and work with Biden

President Biden speaks to Sen. Mitch McConnell after being sworn in at the West Front of the U.S. Capitol on Wednesday. Photo: Erin Schaff-Pool/Getty Images

Several Republicans praised President Biden's calls for unity during his inaugural address on Wednesday and pledged to work together for the benefit of the American people.

Why it matters: The Democrats only have a slim majority in the Senate and Biden will likely need to work with the GOP to pass his legislative agenda.

The Biden protection plan

Joe Biden announces his first run for the presidency in June 1987. Photo: Howard L. Sachs/CNP/Getty Images

The Joe Biden who became the 46th president on Wednesday isn't the same blabbermouth who failed in 1988 and 2008.

Why it matters: Biden now heeds guidance about staying on task with speeches and no longer worries a gaffe or two will cost him an election. His staff also limits the places where he speaks freely and off the cuff. This Biden protective bubble will only tighten in the months ahead, aides tell Axios.

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