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Illustration: Aïda Amer/Axios

Repealing one of former President Trump's last big moves on drug pricing may go a long way toward helping Democrats pay for two of their big legislative priorities.

The big picture: Repealing Trump's regulations on drug rebates could give Democrats upwards of $100 billion to help pay for other priorities.

Where it stands: Repealing Trump's rebate rule has been pitched as a way to help pay for both a bipartisan infrastructure deal and Democrats' partisan "soft infrastructure" push.

  • One industry source said Democrats could claim savings from delaying Trump's rebate regulations in a bipartisan infrastructure bill — then more savings from repealing it their a party-line reconciliation measure.
  • “It has become the most popular offset in both packages’ debate," said one source familiar with the negotiations.

The intrigue: The rule hasn't actually gone into effect.

  • But because the Trump administration finalized it, its cost was folded into baseline spending projections, so Democrats can still claim savings on paper from repealing it.

Details: In 2019, the Congressional Budget Office estimated that the rule would cost the federal government $177 billion over 10 years.

  • It was projected to lower some patients' out-of-pocket costs, but to increase Medicare premiums. Critics argued that it wouldn't effectively address the overall cost of drugs.

What they're saying: Insurers and pharmacy benefit managers would be thrilled if the rule were repealed. Pharma wants to keep the rule in place.

  • "If it is included in the infrastructure package, this proposal will provide health insurers and drug middlemen a windfall and turn Medicare into a piggybank to fund projects that have nothing to do with lowering out-of-pocket costs for medicines," said Debra DeShong, executive vice president of public affairs at PhRMA.

Go deeper

Updated Oct 28, 2021 - Politics & Policy

Biden lays out $1.75 trillion "framework" before Europe departure

President Biden in Kearny, N.J., on Oct. 25. Photo: Michael M. Santiago/Getty Images

President Biden announced Thursday a "framework" for $1.75 trillion in social program and climate change spending after failing in prior efforts to win over his fellow Democrats on a much broader and costlier package.

Why it matters: Biden is gambling that by proclaiming the broad contours of the proposal, which he immediately began selling in a meeting with House Democrats before jetting off to Europe, progressives will vote for his $1.2 trillion infrastructure plan if and when House Speaker Nancy Pelosi brings it to the floor.

House delays infrastructure vote after progressives balk

Photo by Samuel Corum/Getty Images

The House again delayed a vote on the president's bipartisan infrastructure bill Thursday after opposition by progressives made it clear the legislation would not pass.

Why it matters: House Speaker Nancy Pelosi had told Democrats earlier in the day she would call a vote after President Biden said "my presidency will be determined" by the passage — or lack thereof — of his two massive spending bills.

Biden headed to the Hill as Democrats struggle to reach deal on spending bills

President Biden and House Speaker Nancy Pelosi leave a House Democratic Caucus meeting in the U.S. Capitol on Oct. 1. Photo: Kent Nishimura/Los Angeles Times via Getty Images

President Biden on Thursday morning will meet with the House Democratic Caucus on Capitol Hill to provide an update about his Build Back Better agenda and the bipartisan infrastructure deal, according to a White House official.

Driving the news: The meeting comes as Democrats struggle to reach a deal on the spending bills. House Speaker Nancy Pelosi told CNN on Sunday that Democrats were planning to reach an agreement on the infrastructure package this week, before Biden's departure to Europe, which is slated for later on Thursday.