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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What they're saying: Insurers and pharmacy benefit managers would be thrilled if the rule were repealed.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

Ben Geman, author of Generate
Jul 29, 2021 - Politics & Policy

Senate Dems' tricky climate infrastructure message

Illustration: Rae Cook/Axios

We now know more about the Senate's bipartisan infrastructure plan — and Democrats' tactical approach to the advancing package that has a suite of climate-related provisions.

Catch up fast: The Senate voted 67-32 to move the $1.2 trillion plan toward debate last night. Per a White House release it includes...

Jul 30, 2021 - Politics & Policy

Infrastructure cap will force fuzzy math

President Biden answers reporters' questions after a speech Thursday. Photo: Anna Moneymaker/Getty Images

Sen. Kyrsten Sinema's (D-Ariz.) warning that she’s opposed to a budget reconciliation bill costing $3.5 trillion will force Senate Democrats and the White House to either trim the proposals in it or tinker with how many years they'll run.

Why it matters: Such gamesmanship will be necessary if lawmakers and the Biden administration want to keep the support of progressives and centrists. But it will lead to a bill with costs and durations as uneven as the Manhattan skyline.

Manhattan, Westchester prosecutors request evidence from Cuomo investigation

Gov. Cuomo during a press conference in New York City on Aug. 2. Photo: Lev Radin/Pacific Press/LightRocket via Getty Images

The district attorneys for Manhattan and Westchester County on Wednesday requested evidence related to New York Attorney General Letitia James' investigation into sexual harassment allegations against Gov. Andrew Cuomo (D), according to a letter obtained by NBC News.

Why it matters: The district attorneys are investigating if alleged conduct highlighted in an independent report published by James' office that occurred in their jurisdictions was criminal in nature.