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Vulnerable Democrats in the House are calling for major drug price reforms in the spending plan

But this plan, approved by the House of Representatives two years ago, has met new opposition in this Congress, even as its prospects of becoming law become more real. A separate group of 10 democratic centrists has already warned Pelosi and her leadership team said they would not support the drug price negotiation component if it were included in the party’s broader spending plan. Instead, this group – many of whom have a large pharmaceutical industry presence in their districts – has pushed for incremental changes that can win the support of the GOP.

Top Democrats are still trying to include some form of drug price reform in their budget decision that would help fund other health priorities like subsidizing Obamacare plans and expanding Medicare benefits, a senior Senate adviser confirmed Wednesday . But what exactly the party can say goodbye remains unclear. The Democrats are not only faced with thin margins, but also with a violent lobbying push against the proposals of Big Pharma.

Pelosi has vowed to push for the broader drug price bill known as HR 3, which would allow Medicare to lower the prices of hundreds of drugs and apply those prices to other public and private insurance plans.

That provision would save around $ 456 billion in a decade, according to the Congressional Budget Office – a figure quoted by House Democrats they’d like to include in their spending plan.

“We can and must use these savings to invest in our health system,” the letter said.

Senate Finance Chairman Ron Wyden (D-Ore.), Meanwhile, is working on his own drug pricing plan aimed at completing the bipartisan bill he worked with Senator Chuck Grassley, R-Iowa, in the US, add some form of government negotiations to last Congress. But several moderate Democrats in both chambers stay against it, enough to jeopardize the adoption of the measures given the party’s tight margins.

Wyden told POLITICO that he is spending “a significant portion of” [his] waking hours … commuting “between progressives and moderates trying to negotiate a deal. A sticking point was the exact mechanism used to reduce drug costs, and Wyden confirmed that some members of the caucus do not tie prices to what other countries pay for the same drugs.

“Suffice it to say that many members have concerns about this and we are trying to find common ground,” he said.

Alice Miranda Ollstein contributed to this report.

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