The drug lobby had two main policy goals: It wanted to make sure that price controls and a “public option” were not forced onto Medicare Part D, and it wanted to make sure the bill didn’t include a provision allowing drug reimportation. Reimportation would allow health-care providers and consumers in the United States to bring in American pharmaceutical products from other countries — such as Canada — in which drugs are sold at lower prices. This would force pharmaceutical companies selling in the United States to compete with lower-priced versions of both foreign drugs and their own products. This was something that PhRMA obviously wanted to avoid.
The fight over the public option was long and difficult. Liberal Democrats in the House worked tenaciously to get one into the bill, but lobbying by the AMA, PhRMA, and other health-care groups, combined with the White House’s hands-off approach, prevented them from succeeding. On reimportation, though, the Obama administration strongly backed the drug companies. DeParle wrote to PhRMA lobbyists that Obama’s policy would be, “based on how constructive you guys have been, to oppose importation on the bill.” The administration also supported PhRMA on price controls on Medicare Part D.
In the weeks after the June 22 deal was announced, however, it seemed likely to fall apart. Henry Waxman, chairman of the House Energy and Commerce Committee, balked at the deal and claimed that the House’s developing version of the health-care legislation needn’t be bound by it. Waxman wanted more than the $80 billion in concessions that the drug industry had already made. He considered both drug reimportation and price controls to be on the table. And he claimed the White House didn’t feel particularly beholden to the deal either.
Bryant Hall, one of PhRMA’s lead lobbyists, leapt into action and worked with Jim Messina to get the White House and PhRMA on the same page. Multiple media outlets had confirmed that President Obama had backed off of the previous PhRMA deal, but within hours the storyline changed again. Hall convinced Messina to tell both Politico and the New York Times that the White House was standing behind the deal and didn’t support Waxman’s attempt to push for more. It was an incredible display of PhRMA’s political clout, and even Hall’s colleagues were stunned after he bragged, “I pushed Jim Messina to do it.”
Just when it seemed everything had been smoothed over, the Obama team muddied the waters. On July 21, 2009, President Obama read a speech off a teleprompter that implied that drug companies were part of a cabal of “special interests” working to delay or kill reform efforts. Messina, according to the congressional investigation, asked the president why he was suddenly hostile to PhRMA again, and Obama replied, “I was wondering the same.” It turned out that someone on the speechwriting team hadn’t gotten the memo that the White House and the drug companies were on the same side.
“I guess we didn’t give enough in contributions and media ads,” read an internal e-mail from a drug-industry lobbyist at the time. “Perhaps no amount would suffice.” Messina and Emanuel reassured Hall that the president’s newest attack on drugmakers was merely a teleprompter mistake. Yet at the end of July, President Obama gave a speech implying that drug makers had gotten a sweetheart deal and that they might be asked to make additional concessions. Hall complained that the president “beat the piss out of us again” and worried that White House senior adviser David Axelrod was pushing a new, tougher line against the drug companies.
His fears were confirmed as, in the first week in August, Bloomberg reported that Axelrod had told Democrats there was no deal between the White House and PhRMA. Afterward, a furious Hall had to be talked down by Messina once again. They then conducted a joint PR campaign, outflanking Axelrod.