Minnesota Rep. Angie Craig stands up to Big Pharma in fight for affordable drugs

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Incumbent Rep. Angie Craig (D-MN) is running against Republican nominee Tyler Kistner, who accused Democrats in Congress of working to implement 'a communist-centered-type health care plan.'

Democratic Rep. Angie Craig, currently running for reelection in Minnesota's 2nd Congressional District, has dedicated a large part of her two terms in the House of Representatives to fighting for affordable medications for her constituents. While her opponent, Republican nominee Tyler Kistner, has not provided specific information on his intentions regarding the price of health care, he has consistently opposed such efforts as the Affordable Care Act and the Build Back Better plan aimed at reducing medical and drug costs for Americans.

Craig is a co-sponsor of H.R. 3, the Elijah E. Cummings Lower Drug Costs Now Act, a bill intended to lower the cost of prescription drugs for consumers and the government by allowing Medicare to negotiate prices directly with pharmaceutical companies. She is also the lead sponsor of the Affordable Insulin Now Act, which would cap the copayment for a month's supply of insulin at $35 for anyone with a private or public health insurance plan.

Kistner, who ran unsuccessfully against Craig for the seat in 2020, said during a Republican candidate event that year, "I would repeal, then reform" Obamacare, "because our health care system is broken. ... And the way that you fix that is through something that's patient-centered, it's private, it's affordable, and it's portable." He accused Craig of taking marching orders from House Speaker Nancy Pelosi, "and what Nancy Pelosi wants is a single-payer system that is socialist-centered — and actually socialism is actually a popular word now in the younger generation, so it's a communist-centered-type health care plan." He said he would lower drug costs by opening the market to "competition."

The race between Craig and Kistner presents a microcosm of the broader divide between Democrats and Republicans with regard to health care for Americans.

For people like Jody and Dave

Prior to her election to Congress in 2018, Craig worked at a business at which she was responsible for managing health insurance plans for 18,000 people. 

"Having the experience of watching the price, the cost of specialty drugs, of compound drugs, just continue to go up and up and up, really has led me to be active in making sure that we're doing everything we can to lower drug costs in our nation," she told the American Independent Foundation. "To me it is just egregious that this government, Medicare, that isn't allowed to negotiate its drug pricing."

She said with her two decades of working in health care, meeting with constituents inspires her efforts: "Constituents like Jody and Dave, who came to see me to talk about the cost of Jody's insulin, and just hearing their stories over and over again, it made me want to really make a difference in lowering the cost of health care in our country."

Despite nearly universal congressional Republican opposition, measures allowing Medicare to negotiate drug prices and capping the out-of-pocket cost of insulin at $35 a month have passed the House in some form and are expected to be included in the Inflation Reduction Act reconciliation package being considered in the Senate this week.

A "socialist drug pricing scheme"

In 2016, Donald Trump ran for the White House as a supporter of letting Medicare negotiate lower drug prices, claiming that he could "save $300 billion" each year by doing so. "We don't do it. Why? Because of the drug companies," Trump said. 

But the administration responded to a previous congressional session's version of H.R. 3 on Dec. 10, 2019, with a statement that said Trump would veto the bill if it came to him in its current form, as it would "compromise the health of Americans by dramatically reducing the incentive to bring innovative therapeutics to market." The statement said:

The Administration opposes passage of H.R. 3, which contains several provisions that would harm seniors and all who need lifesaving medicines. ... In its current form, H.R. 3 would likely undermine access to lifesaving medicines. The bill creates a statutory scheme for "negotiation" between the Secretary of Health and Human Services and pharmaceutical manufacturers regarding the price of prescription drugs, but the penalty for failing to reach agreement with the Secretary is so large that the Secretary could effectively impose price controls on manufacturers.

However, the nonpartisan Congressional Budget Office (CBO) estimated in 2019 that under H.R. 3, just eight fewer drugs would be introduced to the U.S. market between 2020 and 2029, and only 30 fewer over the subsequent decade.

Republicans in Congress oppose the current version of H.R. 3 as well. In tweets this March, Markwayne Mullin of Oklahoma, Cathy McMorris Rodgers of Washington, and Debbie Lesko of Arizona were among the GOP members of Congress denouncing the bill, claiming without evidence that it would "hinder medical innovation and lead to fewer lifesaving cures" and calling it a "socialist drug pricing scheme" intended "to expand federal control into American's [sic] private health insurance and to take us one step closer to Medicare for All."

Pharma fights back

Craig was one of 22 Democratic members of the House targeted last year by ads funded by the American Action Network, a pharmaceutical industry-funded dark money group. The group spent spent $4 million on an ad campaign calling H.R. 3 "Pelosi's socialist drug takeover plan," telling voters in the Democrats' districts that lowering the cost of prescription drugs would result in a prescription drug market controlled by the federal government, and rehashing claims that it would lead to fewer breakthrough cures and less innovation in the field.

The Pharmaceutical Research and Manufacturers of America, the nation's largest pharmaceutical trade association, has reported giving more than $14 million in donations to the American Action Network since 2010.

Craig told TAIF:

Look at who already in the last year and a half has run ads against me: Pharma. Why? Because they know that I'm going to fight and stand up for my constituents and do what I said I would do while I'm here, and that's make health care more affordable. So I think a lot of Republicans, they like to sort of hide the information. We're talking about copay cap as part of the insulin bill. Copays are capped in every private health insurance plan in the nation these days. They are trying to make an argument that somehow if Pharma is made to negotiate prices, no other drug will ever be created. And, quite frankly, I just call bullshit on that every single time, and that's what I'm going to continue to do, because I think that's what my constituents expect me to do.

Tyler Kistner's campaign did not respond to an inquiry for this story. Kistner did not answer questions posed by Minnesota Public Radio in June about Craig's charges: "My Republican opponent here in the 2nd would have voted against the infrastructure bill. My Republican opponent would have voted against capping the cost of insulin at $35. He would never have supported allowing Medicare to negotiate drug prices." Despite his claim on his campaign website that he will "fight to lower costs of healthcare and prescription drug prices," he provides no specific details about how he will accomplish anything.

Asked about the impact of wins by Tyler and his party in November, Craig noted:

Well, health care costs are gonna go up for my constituents if Tyler Kistner is their member of Congress. He's going to oppose Medicare negotiation pricing, which means senior drug costs are going to stay high. He's going to oppose the bill that would cap copays [at] $35 a month for a 30-day supply. ... In fact, I've got farmers in rural parts of my district who previously were pricing out their health insurance at $25,000-$30,000 annually, just to have their family covered, and the tax credits and the American Rescue Plan lowered that to about $10,000 a year. So significant rise in prices in costs for Americans, if we let Republicans take back the House.

A reflection of the national divide

The differences between Craig and Kistner on the issue of drug pricing, as on other issues, reflect the national divide between Democrats and Republicans. 

The House voted 232-193 on March 31 to pass the Affordable Insulin Now Act that Craig introduced in February; just 12 Republicans joined all 220 Democrats voting in favor. 

According to the Congressional Record for that day, in comments before the vote, Rodgers, the ranking member of the House Energy and Commerce Committee, denounced it as "an attempt to revive Speaker PELOSI's proposed government drug-pricing scheme, part of a socialized medicine approach that would lead to fewer cures," saying: "It is the largest expansion of the Federal Government's role in private health insurance design since ObamaCare. It will cost more than $11 billion over the next 10 years through higher subsidies for higher premiums. ... Today, it is the government fixing the price on insulin. What is next? Gas? Food? History tells us that price-fixing doesn't work. It shifts the problem somewhere else so the powerful have the excuse for more subsidies, more spending, and more control." 

When the House last voted on a version of H.R. 3, in December 2019, it passed 230-192 with only two GOP yes votes. 

In November of last year, the House included many of the bill's provisions in its version of the Build Back Better plan, which passed 220-213 without a single Republican vote.

Stephen J. Ubl, president and CEO of the Pharmaceutical Research and Manufacturers of America, then claimed in a press release

The consequences of this heavy-handed drug pricing plan will make a broken insurance system worse and throw sand in the gears of medical progress. It will stifle continued innovation after a medicine is first approved, discourage the introduction of generics and biosimilar treatments and undermine the robust competition that has made the Medicare Part D program a success for millions of seniors. Meanwhile, the bill doesn't address perverse incentives in the system that are leading to higher costs for patients. This is a disappointing day for patients, and I hope the Senate will reject this flawed drug pricing plan and deliver the more balanced approach patients deserve.

Poll after poll, meanwhile, has found strong public support for the drug price reforms. A February 2019 survey by KFF Health found that about a quarter of American adults and a third of American seniors find it "difficult to afford their prescription drugs." The same poll found that 86% of adults back allowing the government to negotiate lower prices.

Beyond 2022

Craig says she is excited about the possibility that Democrats in Congress could make significant progress on insulin costs and drug prices through their Inflation Reduction Act package. But she said there will be more work to do to truly make medications affordable for everyone. 

"We didn't get everything we wanted. There will likely be a defined set of drugs Medicare can't negotiate on. So we'll be taking a good look at that over the coming days," she said.

Noting that the deal will extend Obamacare premium subsidies for just three years, Craig said if she wins another term, she will fight to eliminate that "level of uncertainty."

"We need to continue to drive down the cost of health care. I've been a strong supporter of having a public option to compete with health insurance companies operating in the individual market, [and] outcomes-based systems, rather than volume-based systems," Craig said. "These are the things I'll keep working on should I have the privilege of continuing to serve in Congress."

Win or lose, Craig said she has no regrets about the fight.

"If I lose my next election because I stood up to Big Pharma on behalf of my constituents, I'll wear it as a badge of honor," she said. "But I'm not going to back down."

Published with permission of The American Independent Foundation.