Klobuchar Drug Importation Amendment Sees Votes Crossing the Aisle

At 11:06 P.M. on January 11, 2017, during the so-called “Vote-A-Rama”, the Senate considered an amendment put forward by Sen. Amy Klobuchar, D-Minn., and co-sponsored by Sen. Bernie Sanders, I-Vt., on the parallel importation of prescription drugs from Canada.

The amendment failed to pass on a vote of 46-52.

The Amendment, S. Amdt. 178 to S. Con. Res. 3, was entered into the Congressional Record as follows:

(Purpose: To establish a deficit-neutral reserve fund relating to lowering prescription drug prices for Americans by importing drugs from Canada)

At the end of title III, add the following:

SEC. 3___. DEFICIT-NEUTRAL RESERVE FUND RELATING TO LOWERING PRESCRIPTION DRUG PRICES FOR AMERICANS BY IMPORTING DRUGS FROM CANADA

The Chairman of the Committee on the Budget of the Senate may revise the allocations of a committee or committees, aggregates, and other appropriate levels in this resolution for one or more bills, joint resolutions, amendments, amendments between the Houses, motions, or conference reports relating to lowering prescription drug prices, including through the importation of safe and affordable prescription drugs from Canada by American pharmacists, wholesalers, and individuals with a valid prescription from a provider licensed to practice in the United States, by the amounts provided in such legislation for those purposes, provided that such legislation would not increase the deficit over either the period of the total of fiscal years 2017 through 2021 or the period of the total of fiscal years 2017 through 2026.

Sens. Klobuchar and Sanders spoke in favor of the amendment. Klobuchar emphasized price spikes in her remarks:

Ms. KLOBUCHAR. Mr. President, I come to the floor to ask that my colleagues support this very important amendment with Senator SANDERS. I will match his passion with numbers. The price of insulin, as our colleagues know, has tripled in the last decade. The antibiotic doxycycline went from $20 a bottle to nearly $2,000 a bottle in 6 months. Naloxone, the drug used to help with overdose, went from $690 to $4,500 to date. We cannot sit here and do nothing. We have an opportunity, for those who believe in the free market, to allow in competition— competition from the safe country of Canada, our neighbors to the north. In Minnesota, we can see Canada from our porch, and we want to see that competition come in and save our constituents’ lives.

In his brief remarks, Sanders highlighted disparities in U.S. trade policy that allow Americans to import fish from all over the world, but not medicines from Canada:

Mr. SANDERS. Mr. President, last year the five major drug companies made $50 billion in profit, while one out of five Americans cannot afford the medicine they need. Please don’t tell me that we can import fish from all over the world, but we can’t bring medicine in from Canada.

Sen. Mike Enzi, R-Wyo., spoke against the amendment, arguing that it would be difficult to prevent patients from importing drugs from elsewhere through Canada:

Mr. ENZI. Mr. President, this discussion will be a little different than any we have had because in a bipartisan way we have been defeating this for at least 14 years. Byron Dorgan used to head it up on that side, and I used to oppose it from this side, but it has always been bipartisan, and that is because we are not sure about the safety of the prescription drugs that come in online.

People who drive over the border and go to a pharmacist are probably getting good drugs there, but we are told that for up to 85 percent of what comes in online, we can’t tell what country it came from. So we can specify Canada, but it may be from another country altogether, particularly the Middle East. If we want to assure we have the safety of our drugs, being able to get it online from even Canada doesn’t have the kind of assurance we need. We have always asked that the Secretary of Health and Human Services specify that the safety is in place. No one has been willing to do that.

The vote was extraordinarily close, at 46 YEAs to 52 NAYs with 2 members not voting. Members on both sides of the aisle crossed the party line in this vote — 12 Republicans voted YEA, and 13 Democrats voted NAY.

The non-voting senators were Dianne Feinstein, D-Calif., who at the time was recovering from pacemaker installation surgery, and Jeff Sessions, R-Ala., the nominee for Attorney General. After testifying on the second day of confirmation hearing, Sessions skipped the night of voting, appearing only for the final vote to repeal the ACA.

In the GOP, a mix of tea partiers, libertarian senators, and long-time affordable drug advocates like John McCain and Chuck Grassley voted YEA to the amendment, bucking PhRMA’s interests:

  • John Boozman, R-Ark.
  • Susan Collins, R-Maine
  • Ted Cruz, R-Texas.
  • Jeff Flake, R-Ariz.
  • Chuck Grassley, R-Iowa
  • Dean Heller, R-Nev.
  • John Neely Kennedy, R-La.
  • Mike Lee, R-Utah
  • John McCain, R-Ariz.
  • Lisa Murkowski, R-Alaska
  • Rand Paul, R-Ky.
  • John Thune, R-S.D.

John Neely Kennedy, from Louisiana, was the only freshman senator to vote against the majority of his party. Several very conservative members supported the amendment, including Ted Cruz, Mike Lee, and Rand Paul.

The 13 Democrats included:

  • Michael Bennet, D-Colo.
  • Cory Booker, D-N.J.
  • Maria Cantwell, D-Wash.
  • Tom Carper, D-Del.
  • Bob Casey, D-Penn.
  • Chris Coons, D-Del.
  • Joe Donnelly, D-Ind.
  • Martin Heinrich, D-N.M.
  • Heidi Heitkamp, D-N.D.
  • Bob Menendez, D-N.J.
  • Patty Murray, D-Wash.
  • Jon Tester, D-Mont.
  • Mark Warner, D-Va.

Cory Booker’s NAY vote was notable, given that he is often mentioned as a possible progressive favorite to challenge Trump in 2020.

The full vote is available at: http://www.senate.gov/legislative/LIS/roll_call_lists/roll_call_vote_cfm.cfm?congress=115&session=1&vote=00020.