Warren splits with party, Mass. interests over drug bill

Senator Elizabeth Warren is coming out against the bill, aimed at boosting medical innovation.Win McNamee/Getty Images/File

WASHINGTON — Senator Elizabeth Warren launched an all-out assault this week on a sweeping $6.3 billion bill aimed at boosting medical innovation, claiming the legislation, after two years of bipartisan effort, has been hijacked by greedy pharmaceutical companies.

Her opposition puts the liberal firebrand at odds with powerful home state interests that support the legislation, known as the “21st Century Cures Act,” including the pharmaceutical, biotechnology, and medical-device industries.

“Any effort to delay or oppose this package serves only to maintain a status quo where it takes too long and costs too much to bring treatments to patients in need,” Robert K. Coughlin, president and chief executive of the Massachusetts Biotechnology Council, said in a statement to the Globe.

Warren’s stand also potentially splits her from the White House and other Democrats who are keen to secure various elements of the bill, which includes funding for Vice President Joe Biden’s Cancer Moonshot Initiative and its goal of accelerating advances in cancer diagnosis, treatment, and prevention. It also includes $1 billion over two years to combat the national opioid crisis, which has hit Massachusetts and the rest of New England hard.

In the House, six Massachusetts Democrats were cosponsors of the original bill that passed in July 2015. Massachusetts’ junior senator, Ed Markey, has pushed hard for the opioid funding included in the bill, a cause that has been the centerpiece of his tenure in the Senate. Spokesmen for the lawmakers either did not respond to requests for comment or said their bosses were reviewing the latest version of the 900-plus-page legislation — released with little fanfare by Republicans over the Thanksgiving weekend. Republicans plan to bring it to a vote in the House Wednesday, with Senate action to follow early next week.

To Warren, the stakes are higher than just the legislation at hand. She is painting this as an early test of Democrats’ willingness to stand up to Republicans and block unpalatable legislation when Washington enters unified Republican rule next year. While they’re in the minority, Democrats will have enough seats next year to mount a filibuster against bills they don’t like, the only leverage they’ll have once Donald Trump occupies the White House.

In her speech Monday night, Warren pointed to all the voters who elected Democrats to represent them in the Senate, along with Hillary Clinton’s popular vote victory over Trump. They didn’t cast those votes “so we could come back to Washington and play dead,” Warren said. “They sent us here to say no to efforts to sell Congress to the highest bidder.”

Or as she put it more bluntly in a series of tweets after her floor speech: “Show some spine & fight back.”

Warren’s challenge to the bill is backed by Senator Bernie Sanders.

“This is a bad bill which should not be passed in its current form. It’s time for Congress to stand up to the world’s biggest pharmaceutical companies, not give them more handouts,” Sanders said.

Democratic leaders so far have been silent on this latest version of the bill. The new version includes cuts to Medicare and looser rules to allow drug makers to market their products to treat conditions that were not part of their Food and Drug Administration approval.

Another deal-breaker for Warren: New research funding for the National Institutes of Health morphed from guaranteed money in the earlier House version to so-called discretionary funding in the latest bill. That means most of the $4.8 billion the bill would provide to the NIH over the next 10 years would be released in future years only if Congress votes to do so, which critics consider a dubious prospect.

That is a particularly hard blow for Massachusetts and other economies with large academic and private-sector research clusters.

Another surprise addition, a provision that would have loosened rules requiring drug and device makers to report payments they make to doctors, was removed under pressure Tuesday. Warren had singled the provision out in her critique — claiming the language would enable bribery.

Senator Chuck Grassley, an Iowa Republican and a longtime critic of some drug company sales tactics, also objected and threatened to block the bill.

Warren has been closely involved in the negotiations over the 21st Century Cures bill for two years. But, she said Monday in her floor speech, while the package contains some good pieces, a few she wrote herself, “I cannot vote for this bill. I will fight it because I know the difference between compromise and extortion.”

Republicans argue the bill would cut out unnecessary red tape in the FDA’s processes, including easing the way for breakthrough medical devices that would boost both the economy and patient health.

Critics have raised concerns that the bill would weaken FDA oversight too much and jeopardize patient safety.

Republicans, at least, are bristling at Warren’s tactics. Senator John Cornyn of Texas, speaking Monday on the Senate floor after Warren, criticized her for leveling “personal attacks” and “name-calling” against supporters of the bill rather than discussing policy.

“If our Democratic colleagues like the result of the election that just occurred on Nov. 8, I would say: Keep on keeping on,” Cornyn said. “I think what they told us on Nov. 8 is that they actually would like to see us accomplish some things.”

It remained unclear Tuesday how persuasive Warren’s pitch to fellow Democrats would be.

Senator Chris Murphy, a Connecticut Democrat, backed the package, which includes a mental health overhaul bill he has worked for years to advance.

“I’m excited Republicans and Democrats have put politics aside and reached a compromise that will allow a mental health reform bill to pass side by side with major new funding to confront the nation’s opioid crisis,” Murphy said in a statement.

The GOP’s point man on the bill in the Senate predicted plenty of Democrats would follow suit. “I expect a big vote” in favor of the bill, Lamar Alexander of Tennessee said on the floor Tuesday afternoon, “because I don’t expect there are a lot of senators who want to vote ‘No’ on a billion dollars in funding for opioids abuse in their home state. I don’t think there’ll be a lot of senators who want to vote ‘No’ on more money to fight cancer.”