Dear Nancy Pelosi,

First of all, please accept my apologies for the impersonal and public nature of this letter. Be that as it may, I have a few thoughts to share.

In his State of the Union address, the President suggested several policy areas for bipartisanship, including investing in infrastructure, defeating HIV, fighting childhood cancer, lowering the cost of prescription drugs and guaranteeing paid family leave. Maybe he is sincere about these things; maybe he is bluffing.

The best starting place for bipartisanship is prescription drug prices, specifically removing the prohibition on Medicare negotiating prices with pharmaceutical companies. The House should act on a current version of the Medicare Prescription Drug Price Negotiation Act of 2007, which would have required the Secretary of Health and Human Services to negotiate the prices that pharmaceutical companies can charge for drugs covered under Medicare Part D. That bill passed the House in 2007 with bipartisan support but failed to clear the Senate. Enactment of this bill would benefit many Americans, including all taxpayers, and its necessity has been obvious for a very long time. Leveraging the language of a bill that previously passed enables the House to respond quickly to the bipartisanship suggested in the SOTU address.

The President has stated his support for combating the high cost of prescription drugs generally, and specifically for Medicare to negotiate prices with the pharmaceutical industry. There is broad public support. With a clean and straightforward bill and the President's support, the likelihood of passage in the Senate is much higher in 2019 than it was in 2007. Upon enactment, the public benefits immediately. The House leadership shows it is serious about solving problems and improving the lives of millions of Americans by enacting beneficial and pragmatic laws. With a growing number of calls for universal healthcare in the form of "Medicare for All," efficiency and cost containment within Medicare will only grow in importance. A Medicare Drug Price Negotiation Act of 2019 would be a vital first step in readying Medicare for a possible large-scale expansion.

I see this as similar to the success you achieved with the Fair Minimum Wage Act of 2007, one of the first pieces of legislation passed in that year, phasing in multiple increases to the Federal minimum wage. While it might have been tempting back then to draft a more comprehensive overhaul of labor laws, with other reforms surely being needed, it was more important to have a win on this specific and urgent priority. Such is the case today with prescription drug prices.

With a win on Medicare drug price negotiation, the table is set for additional legislation in the spaces where bipartisan cooperation is possible, including additional steps to reduce the high costs of prescription drugs (e.g., allowing Americans to import drugs from Canada or removing barriers that slow generic drugs from reaching the market) in addition to the other policy areas mentioned in the SOTU address.

If the President should renounce his support, you will have called his bluff (again!), not just on Medicare drug price negotiation, but on all of his overtures for greater conciliation and unity. That would be unfortunate and unsurprising, but needs to be known as soon as possible.

Start by passing a bipartisan bill. Use language that has passed the House previously. Keep it simple. Sometimes less is more.

Very truly yours,