Senator Roger Marshall on Government Shutdown, ACA Subsidies, and Drug Prices

Government Shutdown Standoff

• 📌 Senator Roger Marshall likens the government shutdown situation to a woman in labor stuck at seven centimeters, expressing a desire for Congress to deliver and finish the job.
• 💡 The core issue is the debate over extra Obamacare (ACA) subsidies, which were part of COVID-era spending and cost an estimated $35 billion annually.
• 🎯 Marshall criticizes Chuck Schumer, stating he is "fighting for his political life" and that his base doesn't realize they lost the 2020 election.
• 🔑 Republicans have repeatedly voted for continuing resolutions without demanding rescission of spending, but now feel justified in shutting down the government over their own priorities and COVID-era expenditures.

Negotiating ACA Subsidies and Healthcare Costs

• 🏥 There's an effort to create legislation that would provide a framework for extending ACA subsidies, with a suggestion to clean up the Continuing Resolution (CR) and handle this by year-end.
• 🗣️ Marshall believes Chuck Schumer has been dishonest about negotiations, noting that Susan Collins and the appropriations team have negotiated extensively.
• 💰 The conversation shifts to the real issues: the cost of healthcare, hospital price transparency, and reforming PBMs to drive down prescription drug prices.
• 📉 Marshall suggests dialing down ACA subsidies over 2-3 years to allow time to fix healthcare and lower its overall price.

Potential Shutdown Outcomes and Trump's Strategy

• ⏳ Marshall fears a prolonged shutdown but believes a solution will be found within three to five days, after which Democrats might "find religion again."
• 🗳️ He posits that Schumer's political decision-making is influenced by fear of his far-left base and potential primary challenges, making it a political rather than logical decision.
• 📢 The President's statements about potential good coming from a shutdown and mass firings are seen as negotiating through the press and trying to make the best of a bad situation.
• 🤝 An off-ramp might involve a clean CR for four to five weeks, allowing continued negotiation on other issues like COVID subsidies, which don't expire until year-end.

Drug Pricing and Pharma Innovation

• 💊 The President's announcement on drug prices with Pfizer's CEO is noted, with questions raised about how to lower prices significantly while maintaining R&D investment.
• 🌍 Marshall suggests that while 80% of pharma income is from the US, there's an effort to push foreign countries to pay their share.
• 💡 He emphasizes the need to innovate in pharmaceuticals, especially for critical needs like Alzheimer's drugs, to avoid "killing the golden goose" and ensure the survival of Medicare.
• 🤔 The idea of a government stake in big pharma companies is considered but deemed something that needs careful measurement before proceeding.