This vote was on final passage of legislation to require the Health and Human Services (HHS) Department to negotiate with drug companies on behalf of beneficiaries in the Medicare prescription drug benefit.

The bill does not specify how the HHS secretary should conduct such negotiations, just that the federal government would have to leverage its buying power to command lower prices from prescription drug manufacturers. The bill prohibits the HHS secretary from establishing a restrictive list of covered drugs, thereby ensuring that he or she has the necessary bargaining power to freeze a particular drug out of the program if a favorable price cannot be negotiated. The measure would represent the first changes to the Medicare drug law enacted in 2003 and represents the delivery of a campaign promise by Democrats to amend the 2003 law to reflect price leverage that they believe should have been in the original legislation. President Bush has promised to veto the legislation.

The legislation's backers said the bill would allow the secretary to drive down the prices of prescription drugs by using Medicare's power to buy in bulk, a premise challenged by the Congressional Budget Office (CBO). Congress' budgetary research arm said the bill "would have a negligible effect on federal spending."

Energy and Commerce Chairman John Dingell, whose committee drafted the legislation, said that CBO's estimates should be taken with a grain of salt. "After what the Republicans and CBO told us about the cost of the Medicare prescription drug bill, I would not suggest taking their advice about the cost."

Rep. Thelma Drake (R-Va.) rose to opposed the bill on grounds that "the current private sector approach has resulted in more choices available to Medicare beneficiaries while simultaneously keeping costs below previous projections," adding that the majority of seniors are "satisfied" with the Medicare's prescription drug coverage.

"Seniors across America want their doctors, not the federal government, to choose the most effective drugs," Drake added.

Rep. John Sarbanes (D-Md.) said just the opposite was true, that most seniors don't understand, "why the Medicare program has been prohibited from negotiating for lower drug prices. Of course there is an explanation: a deal was struck to benefit the insurance and pharmaceutical industries at the expense of our seniors."

Support for the bill among Democrats was unanimous, and 24 Republicans broke ranks and voted for the measure. Thus, by 255 to 170, the House voted to require the federal government to negotiate with the pharmaceutical companies for lower prescription drug prices for beneficiaries of the Medicare drug program. The bill then moved to the Senate, where support for some version of the legislation was mounting despite President Bush's promised veto.