Democrats have heralded Medicare expansion as a major component of the $3.5 trillion package agreed to on Tuesday night, but that provision is only now being written by Senate Finance Committee Chair Ron Wyden, D-Ore. By vowing to take hold of the process, Wyden is in effect discarding several years worth of legislative work in the House of Representatives.

Wyden on Wednesday told reporters he believed he had House Speaker Nancy Pelosi’s blessing for the rewrite of H.R. 3, House Democrats’ signature bill to allow Medicare to negotiate directly with drug companies and use the savings to expand Medicare to cover hearing, vision, and dental insurance. On June 22, Wyden released a set of “principles” to guide negotiations over the Senate’s version of the legislation.

Committee chairs typically release sets of principles ahead of negotiations, which can often go on for several months or years. Wyden has just a matter of weeks, as Democrats hope to have the details of the $3.5 trillion package finalized by August or September. “The last couple of weeks have, in my view, been very positive,” Wyden told The Intercept. “For example, after I laid out principles, I talked to a number of moderate senators, they really liked the provisions that promote breakthroughs and innovations in biotechs. They volunteered — a couple of them said, we read the principles, we went right to that section. And then, and I didn’t know about it ahead of time, the speaker apparently at a presser a couple of days ago, said, ‘I like the principles Senator Wyden laid out.’ So what that’s been is an indication that now as we go to writing the details of the program — and we will write the details, it is the job of the Senate Finance Committee — we’re starting with some pretty good signals.”

House Democrats, meanwhile, are concerned not just at the prospect of a full rewrite, but also worried Wyden will narrow what the House has already agreed to, allowing pharmaceutical industry lobbyists another opportunity to water down H.R. 3. Asked about those concerns by The Intercept, he demurred. “I’m not going to get into the details,” he said. “I will tell you that the speaker’s comments last week were very welcomed, particularly by me, because it was an indication that the coalition that I’m spending a lot of time to build — shuttling back and forth between the progressives and the moderates — has some life.”

Meanwhile, Sen. Robert Menendez, D-N.J., a member of the Senate Finance Committee, hasn’t yet spoken to Wyden about his intentions for the bill, but he said, “I’m sure there will be elements of the House version but I don’t know that it will be exclusively a mirror of it.”

Rep. Pramila Jayapal, D-Wash., who is chair of the Congressional Progressive Caucus, said she hasn’t spoken yet with Wyden about allowing Medicare to negotiate drug prices with pharmaceutical companies, but she’s “looking forward to hearing more from him about what he has to say.”

“Look, I think we need to have Medicare negotiate drug prices. I think we have to bring drug prices down, and I think it needs to be in this package,” Jayapal said, referring to Senate Democrats’ $3.5 trillion deal.

H.R. 3 was sponsored by House Energy and Commerce Committee Chair Frank Pallone, D-N.J. Asked about his reaction to Wyden’s plans, Pallone said: “Empowering the federal government to negotiate prescription drug prices would help save Americans’ hard-earned money while also producing federal cost-savings that we could use to help pay for critical priorities in the upcoming reconciliation package. It’s time for Congress to come together to address high prescription drug prices.”

But Big Pharma is spending furiously to fight H.R. 3, and they even teamed up with some of the building trades unions to run an ad thanking Rep. Scott Peters, D-Calif., for sticking with them.

The ad, funded by the Pharmaceutical Industry Labor-Management Association, tries to make the case that revenue from higher drug costs allow companies to invest in more research and construction, creating union jobs. Meanwhile, a report this month from the House Oversight and Reform Committee found the 14 leading drug companies spent $577 billion on stock buybacks and dividends between 2016 and 2020: $56 million more than what they spent on research in that timeframe. At that rate, they’re slated to spend $1.15 trillion on buybacks and dividends between 2020 and 2029.

Rep. Lloyd Doggett, D-Texas, sought to broaden an earlier version of H.R. 3 while the House Ways and Means Committee was marking up the bill in 2019. He introduced amendments to increase the number of drugs Medicare could negotiate and allow the uninsured to use the resulting lower prices, but only a few Democrats supported the provisions, and they ultimately were voted down by a majority of the committee members, including Chair Richard Neal, D-Mass.

One of the three other Democrats who supported giving access to the uninsured was Rep. Don Beyer, D-Va. Asked for a comment on Wyden’s plans to restart the process, Beyer spokesperson Aaron Fritschner said: “[We] don’t know the details on the Wyden approach and we strongly support H.R. 3, but the most important thing is the results, and if what Senator Wyden does can achieve broad decreases in the cost of prescription drugs Rep. Beyer will gladly support it.”

Democrats have long rallied around the idea of empowering the government to help lower drug prices — clinching to that goal rather than championing more transformative reform to the American health care system, like Medicare for All. After the 2016 elections, the Democratic Congressional Campaign Committee commissioned a survey that encouraged House Democrats to avoid discussing Medicare for All and instead focus on attacking Republicans trying to repeal the Affordable Care Act and, if necessary, decreasing the costs of prescription drugs.

After the late John McCain, former Republican senator from Arizona, helped save Obamacare in 2018, lowering drug prices became a top talking point that Democrats in the midterm election campaigned on. After taking control of the House, though, they were unable to negotiate a deal with President Donald Trump, and again ran on the issue two years later.