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In Congress, Democrats and Republicans like to talk about lowering the cost of prescription drugs, but where's the action? A top Senate Republican, Iowa's Chuck Grassley, actually has a plan to make it happen, even if it means losing some Republicans along the way.
NPR congressional correspondent Susan Davis traveled to Grassley's home state to hear his pitch.
SUSAN DAVIS, BYLINE: For 39 years and counting, Senator Chuck Grassley travels to all 99 counties in his home state every year to meet with Iowans.
CHUCK GRASSLEY: Let's get started here.
DAVIS: At his 84th stop of the annual tour, here in the town of Aurelia, Grassley's promoting a sweeping drug bill just passed out of committee.
GRASSLEY: I'm going to take maybe two minutes to go through just the highlights of that bill.
DAVIS: Iowans like Allan Yeager are eager to hear it. He told me his wife's drug costs have taken a toll on their retirement savings.
ALLAN YEAGER: She was a severe diabetic. She had a gastric bypass. When we retired, she got a bonus for retiring, and that got used up - like that.
DAVIS: So a bill to reduce seniors' out-of-pocket costs and limit drug price increases in Medicare is really popular here. But Iowan John Comstock told the senator he's skeptical Congress can get it done.
JOHN COMSTOCK: Based on coming out of committee with not having total Republican support, what do you feel, in your gut and experiences, the chances of that passing are?
DAVIS: As Grassley sees it, the fact that 9 of the Senate Finance Committee's 15 Republicans voted against his bill is a good sign for what comes next.
GRASSLEY: But if you just looked at doing something in Washington with having every Republican on my side before you can move ahead, we wouldn't get much done. And it takes a lot of bipartisanship in Congress to get things done.
DAVIS: In order to get this done, Grassley started working with the top Democrat on the committee, Ron Wyden of Oregon, back in January. Last month, they unveiled a prescription drug bill that will limit out-of-pocket costs for seniors in Medicare's Part D prescription drug program to $3,100 a year.
GRASSLEY: It's going to give peace of mind to people.
DAVIS: Grassley got it through committee over the objection of a majority of Republicans, but every Democrat voted for it. Those Republicans oppose it on free market principles because the plan includes price controls on the pharmaceutical industry, limiting their ability to raise drug prices faster than the rate of inflation. Grassley told me he is unmoved by this argument.
GRASSLEY: To answer the Republicans that are complaining about that part of it...
DAVIS: The government will not set prices, he argues.
GRASSLEY: ...There's just got to be a limit on what they can increase it year over year.
DAVIS: But he knows he's unlikely to win over these opponents, many getting backed up by the drug industry.
GRASSLEY: Not very often is big pharma taken on. And this is something they just do not like. And they've got plenty of friends in politics.
DAVIS: So Grassley's up against internal GOP opposition, the drug lobby and a Senate majority leader who does not like to bring bills to the floor that divide the party. But he says the 22 Republicans up for reelection next year work in his favor.
GRASSLEY: Every one of them were asking me to do something on the high cost of prescription drugs because it's a big issue in their campaign.
DAVIS: And he says another powerful ally can help him overcome.
GRASSLEY: The president wants this very bad.
DAVIS: Lowering drug costs is a top 2020 campaign priority for the Trump administration. Trump wants a win, and in order to get it, his administration has also indicated a willingness to buck party orthodoxy and has praised this plan. Grassley and other Republican chairmen are strategizing with top Democrats. They want to bring together a number of health care cost-cutting bills to make it as politically appealing to as many senators as possible. Grassley says he's not trying to buck the party on health care; he's trying to help it.
GRASSLEY: Fourteen percent more people feel the Democrats are better for them on health care than we Republicans are. It might help narrow that.
DAVIS: Here in Iowa, Grassley's spending the August recess trying to build support. In this reliably Republican region of the state, he makes no apologies for working with Democrats.
GRASSLEY: That's my reputation, and that's how I get things done.
DAVIS: He'll find out soon enough if that's possible in this Congress. Susan Davis, NPR News, Aurelia, Iowa. Transcript provided by NPR, Copyright NPR.
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