House Democratic leaders are telling rank-and-file lawmakers they have concerns with the wording of the amendment, including the use of “feasibility.”

The top Democrats are concerned the language is too weak and would effectively allow federal officials to unilaterally decide that capping price hikes in the private sector is impossible. Labor union representatives are also questioning whether the provision as written would extend to self-insured plans.

Progressives are open to strengthening the language when the bill reaches the Rules Committee, before a floor vote, but Democratic leaders so far have demurred, one person familiar with the discussions said.

The effort is the latest in a series of attempts by leadership to quell progressive attempts to modify Pelosi’s signature drug pricing effort. Earlier this week Democratic leaders urged Ways and Means Committee members to reject Rep. Lloyd Doggett’s amendments that he hoped would push the bill further left. Three separate committees that have jurisdiction over health care issues marked up the legislation.

Pelosi’s office did not immediately respond to request for comment. But other top Democrats have emphasized this week that the party needs to find common ground so the legislation can get enough votes to clear the House. Some raised concerns that moderates, particularly vulnerable freshman Democrats who won swing districts in 2018, could break ranks if the bill's pricing reforms move too far left. The GOP-controlled Senate is not expected to take up the legislation, whether or not the Jayapal amendment remains.

“It’s hard enough to get 218 of us on the same page, on the same day, on a complicated issue,” said Rep. Dan Kildee, a member of the House Democrats’ whip team, on Wednesday. “Anything that makes that less certain means we’re more interested in the value of our own ideas than the people that we profess to care so much about.”

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House progressives had initially portrayed Jayapal's amendment as a major step in making the bill more aggressive, signaling that it would shore up their support for the final legislation. Jayapal said it would refund portions of price hikes above inflation to 141 million people with employer-based plans.

Outside groups pushing for drug pricing reform were concerned about the leadership attempts to remove the amendment.

“I understand a desire to improve the text of the amendment to make it workable," said Shawn Gremminger, senior director at Families USA. "But I’d be very concerned about trying to undo an amendment that passed the committee of jurisdiction with every Democrat, including the chairman, supporting.”