This isn’t how I understand it. If companies refuse to negotiate they either can accept those excise taxes or they will not be drugs that are covered by Medicar

This isn’t how I understand it. If companies refuse to negotiate they either can accept those excise taxes or they will not be drugs that are covered by Medicare. They can refuse to negotiate and they can refuse to pay the excise tax. They just can’t do that and maintain access to one of their largest markets, which happens to be the group demanding the negotiation. Seems… complicated but fair?