The pharmaceutical industry had a rocky start to its year.

First Senator Bernie Sanders narrowly failed to pass a budget amendment allowing for imports of lower-priced Canadian drugs. Then Donald Trump tweeted that drug companies are “getting away with murder,” and their stock prices dove. Suddenly, Big Pharma is surrounded by populists on both sides, with only a shrinking neoliberal political coalition to show for its ocean of political spending.

And it had all looked so promising. Just weeks earlier, in the shadow of the incoming cabal of billionaires, generals, and creationists that make up the Trump administration, Congress took a step it seldom risked under Obama: it passed a major bill.