What ever happened to the sacred up-or-down vote?

A pillar of the Democratic political program tumbled today when Republicans in the Senate blocked a proposal to allow Medicare to negotiate lower drug prices for millions of older Americans, a practice now forbidden by law.

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Fifty-five senators, including 6 Republicans, supported a Democratic motion to limit debate and proceed to consideration of the bill, while 42 senators voted against it. Such motions require a three-fifths majority under Senate rules.

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The House passed a bill requiring the Secretary of Health and Human Services to negotiate drug prices by a vote of 255 to 170 on Jan. 12, just eight days after the new Congress convened. The Senate bill would permit but not require such negotiations.