President Donald Trump’s administration took aim at drug-pricing reform this month by holding listening sessions with industry groups and advocates. His administration is pursuing actions it can take with and without Congress to combat the industry’s high drug prices, according to a report from The Hill.

The pharmaceutical industry, traditionally a powerful lobbying force on Capitol Hill, now faces unpredictability – it is not yet clear what the president and his team will do or how impactful the decisions will be.

Conventionally, the pharmaceutical industry has been aligned with GOP administrations and Congress.

Trump has repeatedly maintained that the pharmaceutical industry is charging the government too much for drugs, saying in January that companies are “getting away with murder.” In his efforts to reform healthcare, he insisted in February that his administration and Congress should “work to bring down the artificially high price of drugs and bring them down immediately.”

Secretary of Health and Human Services Tom Price held listening sessions with a range of industry groups and healthcare advocates this month and those who attended the sessions told The Hill that the meetings were “more substantive than expected.”

One lobbyist told the news outlet that while they were expecting “a dog and pony show,” Price and other officials were engaged and even offered to bring the group back in the future once the administration brings forth their proposals.

Republicans traditionally opt for market-based solutions to issues involving industry, but Trump called on Congress during his campaign to allow Medicare to negotiate drug prices. It remains unclear if the administration will follow traditionally conservative principles to tackle high drug prices or consider solutions offered by Democrats.

Last week, White House budget director Mick Mulvaney suggested on a panel at Stanford University that the administration could propose that drug companies give discounts through rebates in Medicare – the same process they use in Medicaid. That proposal would require action from Congress and it would be a far cry from traditional Republican thinking.

“The president keeps telling me again and again and again: ‘What are we doing to fix this?'” Mulvaney said, according to The Hill.

As a politician, Price stuck with the conventional Republican path and was largely resistant to wide-sweeping government action when it came to drug prices.

Joel White, president of the Council for Affordable Health Coverage, attended a listening session with Price and suggested that the administration could consider speeding up the drug approval process in the FDA to increase competition.

Others suggested allowing Medicaid to deny coverage of high-priced drugs. One lobbyist proposed changing how Medicare Part B pays for drugs, a move that sparked controversy during the Obama administration.

As the administration considers moves it could make with and without Congress, a group of progressive representatives penned a letter to Trump, asking him to work with them.

The Congressional Progressive Caucus’ Health Care Task Force, led by Rep. Jan Schakowsky (D-Ill.), proposed that the administration and the caucus work together to include drug pricing reform in the upcoming reauthorization of FDA user fee agreements.

The letter includes ideas like allowing Medicare to negotiate the price of drugs, requiring rebates for high-priced drugs and improving transparency around the drug-pricing process.

“Throughout your campaign and since becoming president, you have repeatedly stated your desire to lower drug prices,” the caucus wrote. “In fact, as recently as March 7, 2017, you stated that you are working on a new system to enhance competition and reduce the price of prescription drugs.  We share those goals and believe that we need to take immediate action to reduce the skyrocketing cost of drugs.  To that end, we believe the upcoming reauthorization of the user fee agreements provides an opportunity for your administration and Congress to work together to reform our drug pricing system and bring relief to American families.”