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Tag: President Trump

  • Trump’s executive order on prescription drugs does not reduce drug prices for Americans

    Trump’s executive order on prescription drugs does not reduce drug prices for Americans

    A new Arnold Ventures poll finds that nearly nine out of 10 voters believe the government should have the power to negotiate prescription drug prices. And, more than 75 percent say that it is very important for the government to reduce drug prices, including seven in 10 Trump supporters. Unfortunately, President Trump’s recent Executive Order on prescription drug prices and tariffs are likely to raise drug prices for Americans.

    More specifically, the vast majority of Americans support capping drug price increases to the rate of inflation and Medicare negotiating drug prices for all drugs. Indeed, 86 percent say that they do not want people with Medicare to pay more for their drugs than people in other wealthy nations. But, Trump’s executive order undermines Medicare’s limited efforts to negotiate drug prices, much less expand Medicare’s authority to negotiate drug prices.

    Bottom line: Your prescription drug costs are probably not coming down any time soon. President Trump’s tariffs on China could lead to higher drug costs for all Americans, as pharmaceutical manufacturers import ingredients from China. Meanwhile, Trump’s new Executive Order on prescription drug prices appears to favor the pharmaceutical industry’s interests, allowing drug companies to continue to set prices sky high and calling for changes to the Inflation Reduction Act that would drive up drug prices for people with Medicare.

    Here are some of the key provisions of the Executive Order.

    On a positive note, with caveats:

    • It aims to reduce the cost of insulin and injectable epinephrine at community health centers for uninsured and some low-income individuals. It’s not clear by how much.
    • It asks the FDA to make it easier for states to import drugs. But, it’s not at all clear that this provision will help Americans at the pharmacy. Today, the FDA has only granted permission to Florida to import drugs from Canada, and Florida appears not to have begun importing drugs. Moreover, Florida’s program is not designed to help its residents. It would only help lower the state’s costs a small amount for Medicaid recipients and for the state’s health and corrections departments.
    • It calls for more generics and biosimilars–lower-cost alternatives to brand name drugs. But, the Trump administration has cut FDA staffing drastically. It eliminated the office that was tasked with speeding up generic drug approvals,  slowing down drug approvals. Moreover, the administration has also cut NIH funding, which supports virtually all new drug development. So, while the president’s goal is laudable, it does not seem doable. 

    On a negative note:

    • It is projected to drive up Medicare drug costs by $6 billion and force people with Medicare to pay $1.5 billion more for their drugs. How? The Executive Order buys into a pharmaceutical industry claim that the Inflation Reduction Act discriminates against pills. Discriminates? Well, let’s just say that the law gives license to pharmaceutical companies to charge high prices for injectable drugs for a longer period of time than for pills. The IRA permits drug price negotiation over pills on the market for nine years and injectable drugs on the market after 13 years. The Executive Order asks Congress to allow pharmaceutical companies the same 13 years of protection for pills as for injectables. If the Republican majority complies, more than half the drugs for which the Centers for Medicare and Medicaid Services is negotiating lower prices would no longer have lower negotiated prices.
    • It calls for better transparency around the fees drug middlemen receive from pharmaceutical companies, which does not bring down drug prices for Americans.

    The Trump administration also ended a Biden initiative that would have permitted people with Medicare to buy generic drugs for $2. And, it is denying Medicare coverage of anti-obesity drugs, as the Biden administration had proposed.

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  • Will Trump give his supporters the lower health care costs they want?

    Will Trump give his supporters the lower health care costs they want?

    As we know, Trump supporters, like most Americans want to see lower prices on basic necessities, like gas and eggs. They also want to see lower health care costs, reports Noam Levey for NPR.

    What could Trump do? He could lower the out-of-pocket maximum on health care costs for working people. But, that would also likely drive up people’s premiums. And, the Republicans opposed the new $2,000 a year maximum on outpatient prescription drug costs for people with Medicare.

    But, the polls indicate that, unlike 10 or 15 years ago, a lot of Trump supporters now want more government involvement to rein in health care costs. People recognize that the “free market” for health care is not their friend. People no longer think that government should stay away.

    In fact, Republicans want the government to step in and limit drug prices and hospital charges. They also want the government to regulate and restrict health care providers from going after medical debt according to recent polls. More than eight in ten support a $2,300 annual cap on medical debt collection.

    Republicans still don’t support Medicare for all. In fact, that would do most to lower their health care costs and ensure they received the health care they needed. One size fits all means that it works for everyone. Other options will not work for people in some or more instances, and there’s no telling when you buy insurance whether that restriced insurance coverage will work for you over time.

    Republicans also overall support Medicaid. Medicaid is especially critical for lower and middle income older adults who need long-term nursing home care. Yet, the House Budget resolution puts in place a plan that will likely slash Medicaid spending and with it push many people off Medicaid.

    Today, Republicans more often hold corporate health insurers, pharmaceutical companies and hospitals responsible for high costs than the government. They see the greed and profiteering in our corporate health care system.

    One poll shows that 75 percent of people who voted for Trump want the government to limit hospital charges. They also want the Trump administration to do more Medicare drug price negotiation, not less.

    Right now, Republicans in Congress are not focused on any of their supporters’ cost-cutting health care priorities. They are poised to slash Medicaid and end subsidies for plans in the state health insurance exchanges, both of which will drive up health care costs for millions.

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  • President Trump threatens Pharma with tariffs

    President Trump threatens Pharma with tariffs

    President Trump has spent his first few weeks in office undoing much of what President Biden had put in place, but he is not (yet) prepared to undo the Medicare drug price negotiation provisions in the Inflation Reduction Act. In fact, in a meeting with pharmaceutical company executives, he threatened to impose tariffs on pharmaceutical companies if they did not relocate their manufacturing to the US, reports Tristan Manalac for Biospace.

    “Pharmaceuticals, it’ll be 25 percent and higher, and it’ll go very substantially higher over [the] course of a year,” said President Trump. These tariffs would drive up drug prices substantially for working Americans. The Inflation Reduction Act (IRA), passed under the Biden Administration, penalizes drug companies for raising Medicare and Medicaid drug prices more than the rate of inflation.

    President Trump has still not said what he will do about Medicare drug price negotiation. Among other things, the IRA calls for the Centers for Medicare and Medicaid Services (CMS), which oversees Medicare, to negotiate the price of 15 prescription drugs that drive high Medicare spending in 2025.  In 2024, CMS negotiated the price of 10 high-cost prescription drugs. Those new drug prices are set to take effect in 2026.

    Pfizer, Lilly, Merk CEOs all attended the meeting with President Trump. Their trade association, PhRMA, has been trying to undo the provisions in the Inflation Reduction Act that reduce drug company profits. The drug companies have sued the government, so far unsuccessfully, claiming that lower drug prices are effectively a taking of their property. Of course, the only reason they can charge the prices they do in the US is because our government has given them monopoly pricing power on patented drugs, unlike the governments in every other wealthy nation.

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  • Trump signs executive order creating “MAHA” commission

    Trump signs executive order creating “MAHA” commission

    President Trump signed an executive order creating a Make America Health Again (“MAHA”) Commission to be chaired by Robert F. Kennedy Jr., the newly confirmed head of the US Department of Health and Human Services, reports Noah Tong for Fierce Healthcare. The Commission will look into the “root causes of America’s escalating health crisis.”

    RFK Jr.’s priority is the childhood chronic disease epidemic.  The Commission will focus on health research, our diet, toxins and other environmental factors, health care coverage and corporate influence.  The Commission will release its “Make Our Children Healthy Again Assessment” to President Trump in 100 days.

    The Commission has 180 days to recommend a strategy for addressing childhood chromic conditions. RFK has long blamed vaccines for some childhood chronic conditions, and he has not wavered from that position, even though the evidence weighs heavily against his thinking.

    RFK Jr. has explicit authority to hold hearings and meetings and other public events, to the extent he chooses, and he can solicit expert advice from public health leaders. He says that he wants to remove dangerous chemicals from our environment and food.

    In addition to Chairman RFK Jr., Commission members include the Director of the National Institutes of Health, the Director of the Centers for Disease Control, the Commissioner of the Food and Drug Administration, the Education Department Secretary and the Housing and Urban Development Secretary.

    Meanwhile, it remains unclear how or whether President Trump will address high drug prices. The pharmaceutical industry is hoping he will end Medicare drug price negotiations required under the Inflation Reduction Act. New tariffs Trump imposed on China are projected to drive up drug prices, as many pharmaceutical ingredients are imported from China.

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  • 2025: Tariffs take effect, your costs likely to rise

    2025: Tariffs take effect, your costs likely to rise

    President Trump is making good on his pledge to place high tariffs on goods from China beginning today, February 4. (Tariffs on goods from Mexico and Canada have been postponed for a month, as of now.) The fallout just from the tariffs on China is likely to be bad for your health and financial well-being. Along with the price of gas, cars, and eggs if the tariffs on Canada and Mexico go into effect, prepare now for increases in prescription drug and other health care costs, reports John Wilkerson for StatNews.

    Trump now acknowledges that his tariffs will cost you. Because China delivers us many prescription drug ingredients (Mexico provides us medical devices and Canada supplies gas, eggs and avocados and other produce) it’s far to assume the prices of prescription drugs will increase as well. In fact, we might end up with shortages of generic drugs if their manufacturing cost increases so much that companies can’t profit off their sale.

    In addition, hospital charges could rise. Hospitals use imported gowns, syringes and other supplies. Sometimes CT and X-ray machines are imported. Consequently, people are likely to see still higher health insurance premiums.

    Trump: “WILL THERE BE SOME PAIN? YES, MAYBE (AND MAYBE NOT!). BUT WE WILL MAKE AMERICA GREAT AGAIN, AND IT WILL ALL BE WORTH THE PRICE THAT MUST BE PAID.” Trump suggested that the Canadian tariffs might lead Canada to agree to become a 51st state!

    Even conservative groups are concerned about the effects of the tariffs. The US Chamber of Commerce called the tariffs a mistake. Tariffs on Mexican and Canadian goods will not address immigration or fentanyl issues, as the President has suggested.

    If the Canadian and Mexican tariffs go into effect, Americans should assume those countries will retaliate. Before Trump backed off the tariffs on Canadian goods (yesterday), Trudeau had asked Canadians to boycott American goods, including Kentucky bourbon and Florida orange juice, and avoid vacations in the US.

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  • Donald Trump’s threat to Medicare and Social Security

    Donald Trump’s threat to Medicare and Social Security

    Donald Trump was the worst president for seniors in the history of the nation. That is not hyperbole. Alarmingly, if elected again, he will be even worse—and, worryingly, more effective.

    When Trump ran for president in 2016, he claimed he would be the one Republican not to cut our earned benefits but, when he actually became president, every single one of his budgets proposed deep cuts to Social Security and Medicare, as well as Medicaid.

    When Trump couldn’t get the cuts enacted, he employed the old tactic of “starve the beast.” Figuring tax cuts are easier to enact than benefit cuts, he cut income taxes which help to fund Medicare and Medicaid, and sought to defund Social Security, which has its own dedicated revenue source.

    To advance his goal of undermining Social Security, Donald Trump grabbed the questionable power to go after its dedicated revenue unilaterally—something without precedent. Because Trump was limited to executive action, he was able to only defer the revenue, but he made clear that he would not just defer the revenue, but eliminate it, if he were re-elected. Insufficient dedicated revenue leads to automatic cuts. Conveniently, automatic cuts means there is no one to clearly be held accountable.

    Trump’s goals to undermine these programs, so vital to seniors, have not changed. Trump continues to claim he won’t cut benefits despite his record to the contrary, but tells the truth from time to time. Moreover, he is reportedly considering, once again, defunding Social Security, if he has the chance. Trump also plans to continue to give his billionaire friends massive tax giveaways.

    And we know what those cuts will look like. The Republican Study Committee, which includes 80 percent of all House Republicans and 100 percent of House Republican leadership, releases a budget every year. Every year, it contains deep, draconian cuts and radical transformative proposals for Social Security. Indeed, its recently-released FY 2025 budget slashes Social Security’s already inadequate benefits by $1.5 trillion in just the first ten years. In fact, it cuts Social Security by $73 billion in the first year alone.

    These are much deeper cuts than are necessary to eliminate Social Security’s modest projected shortfall. And they would occur much sooner than if Congress did nothing whatsoever! Even worse, the Republican proposal would radically transform Social Security, ending it as we know it.

    Social Security provides wage-related benefits designed to maintain one’s standard of living when wages are lost in the event of old age, disability, or death. Today’s extreme Republicans want to instead provide only subsistence-level benefits, designed to barely keep beneficiaries above abject poverty. And these radicals propose to privatize Social Security and Medicare, on top of that.

    For years, politicians have talked about giving Medicare the power to negotiate lower prescription drug prices. Biden got it done. Thanks to Biden, out-of-pocket insulin costs have been capped at $35 per month, hearing aids are cheaper, and inhaler prices are lower. If Trump wins a second term, he has made clear he will seek to repeal those reforms, just as he sought to repeal the Affordable Care Act. Nor will Medicaid be spared.

    None of this should be a surprise. Before running for president, Trump slandered Social Security by calling it a Ponzi scheme – an illegal enterprise used to dupe and defraud the unsuspecting. He supported privatizing Social Security and raising the retirement age, with the condescending remark, “how many times will you really want to take that trailer to the Grand Canyon?”

    Before running, Trump praised proposals by former Republican vice presidential nominee Paul Ryan that would have destroyed Medicare by turning it into a voucher program, forcing seniors to fend for themselves in a hostile market.

    And there’s more evidence of Donald Trump’s true plans. Look who Trump surrounded – and continues to surround – himself with. Everyone around Trump is hostile to these programs.

    In 2016, Donald Trump picked Mike Pence to be his running mate, despite the fact that Pence had a clear record of favoring cuts to these programs, including raising the retirement age and privatizing our earned benefits. Pence wouldn’t help Trump steal the 2020 election so he is being replaced – but not because of his policy views on Social Security, Medicare, and Medicaid. Those who are reportedly being considered have as hostile or even worse views than Pence.

    And Trump’s other appointments were no better. Just to name two, Trump appointed extreme Social Security, Medicare, and Medicaid opponent Mick Mulvaney as his Director of the Office of Management and Budget, and later chief of staff. Mark Meadows, another Trump chief of staff (currently under indictment) also has a long record of supporting massive cuts to Social Security, Medicare, and Medicaid.

    Perhaps even more concerning than Trump’s hostility to programs that are vital to seniors is his utter disregard for their health and well-being. It was seniors who overwhelmingly bore the brunt of Trump’s completely incompetent handling of the COVID pandemic. Too many Americans, disproportionately seniors, died because of Trump.

    Rather than deal effectively with the pandemic, Trump’s administration shockingly used it to further Trump’s goal of undermining Social Security. At the height of the pandemic, Trump’s son-in-law Jared Kushner proposed pressuring desperate Americans, thrown out of work because of the impact and dangers of COVID, to trade their earned Social Security benefits for upfront, immediate cash. Fortunately, it went nowhere, but did show a single-minded effort to rip away the protections of Social Security despite where the focus should have been – on saving lives.

    It is essential that the American people not be fooled by the rhetoric. Trump has shown he understands how unpopular cutting Social Security, cutting Medicare, cutting Medicaid, and raising drug prices are with everyone but his billionaire donors. But he showed early on that he understood the politics. In 2011, for example, Trump told Sean Hannity that Republicans “are going to lose elections” if they “fall into the Democratic trap” of advocating cutting Social Security, Medicare and Medicaid without bipartisan cover.

    So don’t be fooled. Social Security, Medicare, Medicaid, and drug prices are on November’s ballot. Donald Trump will be more effective this time around. The choice is clear: Trump and his Republican allies in Congress want to cut Social Security, cut Medicare, cut Medicaid, and increase the already-huge profits of drug companies while giving tax breaks to Big Pharma and their other billionaire friends. Democrats want to expand Social Security, expand Medicare, lower drug prices, and force billionaires and multinational corporations to pay their fair share.

    For the sake of all of our economic security, it is essential that the American people, and seniors in particular, understand this fundamental difference between the two parties and vote accordingly.

    [This post was originally published on Common Dreams.]

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  • Poll: Health care costs are a top economic priority for voters

    Poll: Health care costs are a top economic priority for voters

    As you’ve likely been reading, voters continue to have negative views about the US economy. High health care costs (and inflation, which is actually in check) feed into that view, with voters saying they are big concerns. The Kaiser Family Foundation’s latest poll finds that voters want to hear President Biden and former President Trump discuss these issues.

    Americans believe that their cost of living, including housing, is rising; health care costs also represent a piece of that expense. They do not seem to consider that unemployment is low and the stock market has been climbing. Almost three in four Americans are concerned about paying unexpected medical bills; more than half are worried that they won’t be able to afford their prescription drugs and nearly half express concern about paying their health insurance premiums.

    What’s particularly noteworthy is that even though former President Trump would likely cut some of the benefits voters enjoy and President Biden has worked hard to boost them, nine in ten Republicans say they would vote for former President Trump. Curiously, Republican voters believe that former President Trump did more to address high health care costs than President Biden, although not enough. Nearly six in ten Republicans (59 percent) say Trump did enough to address health care costs, whereas only one third (33 percent) of Democrats say Biden has done enough.

    Voters who say they support Trump recognize that he does not have a vision for replacing the Affordable Care Act, only for ending it. But, they don’t appreciate that President Biden was the Vice President when the ACA was passed and played a significant role in its passage.

    The ACA is not well understood, likely because only a fraction of the population benefits from it today. Most people don’t appreciate the protections it offers people who lose their employer coverage or who are self-employed, particularly those who have pre-existing conditions, and why it needs to be strengthened. Many Republicans suggest they would be happy to see it cut or repealed.

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  • Biden brought down the price of insulin significantly; a Trump presidency could undo that

    Biden brought down the price of insulin significantly; a Trump presidency could undo that

    Drug prices remain out of control, and there’s a lot that President Biden could still do to bring them down. But, Americans should give President Joe Biden credit for reducing the cost of insulin significantly, a huge achievement for which he has not gotten the credit he is due, writes Jonathan Cohn for Huffington Post. If Trump is reelected, he could undo this.

    In fact, President Biden is responsible for several new laws that are bringing down the cost of health care and making it a little more affordable. [Editor’s note: Not nearly enough, but far more than President Trump.]

    With insulin, which millions of diabetics rely on for their well-being to process sugars in their bodies, the list price can be hundreds of dollars. That price is insane. People in other developed countries pay as little as 10 percent of the amount we pay for their insulin. Their governments negotiate the price of insulin and every other drug on their behalf.

    About 25 percent of Americans with diabetes cannot afford insulin and other basic needs. In some cases, people forego insulin to the detriment of their health. They might not have health insurance and cannot afford the full cost of insulin. Fortunately, thanks to the Affordable Care Act, fewer Americans than ever are uninsured.

    As of 2023, because of the Inflation Reduction Act, older adults and people with disabilities should pay no more than $35 a month for an insulin prescription. If they have two prescriptions, it would cost them $70. Since the government has not yet negotiated the price of insulin, it’s not clear how much more everyone with Part D prescription drug coverage is paying in premiums as a result of the Inflation Reduction Act.

    Unfortunately, reports are that some Part D drug plans have stopped covering insulin in response to the $35 maximum copay. If you have diabetes, make sure that your drug plan covers your insulin prescriptions.

    As of January 1, 2024, people who do not have Medicare should also see lower insulin prices. The three major companies that manufacture insulin have reduced their prices to $35 a month voluntarily. One policy expert explains, however, that the price drop actually helps these companies maximize profits: “They’re lowering prices to avoid paying rebates to Medicaid programs and therefore maximize profits.”

    If President Trump is reelected in November, watch out. His administration would likely undo President’s Biden important legislation on insulin prices. And, many of the 8.4 million Americans who rely on insulin would again be struggling to afford it or, worse still, forced to go without it.

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  • President-elect Biden proposes German model for drug pricing

    President-elect Biden proposes German model for drug pricing

    President-elect Joe Biden is proposing that the US look to Germany as a model for drug pricing. On one hand, a German model could be a step forward, putting in place a national system for evaluating and pricing drugs. But, the devil is in the details; how will they compare with President Trump’s latest interim-final drug pricing rule for Medicare.

    Germany, like many other countries, has a government-run system for determining the value of a drug and pricing the drug. The US has no such system at the moment. Our federal government does nothing to assess the value of drugs it approves or to rein in drug prices.

    Biden’s proposal would establish a government team charged with determining a drug’s fair value. It could work much like the non-profit Institute for Clinical and Economic Review. That group has taken on a significant amount of work evaluating the cost-effectiveness of drugs.

    Biden also proposes that, as in Germany, pharmaceutical companies would be required to negotiate drug prices, in collaboration, at the national level, that would apply to both public and private insurance.

    It’s not clear what pricing elements a Biden administration would factor into the determination of a drug’s price. Everything turns on how much weight the group gave to various pricing elements. Under Biden’s proposal, if a “quality-adjusted life year” or QALY was worth as much as $150,000, much higher than in Europe, drug prices likely would not come down much. And, tens of millions of Americans would continue to be forced to forego needed medicines.

    The international reference pricing bill, which passed in the House of Representatives, HR3, gives significant weight to the price paid by other wealthy nations, which makes tremendous sense. Why should we be paying more than the Germans and the Japanese for our drugs?

    HR3 would bring down the price of 350 drugs significantly. But, it is going nowhere in the Senate. That said, the Trump administration has issued an interim final rule that would set Medicare drug prices at a level comparable to what other wealthy countries pay. President-elect Biden might intend to undo Trump’s rule, even though it would drive down prices considerably and eat deeply into pharmaceutical company profits.

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  • Joe Biden will build a strong public health infrastructure

    Joe Biden will build a strong public health infrastructure

    Atul Gawande makes the case for electing Joe Biden President in the New Yorker. He argues that a Biden administration will build a strong public health infrastructure to control the pandemic, which will begin the reforms necessary to fix our broken health care system. At the same time, Gawande appreciates that the Biden administration will not deliver us the guaranteed health care we so desperately need.

    No question that a President Biden will make controlling the pandemic a priority. And, there’s also no question that doing it well will move us towards a better health care system. The only question is whether Biden and a Democratic Congress will do it as well as it should be done.

    Vice-President Biden and House Speaker Nancy Pelosi have already made clear that they do not have any interest in automatically guaranteeing everyone access to affordable health care through Medicare for All. But, continuing our fragmented private health care system means no good real-time data of what’s happening with the pandemic and, more generally, with people’s health care. It also means premiums and out-of-pocket costs will continue to rise. There’s good reason to believe many people will skip testing and treatment because of the cost.

    Without a single public health care system, the federal government will have little ability to make system improvements that will help. Just look at how poorly hospitals and insurers responded to the Congressional mandate that COVID-19 testing be free. People continue to see big bills, and as a result, many people are not getting tested or treated when they should.

    If there’s good news, it’s that Vice-President Biden and a Democratic Congress will trust the science and available evidence. They will be forthright about what is happening in the country and what people need to do to protect themselves and their community. They will also appropriate and disburse at least some of the funds needed to keep the economy from sinking. And, they will offer help to people and hospitals in need. How much help they will provide businesses and individuals is still an open question.

    In stark contrast, President Trump and his administration and Congress have lied to the American people about the dangers of the virus, denied the science, and done precious little to fight the virus. For example, they should have imposed a national mask mandate. Instead, their actions have led to the needless death of countless older adults, health care workers, working people and their children. They have failed to ensure adequate supplies of personal protective equipment for health care workers and other essential workers, including a disproportionate number of Americans who are Black, Latino and low-income.

    The number of reported COVID-19 deaths is unconscionably high at 220,000; and the Trump administration likely has underreported these deaths; more than 300,000 people have died this year than at the same time last year. The Trump administration also has failed to ensure that people have access to free tests with timely results or that health care workers have the personal protective equipment they need.

    Pandemic management must start with the federal government, not with the states, as Vice-President Biden acknowledges. It must include universal health care coverage. But, pre-pandemic, 45 percent of working Americans were uninsured or underinsured, with unaffordable out-of-pocket costs.

    Moreover, as the pandemic has made clear, we must end the tie between work and health care coverage if we are to ensure Americans access to needed health care. Tying health insurance to people’s jobs puts them at severe health risk when the economy turns and the job market shrinks.

    If we don’t fix health care, we can’t fix financial or racial inequality. Yet, Gawande recognizes that a Biden administration has not yet committed to take the bold steps we will need to guarantee everyone access to care. Biden wants to build on the Affordable Care Act, which tends to offer health plans with few high-quality specialists and high out-of-pocket costs. Time will tell whether Biden’s version of a public health insurance option will guarantee people the reliable and affordable coverage they need.

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