President Trump says his success negotiating lower prescription drug prices is such a huge win that the GOP should win the midterms on that alone.
Many voters won’t know whether they’re benefiting from the discounts, however, and overall inflation and foreign wars have overshadowed the issue, creating a mismatch between Mr. Trump’s hopes and campaign realities.
“It’s eclipsed by Iran, tariffs — all the other aspects of the affordability concerns,” said Douglas Holtz-Eakin, a former director of the Congressional Budget Office and the current president of the American Action Forum, a center-right nonprofit.
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Mr. Trump struck deals with over two dozen drugmakers to cut prices to what other developed nations pay, a policy known as Most Favored Nation pricing, or MFN.
Getting Big Pharma to slash prices in the U.S. at all is a big win, and the White House projects that applying discounted prices to Medicaid – the state-federal program for 70 million low-income Americans — will save more than $64 billion over 10 years.
“I mean, this one thing alone should win us the midterm,” Mr. Trump said recently.
But political forecasters think Democrats have the upper hand this cycle, including on healthcare costs.
Mr. Trump might have oversold the discounts’ political impact.
Many voters will not be affected by the policy, which primarily impacts the Medicaid program for the poor and medicines sold on TrumpRx, a website for direct-to-consumer purchases that do not involve insurance.
“Most people with Medicaid don’t really pay anything for medication, so while that model might produce some savings for states, it’s really not going to benefit people on Medicaid directly,” said Juliette Cubanski, a KFF vice president and director of its Program on Medicare Policy.
Some Americans will save money on Ozempic and other pricey drugs through TrumpRx, but many people use insurance and will not browse the site.
“For most people, what they notice in their healthcare costs is their insurance premiums. That’s a very visible thing, and the actual price of the drugs behind that? They don’t know. They don’t care,” Mr. Holtz-Eakin said.
With the midterms looming, Republicans get high marks on topics such as border security. But they’re underwater in polling on healthcare, despite Mr. Trump’s drug discounts.
The Republican National Committee said it is not for lack of trying.
It pointed to nearly two dozen instances in which GOP candidates highlighted Mr. Trump’s pricing deals, called for drug price parity with other nations or pushed to codify Mr. Trump’s discounts.
“Republicans have been shouting our wins for working families from the rooftops – including the rapid decline in drug costs – but the failing liberal media won’t print a word of it,” said Republican National Committee spokeswoman Natalie Baldassare.
Some Republicans are latching onto the Most Favored Nations concept, even if they do not use the arcane term.
“Why do your prescription drugs cost so much more in Michigan than they do in Canada?” Mike Rogers, the Republican nominee for Senate in Michigan, says in an ad. “I’ll make sure our healthcare is more affordable.”
Rep. Dan Meuser, a Republican defending his seat in Pennsylvania, is pushing for a legislative stamp on the issue. He filed a bill to write Mr. Trump’s deals into law, saying it “would lock in MFN savings for years to come and ensure that all Americans can purchase drugs at lower prices.”
There is a glaring reason why some lawmakers are talking about potential legislation instead of latching onto Mr. Trump’s deals.
“If you’re a member of Congress, you want to talk about what you did,” Mr. Holtz-Eakin said. “This is all executive action, so they don’t really get anything out of it.”
The White House said Mr. Trump wants to work with Congress to extend the discounts in perpetuity.
“Countless Americans have already saved over $1 billion thanks to President Trump’s Most-Favored-Nation framework through TrumpRx.gov and the Medicare Bridge program,” White House spokeswoman Allison Schuster said. “The White House continues to work with Congress to pass the President’s Great Healthcare Plan to codify his Most Favored Nations deals and expand drug pricing savings for everyday patients.”
Whether that message gets votes for Republicans remains to be seen.
Republicans trail Democrats by at least 20 points in multiple polls asking which party is better on healthcare costs.
The Democratic National Committee said that “in two weeks, voters are going to hold Republicans accountable for hiking healthcare costs and elect Democrats across the board who are fighting to lower costs and make healthcare affordable.”
Mr. Trump used the threat of massive tariffs to prod drugmakers into signing voluntary deals that slashed some prices.
Health experts said Mr. Trump’s confidential arrangements make it hard to study the policy or draw a direct line between the discounted price and what other countries pay for the same drug.
A KFF study from September found that Americans using TrumpRx might pay less or they might pay more than the average price in other developed countries, depending on which drug they choose.
KFF studied 32 brand-name drugs and found the TrumpRx price was lower than the average foreign price for 17 of them. Eight drugs cost at least $100 less than the foreign average.
For the other 15 drugs, the TrumpRx price was higher than the average price in other countries.
Pharmaceutical companies received tariff relief or expedited reviews for their products as part of the negotiations, and companies hope the discounts increase sales and revenue on certain drugs.
“The drug companies actually are making just as much, if not more, money than they were before,” said Avik Roy, chairman and co-founder of The Foundation for Research on Equal Opportunity. “They’re not worried about losing money from these deals at all.”
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