The Future Of Biden’s Health Care Policies Under Trump

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One of President Joe Biden’s great figures, but little known Achievements Efforts are being made to make prescription drugs more affordable. And that effort continues into the 11th hour as Trump prepares to hand over the presidency to Donald Trump.

On Friday morning, the Department of Health and Human Services announced The names of the 15 drugs targeted by Medicare’s new negotiating authority mean the federal government will negotiate directly with manufacturers to lower the prices of these drugs.

IThis is the second time the federal government has undertaken this process, which will take approximately 11 months to complete. big heading This year’s batch includes Ozempic and Wigovy, innovative, popular, and expensive weight loss drugs used to treat diabetes and heart disease. Lower prices would benefit both the federal government (which would have to fund Medicare) and individual seniors (who would have to pay drug insurance premiums and then cover co-pays at pharmacies). can save you money.

None of this would have happened without Biden. That’s because it was Biden’s signature legislative achievement, the Inflation Control Act of 2022, that gave the federal government the power to negotiate. That’s not the only thing we’ve done to make prescription drugs more affordable for Medicare enrollees.

The Comprehensive Climate and Health Act, passed by Congressional Democrats on a party-line vote, introduced a $35 monthly cap on insulin and penalties for manufacturers who raise prices faster than inflation. It also caps total out-of-pocket costs for drugs at $2,000 per year, which alone could make a big difference, especially for seniors and people with disabilities, who often have high drug costs.

Together, these policy changes represent a major part of Biden’s domestic policy agenda, and outgoing Biden administration officials are using these final days to highlight it.

“It was the most meaningful time I have had in years.” Chiquita Brooks LasureA retired Centers for Medicare and Medicaid Services administrator said in a telephone interview. “Just talking to so many people who are on very expensive drugs, so many spouses who continue to work to pay for their husbands’ or wives’ drug insurance, they are no longer… I don’t have the security of being able to retire. I have to worry about my spouse and the younger generation.”

But Brooks Rasul won’t be around to ensure this happens, and neither will Biden. Assuming Trump and Congressional Republicans do not decide to wipe drug pricing off the books completely, it is becoming Trump’s responsibility to implement these drug pricing efforts. And while there are good reasons to think the reforms will be resilient, there are also good reasons to think they are not.

One reason for this is timing. The first round of drug negotiations concluded in August, resulting in lower prices for popular drugs to treat blood clots, diabetes and some cancers. But the new prices won’t take effect until 2026, meaning the projected billions in savings won’t be passed on to individual seniors until then. (Similarly, Ozempic and Wegovy prices will not fall until 2027.)

This long delay may help explain the reason for drug price reform I don’t think so Be registered with the general public. Research shows that these reforms quite popularmeaning people responded favorably when pollsters asked about them. but questionnaire Equally consistently, pollsters have shown that relatively few people know about the reforms being implemented, absent guidance from pollsters.

Perhaps the most shocking discovery was (again): KFFA poll of seniors conducted over the summer found that the group that stands to benefit most directly, the elderly, is the group that seems to be getting the most attention, and that older people generally This is because they pay more attention to politics than groups.

The survey found that only 48% of seniors knew about the power of negotiating new drugs, and even fewer knew about out-of-pocket maximums and inflation penalties. The only feature that the majority recognized was the insulin cap, which was barely recognizable at the time. (In the survey, 52% said they knew about it.)

That lack of awareness will make drug pricing policies even harder to defend if Republicans pursue them, as many believe they do. tilted to do.

Conservatives have long been hostile to the whole idea of ​​the government using its power to force lower drug prices. That’s because a fundamental tenet of conservatism is that markets, competition between private companies, work best when there is minimal effort from government. Among the warnings republican party and their industry allies We know that even if these reforms make medicines a little cheaper now, there will be fewer breakthroughs because there will be less economic incentive to invest in innovation.

Last year’s budget proposal Republican Study CommitteeLawmakers representing conservatives in the House of Representatives and promoting their policy agenda called for: abolish New prescription drug reform. it was project 2025a Heritage Foundation document designed to serve as Trump’s governing agenda for his second term.

said Sen. Mike Crapo (R-Idaho), who is leading the drug repeal bill as chairman of the Finance Committee. Axios Back in September, he was hoping to do so. President Trump has said that HHS will have the authority to enforce the law. Robert F. Kennedy Jr. To lead. Kennedy is no friend of the pharmaceutical industry, but neither is he an experienced administrator who has shown the ability to push an agenda beyond a vaccine attack.

In particular, when it comes to more technical decisions about managing the drug negotiation process, Mr. Kennedy is likely to be at the mercy of other administration officials with more expertise. That could include conservative White House advisers.

That could include Mehmet Oz, whom President Trump nominated to be Medicare administrator. tie To pharmaceutical companies industry already have drawn criticism From consumer advocacy groups.

But other factors are at play, including President Trump’s own unpredictable feelings on drug pricing.

He has been more critical of the pharmaceutical industry than many Republicans, particularly regarding the fact that drug prices are not as low in the United States compared to other countries where the government negotiates the price of all drugs. There is. He also It goes without saying that I praise the achievements of my predecessor.once it turns out to be popular.

It may not be a good idea to expect Mr. Trump to have truly strong feelings about health policy, let alone to act on those policies. However, he is famously sensitive to public opinion, especially among voters. And while drug price reform has so far remained out of the public eye, that could change if Republicans try to weaken or roll back drug price reform.

Trump should know this better than anyone, since he was a key figure in recent vaguely parallel events. That dates back to 2017, when Trump and Republicans tried to repeal the bill. Affordable Medical Care Act — a signature achievement of their then-predecessor Barack Obama — and because polls showed little enthusiasm for the law, they thought it would succeed.

The situation suddenly changed when the public realized that repealing the law would mean millions of people would lose their insurance, and guaranteed coverage for people with pre-existing conditions would also be cut off. This change in public opinion is a major reason why repeal failed, and why Republicans supported repeal. big loss During midterm exam.

Brooks-LaSure said he has seen this pattern before with other health initiatives, saying, “Implementation takes time, and it may be years before the importance of these programs is fully recognized.” It will also take a while. And while this belated approval may not be of much help politically to the elected officials who worked hard to enact the sweeping reforms, opponents have tried to water them down. In this case, the policy itself may become isolated.

However, this process does not occur automatically. For example, in the case of the Affordable Care Act, gaining public attention almost certainly required organizing, education, and mobilization by the program’s champions. It may need to happen again. The sweeping changes to drug prices that are a big part of Biden’s legacy are likely to remain. But only if the people recognize that their future is at risk.