September 24, 2020

America First Health Care

Key Takeaways:

  • Today, President Trump is unveiling a new health care plan that will put Americans first

  • The President and his Administration have taken numerous actions to increase choice and competition in health care to bring down costs, saving Americans billions of dollars

    • The Trump Administration has expanded the use of short-term, limited-duration health insurance (STLD) plans, which offer more choices at lower costs to consumers

    • The Trump Administration has expanded access to Association Health Plans (AHPs), which make it easier for small businesses to band together to offer better insurance and lower premiums for their workers

    • The Trump Administration expanded Health Reimbursement Arrangements (HRAs), allowing employees to use money from their employer to buy the insurance of their choice

  • President Trump has taken a number of actions to dismantle Obamacare, and his Administration’s policies have lowered Obamacare premiums for the first time

  • The Trump Administration is working to protect the most vulnerable in our health care system

    • President Trump is committed to protecting Americans with pre-existing conditions

    • President Trump signed the historic Right to Try legislation, giving terminally ill patients hope and the ability to try new experimental drugs

    • President Trump signed the Childhood Cancer STAR Act, investing $30 million a year for child cancer research

    • President Trump has taken action to expand the availability of organ donations

  • President Trump is working to set ambitious health care goals

    • President Trump put forward principles to stop surprise medical billing

    • In 2019, President Trump set a goal to end the HIV/AIDS epidemic in the United States within a decade

  • President Trump is aggressively fighting to bring down drug prices and the American people are seeing the results

    • The White House Council of Economic Advisors has said the U.S. is making progress on drug prices at rates not seen since the 1960s

    • So far, in every year of the Trump Administration, the FDA has approved a record number of generic drugs, delivering cheaper alternatives to name brands

    • The Trump Administration released new principles for reducing the cost of prescription drugs which was praised by both Republicans and Democrats

    • President Trump signed legislation to improve transparency in drug pricing and is fighting to bring lower drug prices that the rest of the world sees to America

    • The Trump Administration is helping Medicare recipients by providing better price transparency and eliminating kickbacks, saving thousands of dollars for America’s seniors

    • The Trump administration has worked to allow the importation of cheaper drugs from Canada and other countries to reduce prescription drug costs

    • President Trump worked to help lower income Americans gain access to life-saving medications, including insulin, at affordable costs

PRESIDENT TRUMP HAS TAKEN ACTION TO EXPAND CHOICE AND COMPETITION IN HEALTH CARE, LOWERING PRICES

Expanding Short-Term, Limited Duration Health Plans (STLDs)

The Trump Administration Has Expanded The Availability Of Short-Term, Limited-Duration (STLD) Plans, Which Offers Consumers More Choice And Plans That “Typically Cost Less Than Half Of Obamacare Plans.” “President Trump’s Administration took action last year to expand short-term, limited-duration plans, giving Americans more access to plans that fit their needs. Subject to State regulation, these plans can be offered for up to 364 days and renewed for up to 36 months after the Obama Administration limited them to 3 months. Short-term health plans are a particularly attractive option for the nearly 30 million uninsured people with gaps in employment, and those most hurt by rising premiums. Short-term health plans typically cost less than half of the cost of Obamacare plans.” (“President Donald J. Trump’s Healthcare Actions To Expand Choices And Lower Costs Are Producing Real Results,” The White House, 2/8/19)

  • An Estimated 1.7 Million People Who Would Otherwise Be Uninsured Are Expected To Enroll In STLD Plans, According To An Estimate From The Urban Institute. “About 1.7 million of the people buying STLD policies would have been uninsured (in the traditional sense) under current law, and 2.6 million STLD policy holders would otherwise have had insurance of some type.” (Linda J. Blumberg, Matthew Buettgens, And Robin Wang, “Updated: The Potential Impact Of Short-Term Limited-Duration Policies On Insurance Coverage, Premiums, And Federal Spending,” Urban Institute, 3/18)

  • A Report By The White House Council Of Economic Advisers Found That The Trump Administration’s Expansion Of STLDs Will Produce $82 Billion Of Benefits Over A Ten Year Period. (The Council Of Economic Advisors, “Deregulating Health Insurance Markets: Value To Market Participants,” The White House, 2/19)

Increasing Access To Association Health Plans (AHPs)

The Trump Administration Issued A Rule Making It Easier For Small Businesses And Self-Employed Workers To Join Together To Form Association Health Plans (AHPs), Increasing The Availability And Choice Of Insurance For These Workers. “Last year, the Administration introduced a second pathway for employers to join together to form Association Health Plans and provide more affordable health coverage to employees. A new report found that 28 AHPs have formed already, with more under development, and offer coverage similar to employer-based coverage. Some AHPs show up to 30 percent savings on premiums.” (“President Donald J. Trump’s Healthcare Actions To Expand Choices And Lower Costs Are Producing Real Results,” The White House, 2/8/19)

There Are A Number Of Examples Of Association Health Plans Leading To Lower Premiums For Workers: (“Successful Association Health Plans,” U.S. Chamber Of Commerce, Accessed 11/1/19)

  • The Las Vegas Metro Chamber Of Commerce’s AHP Reduced Employees’ And Employers’ Costs By An Average Of 49 Percent And 13 Percent Respectively. “The Las Vegas Metro Chamber has reported that it was able to negotiate terms, such as a two-year rate lock, to prevent precisely the sort of premium volatility that made the individual and small-group markets untenable before the Final Rule. Specifically, their plan reduced employees’ and employers’ costs by an average of 49% and 13%, respectively.” (“Successful Association Health Plans,” U.S. Chamber Of Commerce, Accessed 11/1/19)

  • In Southern Nevada, Clark County’s AHP Allows Members To Save Up To 30 Percent On Annual Premiums. “The Clark County Health Plan Association in Southern Nevada, led by the Henderson Chamber of Commerce, covers more than 10,000 people. Since September 2018, it has offered a range of health plans for working owners and small businesses that save members up to 30% on annual premiums, with no rate increases until summer or fall of 2020.” (“Successful Association Health Plans,” U.S. Chamber Of Commerce, Accessed 11/1/19)

  • The Lubbock, Texas Chamber Of Commerce’s AHP Offered Savings Of Up To 30 Percent On Premium Rates. “The Lubbock Chamber of Commerce created an association health plan that offered several plan designs and resulted in similar savings of up to 30% on premium rates.” (“Successful Association Health Plans,” U.S. Chamber Of Commerce, Accessed 11/1/19)

Expanding Health Reimbursement Arrangements (HRAs)

The Trump Administration Issued A Rule To Expand Health Reimbursement Arrangements (HRAs), Which Allow Workers Use Money From Their Employer To Buy The Insurance Of Their Choice On The Individual Market. “President Donald J. Trump is expanding Health Reimbursement Arrangements (HRAs), opening new coverage options for American workers. The Trump Administration has finalized a rule to expand HRAs, giving businesses a better way to offer health insurance coverage. Under the rule, employers will be able to provide their workers with tax-preferred funds to pay for the cost of health insurance coverage that workers purchase in the individual market. This rule will particularly benefit small businesses that face significant costs in offering a traditional group health plan and businesses that do not currently offer coverage.” (“President Donald J. Trump Is Working To Improve Health Insurance Coverage For American Workers And Help Small Businesses,” The White House, 6/14/19)

Expanding Access to Telehealth

Under The Trump Administration, The Centers For Medicare And Medicaid Expanded Medicare Coverage For Telehealth. “Bold action by President Trump and his administration made this explosive growth possible. The Centers for Medicare & Medicaid Services dramatically expanded Medicare coverage for telehealth, doubling the number of services that can be provided through telehealth to include everything from emergency department visits to eye exams and therapy services.” (Secretary Alex M. Azar II, “Trump Administration Aims To Keep Telehealth Revolution Here To Stay,” USA Today, 7/31/20)

DISMANTLING OBAMACARE, LOWERING PREMIUMS

Eliminating The Individual Mandate Penalty

President Trump’s Tax Cuts Eliminated Obamacare’s Burdensome Individual Mandate Penalty, Which Forced Americans To Buy Health Insurance Whether They Wanted To Or Not. “President Trump’s historic tax reform legislation removed the burdensome individual mandate tax penalty. Obamacare’s individual mandate coerced people into buying health insurance they did not want and burdened taxpayers because the plans are so heavily subsidized.” (Fact Sheets, “President Donald J. Trump’s Healthcare Actions To Expand Choices And Lower Costs Are Producing Real Results,” The White House, 2/9/19)

Despite The Elimination Of The Individual Mandate Penalty, The Insured Rate Has Held Steady. “The newest evidence comes from census data released Tuesday, which shows health coverage in the United States held relatively steady in 2019, even though the elimination of the mandate penalties took effect that year.” (Sarah Kliff, “Republicans Killed the Obamacare Mandate. New Data Shows It Didn’t Really Matter.,” The New York Times¸ 9/21/20)

  • “Many Experts Now View The Individual Mandate As A Policy That Did Little To Increase Health Coverage.” (Sarah Kliff, “Republicans Killed the Obamacare Mandate. New Data Shows It Didn’t Really Matter.,” The New York Times¸ 9/21/20)

In 2016, Nearly 5 Million Americans Were Forced To Pay The Individual Mandate Penalty, Costing Them $3.6 Billion. (“Obamacare’s Poverty Tax: Americans Paying individual Mandate Tax Penalty,” Senator Steve Daines, 2016)

  • 77 Percent Of These Taxpayers Earned Less Than $50,000 A Year. (“Obamacare’s Poverty Tax: Americans Paying individual Mandate Tax Penalty,” Senator Steve Daines, 2016)

  • 34 Percent Of These Taxpayers Earned Less Than $25,000 A Year. (Alex Hendrie and Gillian Richards, “GOP Tax Cuts Abolished Obamacare Individual Mandate Tax,” Americans For Tax Reform, 10/9/18)

Repealing Obamacare’s Independent Payment Advisory Board (IPAB)

In February 2018, President Trump Signed Legislation Repealing Obamacare’s Independent Payment Advisory Board (IPAB). “This week, Congress did away with another unpopular provision: the law’s Independent Payment Advisory Board. The IPAB, which has been unfairly labeled a rationing board or  ‘death panel,’ was designed to help tame runaway Medicare costs, should they ever arise.” (Margot Sanger-Katz, “Another Of Obamacare’s Unloved Provisions Is Gone,” The New York Times, 2/9/18)

  • In February 2018, President Trump Signed H.R. 1892, The Bipartisan Budget Act Of 2018, Which Included A Provision That Repealed IPAB. (H.R. 1989, Signed 2/9/18)

The IPAB Was Viewed As Unpopular Among Both Democrats And Republicans. “But the idea was never particularly popular, even in the Congress that voted for it. The IPAB would have taken away Congress’s power to make the cost-saving choices it wanted — or its choice to avoid them.” (Margot Sanger-Katz, “Another Of Obamacare’s Unloved Provisions Is Gone,” The New York Times, 2/9/18)

For The First Time, Obamacare Premiums Are Going Down

In 2019, Average Premiums For Obamacare Plans Dropped, The First Time Since Obamacare Was Signed Into Law. “After two years of double-digit price hikes, the average premium for individual health coverage on the federal health law’s insurance marketplace will drop by 1.5 percent for 2019, the Trump administration said Thursday.” (“Obamacare Premiums Dip For First Time. Some Call It A Correction,” Kaiser Health News, 10/11/18)

  • In 2019, The Average Premiums For The Lowest-Cost Bronze, Silver, And Gold Plans All Declined. (Kaiser Family Foundation, Accessed 9/11/19)

In 2020, The Average Premium For The Benchmark Obamacare Plan Dropped By 4 Percent. “The Affordable Care Act is looking stronger for 2020 -- and the Trump administration is claiming credit for it, even as officials try to upend the landmark health reform law. The average premium for the benchmark plan will drop by 4% next year in the 38 states using the federal Obamacare exchanges -- the second year in a row of lower rates.” (Tami Luhby, “Obamacare Premiums Are Dropping 4% For 2020 Plans.” CNN, 10/22/19)

  • For 2020, The Average Premiums For The Lowest-Cost Bronze, Silver, And Gold Plans Are All Declining. (Kaiser Family Foundation, Accessed 11/1/19)

From 2014 To 2017, Average Premiums For Benchmark Obamacare Plans Increased From $273 To $359, Or 31.5 Percent, According To The Kaiser Family Foundation. (Kaiser Family Foundation, Accessed 9/23/20)

  • For The Last Two Years, 2019 – 2020, The Cost Of A Benchmark Obamacare Plan Has Dropped By 4 Percent. (Kaiser Family Foundation, Accessed 9/23/20)

There Are More Health Insurers On The Obamacare Exchanges

The Trump Administration Has Seen An Increase In Issuers That Participate In States That Use Obamacare Exchanges. “Additionally, 20 more issuers will participate in states that use the Federal Health Insurance Exchange platform in 2020 bringing the total to 175 issuers compared to 132 in 2018, delivering more choice and competition for consumers. As a result of the Trump Administration’s actions to stabilize the market, Americans will experience lower premiums along with greater choice for the second consecutive year.” (Press Release, “Premiums For HealthCAre.Gov Plans Are Down 4 Percent But Remain Unaffordable To Non-Subsidized Consumers,” Center For Medicare & Medicaid Services, 10/22/19)

In 2020, 68 Percent Of Obamacare Enrollees Had A Choice Of Three Or More Insurers, Up From 44 Percent In 2018. (“Plan Year 2020 Qualified Health Plan Choice And Premiums In HealthCare.Gov States,” Center For Medicare & Medicaid Services, 10/22/19)

Under President Trump, Obamacare Enrollees Have Enjoyed Greater Choice In Healthcare Insurers. “Insurance company margins have continued to improve during 2018, and a number of insurers entered the market or expanded their service area for 2019. The average number of companies per state in 2019 is 4.0, ranging from one company in five states (Alaska, Delaware, Mississippi, Nebraska, and Wyoming) to more than 10 companies in three states (California, New York and Wisconsin). In 2019, 58% of enrollees (living in about 23% of counties) have a choice of three or more insurers, up from 48% of enrollees in 2018.” (Rachel Fehr, Cynthia Cox, And Larry Levitt, “Insurer Participation On ACA Marketplaces, 2014-2019,” Kaiser Family Foundation, 11/14/18)

PRESIDENT TRUMP IS PROTECTING THE MOST VULNERABLE

Protecting Americans With Pre-Existing Conditions

President Trump Is Committed To Protecting Americans With Preexisting Conditions. “The President has reaffirmed that protecting Americans with preexisting conditions is fundamental to his healthcare agenda.” (Fact Sheets, “President Donald J. Trump’s Healthcare Agenda Puts Seniors And American Patients First,” The White House, 10/3/19)

Signing The Right To Try Act

In May 2018, President Trump Signed The Right To Try Act Into Law. “President Donald Trump signed the ‘Right to Try Act’ Wednesday, a measure aimed at helping terminally ill patients access drug treatments that are yet to be fully approved by the Food and Drug Administration. Trump, at a White House ceremony surrounded by patients and families who will be affected by the legislation, said his administration ‘worked hard on this’ but said repeatedly he didn't understand why it hadn't been done before.” (Allie Malloy, “Trump Signs ‘Right To Try Act’ Aimed At Helping Terminally Ill Patients Seek Drug Treatments,” CNN , 5/30/18)

  • The Right To Try Act Allows Certain Unapproved Experimental Drugs To Be Used By Terminally Ill Patients. “The bill amends Federal law to allow certain unapproved, experimental drugs to be administered to terminally ill patients who have exhausted all approved treatment options and are unable to participate in clinical drug trials.” (“President Donald J. Trump To Sign Right To Try Legislation Fulfilling The Promise He Made To Expand Healthcare Options For Terminal Americans,” The White House, 5/30/18)

Investing In Pediatric Cancer Research

In 2019, President Trump Asked Congress For $500 Million In Pediatric Cancer Research Over The Next Ten Years. PRESIDENT DONALD TRUMP: “Many childhood cancers have not seen new therapies in decades.  My budget will ask the Congress for $500 million over the next 10 years to fund this critical life-saving research.” (President Donald Trump, President Donald J. Trump’s State Of The Union Address, Washington, D.C., 2/5/19)

In 2018, President Trump Signed The Childhood Cancer STAR Act, Which Appropriates $30 Million A Year For Pediatric Cancer Research, All While Increasing The NIH’s Budget From $36 Billion To $39 Billion. “Last year, Trump signed the Childhood Cancer STAR Act, which appropriates $30 million a year for the NIH and the Centers for Disease Control and Prevention to spend on research for childhood cancer. Under Trump, the NIH’s budget has increased from $36 billion in 2017 to an estimated $39 billion in 2019.” (Victoria Knight, “Trump’s Pediatric Cancer crusade A Drop In Bucket Compared With Past Presidential Pitches,” Kaiser Health News, 2/8/19)

Making Organ Implants Easier And Increasing The Supply Of Organs

In 2019, President Trump Signed An Executive Order To Help Over 113,000 Americans Who Are Waiting For A Life-Saving Organ Donation. “As a key goal, the President’s Executive Order and this proposed rule seek to help the more than 113,000 people in the United States currently on the wait list for a lifesaving organ transplant, which far exceeds the number of transplantable organs available.” (Press Release, “Organ Procurement Organization (OPO) Conditions For Coverage Proposed Rule: Provisions to Outcome Measures For OPOs,” U.S. Centers For Medicare & Medicaid Services, 12/17/19)

Under President Trump, The U.S. Health Resources & Services Administration Proposed Changes To Cover The Expenses Lost Wages, Child-Care, And Elder-Care For Living Organ Donors. “On December 17, 2019, Health Resources and Services Administration (HRSA) announced a Notice of Proposed Rulemaking (NPRM) which proposes to expand the scope of reimbursable expenses incurred by living organ donors to include lost wages and child-care and elder-care expenses. This proposal, once finalized, would remove potential barriers to living organ donations.” (“Notice Of Proposed Rulemaking (NRPM) To Amend The Regulations Implementing The National Organ Transplant Act Of 1984 (NOTA),” U.S. Health Resources & Services Administration, 12/17/19)

  • This New Proposal Will Increase The Number Of Transplants And Improve Overall Health Outcomes Of Americans Receiving Organ Transplants. “Health outcomes would also improve, since recipients of kidneys from living donors fare better than those whose donors have died.” (Mary Vought, “Trump Delivers A Vital Christmas Gift,” The Wall Street Journal, 1/8/20)

The Centers For Medicare And Medicaid Services Issued New Proposed Rules That Would Improve The Transparency Of the Organ Procurement Organizations (OPO), Allowing Better And Reliable Support For Higher Donation Rates. Specifically, this proposed rule would revise the outcome measures for assessing OPO performance to ensure they are transparent, reliable, and enforceable; support higher donation rates; help shorten transplant wait lists; reduce discarded but viable organs; and increase safe, timely transplants that save lives.” (Press Release, “Organ Procurement Organization (OPO) Conditions For Coverage Proposed Rule: Provisions to Outcome Measures For OPOs,” U.S. Centers For Medicare & Medicaid Services, 12/17/19)

SETTING AMBITIOUS HEALTH CARE GOALS

Stopping Surprise Medical Billing

In May 2019, President Trump Put Forward Principles To Address The Issue Of Surprise Medical Billing. “The Trump Administration believes that any effort to address the issue of surprise billing should be undertaken with these principles in mind.” (“President Donald J. Trump Wants To Protect Patients And Their Families From Surprise Billing,” The White House, 5/9/19)

  • Patients Receiving Emergency Care Should Not Be Forced To Shoulder Extra Costs Billed By A Care Provider But Not Covered By Their Insurer. (“President Donald J. Trump Wants To Protect Patients And Their Families From Surprise Billing,” The White House, 5/9/19)

  • Patients Receiving Scheduled Care Should Have Information About Whether Providers Are In Or Out Of Their Network And What Costs They May Face. (“President Donald J. Trump Wants To Protect Patients And Their Families From Surprise Billing,” The White House, 5/9/19)

  • Patients Should Not Receive Surprise Bills From Out-Of-Network Providers They Did Not Choose. (“President Donald J. Trump Wants To Protect Patients And Their Families From Surprise Billing,” The White House, 5/9/19)

  • Federal Spending On Health Care Should Not Increase. (“President Donald J. Trump Wants To Protect Patients And Their Families From Surprise Billing,” The White House, 5/9/19)

There Is Bipartisan Congressional Support To Address Surprise Medical Billing. “Following the announcement, Energy and Commerce Chairman Frank Pallone Jr, D-New Jersey, and Ranking Member Greg Walden, R-Oregon, released a joint statement voicing their commitment to working on bipartisan legislation. ‘No family should be left in financial ruin through no fault of their own, which is why we have been working together on a bipartisan solution to protect patients that we hope to announce soon,’ they said.” (Jaime Rosenberg, “Trump Outlines Plan To Tackle Surprise Medical Billing,” AJMC, 5/9/19)

Ending HIV/AIDS Transmission

During President Trump’s 2019 State Of the Union Address, The President Pledged To End The AIDS Epidemic In America Within A Decade. PRESIDENT DONALD TRUMP: “In recent years we have made remarkable progress in the fight against HIV and AIDS. Scientific breakthroughs have brought a once-distant dream within reach. My budget will ask Democrats and Republicans to make the needed commitment to eliminate the HIV epidemic in the United States within 10 years. We have made incredible strides. Incredible. Together, we will defeat AIDS in America. And beyond.” (President Donald Trump, President Donald J. Trump’s State Of The Union Address, Washington, D.C., 2/5/19)

  • The U.S. Department Of Health And Human Services Plans To Invest In Resources And Data Tracking Efforts To Bolster Disease Prevention. “Health and Human Services Secretary Alex Azar, who provided details of the initiative after Trump’s announcement, said the administration will target viral hot spots by providing local groups more resources, using data to track the spread of the disease and creating local task forces to bolster prevention and treatment.” (Carmen Heredia Rodriquez, “Trump Pledges To End HIV Transmission By 2030. Doable But Daunting.,” Kaiser Health News, 2/6/19)

THE TRUMP ADMINISTRATION’S DRUG POLICIES ARE GETTING RESULTS

The Council Of Economic Advisors Have Said Prescription Drug Prices Have Fallen Below Their Historical Trend

During The Trump Administration, Increases In The Cost Of Prescription Drugs Have Fallen Below The Historic Trend According To The Council Of Economic Advisors. “While the media continues to claim prescription drug prices are rising, a recent Council of Economic Advisers (CEA) paper shows the opposite: Under President Trump, prescription drug prices are decreasing at rates not seen since the 1960s. In the eight years prior to President Trump’s inauguration, prescription drug prices increased by an average of 3.6 percent per year. Fast forward to today, and prescription drug prices have seen year-over-year declines in nine of the last ten months, with a 1.1 percent drop as of the most recent month. In June 2019, the United States saw the largest single-year drop (2.0 percent year-over-year decline) in prescription drug prices since 1967.”  (“Prescription Drug Prices Are Falling at Historic Levels Thanks to Trump Administration Policies.” Council Of Economic Advisors, The White House, 11/5/19)

  • Council Of Economic Advisors: “Under President Trump, Prescription Drug Prices Are Decreasing At Rates Not Seen Since The 1960s.” (“Prescription Drug Prices Are Falling at Historic Levels Thanks to Trump Administration Policies.” Council Of Economic Advisors, The White House, 11/5/19)

  • Council Of Economic Advisors: “The Media’s Narrative About Rising Drug Prices, While Perhaps True For Individual Drugs Or Certain Classes Of Drugs, Is Not True For General Drug Prices.” “The media’s narrative about rising drug prices, while perhaps true for individual drugs or certain classes of drugs, is not true for general drug prices due to limitations in frequently cited reports. These misleading reports make broad claims even though they consider only narrow measures like list prices, brand name drugs, or drugs with recent price increases. Additionally, some reports use unknown methodologies (see the Appendix of CEA’s paper for more details about other reports’ flaws).” (“Prescription Drug Prices Are Falling at Historic Levels Thanks to Trump Administration Policies.” Council Of Economic Advisors, The White House, 11/5/19)

The Trump Administration Has Approved A Record Number Of Generic Drugs Every Year From 2017 Through 2019, Saving Americans Billions

In 2019, The Food And Drug Administration (FDA) Approved A Record Number Of Generic Drugs, From 971 In 2018 to 1,171 In 2019. (Press Release, “Secretary Azar Statement On FDA’s 2019 Generic Drug Approval Record,” U.S. Department Of Health And Human Services, 10/16/19)

“In 2018, The Food And Drug Administration (FDA) Approved A Record Number Of Generic Drugs, Breaking The Previous Record Set By The Administration In 2017.” (“The Historic Results Of President Donald J. Trump’s First Two Years In Office,” The White House, 1/20/19)  

  • “The FDA’s Fiscal Year (FY) 2017 Generic Drug Approvals Are Expected To Bring Nearly $9 Billion In Savings In 2017 Alone.” (“The Historic Results Of President Donald J. Trump’s First Two Years In Office,” The White House, 1/20/19) 

  • “[These] Included The First-Ever Approvals Of A Generic Competitor To The Epipen And A Generic Competitor For A Common Asthma Inhaler.” (Alex Azar, “How President Trump Is Delivering Results On Drug Prices,” The Kansas City Star, 5/30/19) 

Since January 2017, The Influx Of Generic Drugs Had “Saved Consumers $26 Billion” And Is Providing “An Estimated $43 Billion In Annual Benefits To Consumers” According To A 2018 Report From The White House Council Of Economic Advisers. “We find that relative annual price growth for prescription drugs has slowed since January 2017, and estimate that lower prices from new generic drug products saved consumers $26 billion through July 2018. We also argue that the influx of new brand name drugs should be viewed as implicitly lowering the price of improved health, even though the methods currently being used to estimate changes in drug prices do not reflect this. Implicit price reductions from new, brand name drugs since January 2017 are providing an estimated $43 billion in annual benefits to consumers.” (“The Administration’s FDA reforms And Reduced Biopharmaceutical Drug Prices,” Council Of Economic Advisers, 10/18) 

White House Released Principles For Reducing Drug Costs

In March, The White House Outlined Principles For Reducing Prescription Drug Prices. (Press Release, “Statement from the Press Secretary,” The White House, 3/10/20)

  • Capping Out-Of-Pocket Expenses Will Help Seniors Who “Often Bear The Brunt Of The High Cost. “Cap out-of-pocket expenses in Medicare Part D. Seniors with the most expensive conditions often bear the brunt of high drug prices, despite a program ostensibly designed to mitigate catastrophic costs. The unlimited cost-sharing of the Medicare Part D benefit leaves more than one million beneficiaries on the hook for potentially thousands in additional spending annually.” The Wall Street Journal, 3/10/20)

  • A Cost Gimmick In Obamacare Caused Some Seniors To Have To Pay Up To An Additional $1,250 Per Year.  “Offer protection against the cost cliff created by ObamaCare. The recent expiration of a temporary ObamaCare gimmick has increased the amount some seniors must pay out-of-pocket by up to $1,250 a year. They need relief until the new out-of-pocket cap can be implemented.”  (Stephanie Armour and Thomas M. Burton, “U.S. Advances Plan to Allow Imports of Some Drugs in Bid to Cut Prices., The Wall Street Journal, 12/18/19)

  • Limiting Drugmakers’ Price Increases Will Limit Price Gouging. “Limit drugmakers’ price increases. The price Medicare Part B pays for one common rheumatoid-arthritis drug increased on average more than 15% each year from 2014-18. That increased spending in Medicare on this one drug alone by more than $340 million a year during that span. This price gouging can be limited without jeopardizing future innovation.” (Stephanie Armour and Thomas M. Burton, “U.S. Advances Plan to Allow Imports of Some Drugs in Bid to Cut Prices., The Wall Street Journal, 12/18/19)

The Trump Administration’s Principles For Drug-Pricing Have Been Labeled As “Achievable” And Endorsed By Both Republicans And Democrats In Congress. “These White House principles for drug-pricing legislation are achievable. They have been endorsed by members of Congress from both sides of the aisle. Elements of each principle are reflected in the bipartisan policies in both Senate Finance Committee Chairman Chuck Grassley and Ranking Member Ron Wyden’s drug package and a bill introduced by Rep. Greg Walden (R., Ore.), ranking member of the House Energy and Commerce Committee. Additionally, though the White House opposes the Democrat-backed H.R. 3 (styled the Elijah E. Cummings Lower Drug Costs Now Act), elements of the bill, such as the Part D redesign, are consistent with these principles.” (Joe Grogan, “White House Principles For Reducing Drug Costs,” The Wall Street Journal, 3/10/20)

Taking Action To Lower Drug Prices

In 2018, The Trump Administration Released The American Patients First Blueprint, “A Comprehensive Plan To Bring Down Prescription Drug Prices And Out-Of-Pocket Costs.” “To address this issue, in May 2018, President Donald Trump and Health and Human Services (HHS) Secretary Alex Azar released the American Patients First blueprint, a comprehensive plan to bring down prescription drug prices and out-of-pocket costs. Since the launch of the blueprint, the men and women of HHS have been taking action across the department’s programs and authorities to turn the President’s vision into action, and improve the health and well-being of every American.” (“Drug Pricing,” Department Of Health And Human Services, Accessed 7/1/19) 

  • Within 100 Days Of The Blueprint’s Release, “15 Drug Companies…Reduced List Prices, Rolled Back Planned Price Increases, Or Committed To Price Freezes For The Rest Of 2018.” (Press Release, “100 Days of Action On The President’s American Patients First Blueprint,” Department Of Health And Human Services, 8/20/18) 

Signing Legislation To Give Americans More Information On Drug Pricing

The President Signed The Know The Lowest Price Act And The Patient Right To Know Drug Prices Act In October 2018. (“President Donald J. Trump Is Ensuring Patients Receive The Information They Need To Save Money On Prescription Drugs,” The White House, 10/10/18)

In 2018, President Trump Signed Into Law Legislation That Eliminated The Pharmacy ‘Gag Clause,’ Increasing Health Care Transparency And Savings. “Pharmacists around the country say they have often been forbidden to share information on drug pricing with customers. The restrictions, they say, have been imposed by companies that manage drug benefits for insurers and employers. The legislation will ‘completely end these unjust gag clauses once and for all,’ Mr. Trump said.” (Robert Pear, “Trump Signs New Laws Aimed At Drug Costs And Battles Democrats On Medicare,” The New York Times, 10/10/18)

  • Pharmacists Are Now Able To Inform Patients About Cheaper Methods To Buy Prescription Drugs. “Today, @POTUS signed legislation banning pharmacy gag clauses which prevent pharmacists from informing patients when they can pay less out of pocket for a Rx drug. This bipartisan legislative accomplishment was secured by President Trump’s historic leadership on drug pricing.” (Secretary Alex Azar, Twitter, 10/10/18)

President Trump Implemented Medicare Reforms To Save Seniors $320 Million In Drug Prices In 2018 

“The Administration Implemented Reforms To The Amount Medicare Pays Hospitals For Drugs That Are Purchased Under The 340B Program, Saving Seniors $320 Million In 2018.” (“The Historic Results Of President Donald J. Trump’s First Two Years In Office,” The White House, 1/20/19)

By April 2018, It Was Estimated That Medicare Recipients Had Saved $320 Million On Out-Of-Pocket Payments On These Drugs. “Due to CMS’s policy change last year, Medicare beneficiaries are currently benefiting from the discounts that 340B hospitals receive. Beneficiaries are saving an estimated $320 million on out-of-pocket payments for these drugs in 2018 alone.” (Press Release, “CMS Lowers The Cost Of Prescription Drugs For Medicare Beneficiaries," Centers For Medicare And Medicaid Services, 4/2/18)

Fighting To Modernize The Medicare Payment System To Lower The Cost Of Prescription Drugs For Millions Of Medicare Recipients 

In November 2017, The Centers For Medicare And Medicaid Took An “Important Step” And Released A Memo Regarding A Revision In The Physician Fee Schedule That Would “Modernize The Medicare Payment System.” “As part of the President's priority to reduce drug costs for Americans, CMS is taking an important step in the Physician Fee Schedule to modernize the Medicare payment system through innovation in the biopharmaceutical market.” (Press Release, “CMS Finalizes Policies That Reduce Provider Burden, Lower Drug Prices,” Centers For Medicare And Medicaid Services, 11/2/17) 

  • The Notice Announced That In 2018, CMS Would Begin Updating Payments For "Biosimilars," Which Are Lower-Cost Alternatives To Certain Prescription Drugs Which Would Promote Competition And Make Sure That Patients “Have Access To Lower Cost Therapies.” “Beginning in 2018, CMS will update payment for biosimilars, which are lower-cost alternatives to certain types of drugs known as ‘biologicals.’ This change promotes competition to ensure millions of patients will have access to new lower cost therapies.” (Press Release, "CMS Finalizes Policies That Reduce Provider Burden, Lower Drug Prices," Centers For Medicare And Medicaid Services, 11/2/17) 

  • In April 2018, CMS Released Final Policies That Would Reduce The “Maximum Amount” That A Low-Income Beneficiary Would Pay For Certain Prescription Biosimilars. “The final policies announced today further the Trump Administration's commitment to lowering drug prices. CMS is finalizing a reduction in the maximum amount that low-income beneficiaries pay for certain innovative medicines known as ‘biosimilars.’” (Press Release, "CMS Lowers The Cost Of Prescription Drugs For Medicare Beneficiaries," Centers For Medicare And Medicaid Services, 4/2/18) 

The Trump Administration Has Finalized New Actions To Increase Drug Price Transparency And Drug Pricing Negotiating Power For Medicare Plans 

In May 2019, CMS Finalized New Regulations That Require Medicare Part D Plans To Provide Better Price Transparency Tools To Physicians To Use When Discussing Out Of Pocket Costs With Medicare Beneficiaries. “Today’s rule requires Part D plans to adopt tools that provide clinicians with information that they can discuss with patients on out-of-pocket costs for prescription drugs at the time a prescription is written. By empowering patients with information on the cost of their prescription drugs, today’s rule will ensure that pharmaceutical companies have to compete on the basis of price.” (Press Release, “CMS Takes Action To Lower Prescription Drug Prices And Increase Transparency,” Centers For Medicare & Medicaid Services, 5/16/19) 

In 2018, CMS Rescinded A Policy That “Discouraged Medicare Advantage Plans From Using Tools That Are Widely Used In Private Insurance Plans To Negotiate Lower Prices From Pharmaceutical Companies.” “The Centers for Medicare & Medicaid Services is rescinding a policy regarding Medicare Part B drugs that discouraged Medicare Advantage plans from using tools that are widely used in private insurance plans to negotiate lower prices from pharmaceutical companies. Specifically, patients will now be able to choose Medicare Advantage plans that require enrollees to try certain more cost-effective drugs first (known as “step therapy”). Plans will also be able to cross-manage between the drugs covered by different parts of Medicare, allowing them to pay for the most appropriate, most affordable drugs, regardless of whether patients receive them in a doctor’s office (Part B) or at a pharmacy (Part D).” (Press Release, “Trump Administration Gives Medicare New Tools To Negotiate Lower Drug Prices For Patients,” Department Of Health And Human Services, 8/7/18) 

The Trump Administration Is Enforcing Anti-Kickback Laws That Will Save Hundreds Of Thousands Of Dollars For Prescription Drug Recipients

In July 2020, President Trump Signed An Executive Order That Will Lower Prices For Patients By Eliminating Kickbacks To Middlemen. (“Executive Order On Lowering Prices For Patients By eliminating Kickbacks To Middlemen,” The White House, 7/24/20)

  • President Trump’s Executive Order Will Initiate Anti-Kickback Statues, Allowing Tens Of Billions Of Dollars Of Prescription Drug Rebates To Go Directly Back To Patients, Saving Them Hundreds Or Thousands Of Dollars A Year. “Fixing this problem could save Medicare patients billions of dollars.  The Office of the Inspector General at the Department of Health and Human Services has found that patients in the catastrophic phase of the Medicare Part D program saw their out-of-pocket costs for high-price drugs increase by 47 percent from 2010 to 2015, from $175 per month to $257 per month.  Narrowing the safe harbor for these discounts under the anti-kickback statute will allow tens of billions in dollars of rebates on prescription drugs in the Medicare Part D program to go directly to patients, saving many patients hundreds or thousands of dollars per year at the pharmacy counter.” (“Executive Order On Lowering Prices For Patients By eliminating Kickbacks To Middlemen,” The White House, 7/24/20)

Health And Human Services Secretary Alex Azar Estimated The Reform Would Save Seniors $30 Billion Each Year. “Alex Azar, secretary of the Department of Health and Human Services, told reporters on a conference call after the signing ceremony that drug companies currently pay about $150 billion in undisclosed kickbacks to middlemen often in exchange for more favorable insurance coverage for their drugs. ‘The new rule would require those kickbacks be passed through to our seniors when they walk into the pharmacy,” Azar said, adding that it would reduce prescription drug costs for senior by about 26% to 30% or $30 billion a year.’”  (Noah Higgins-Dunn, Jasmine Kim and Berkeley Lovelace Jr. “Trump Signs Series Of Executive Orders Aimed At Lowering Drug Costs,” CNBC, 8/6/30)

GLOBAL FREELOADING PROPOSAL

Fighting To Eliminate The Price Difference Between Drugs In The U.S. And In Foreign Countries

President Trump Has Proposed Ending So-Called “Global Freeriding” By Linking The Price Of Some Drugs To Its Price Overseas – Which Is Often Lower Than In The United States. “Another major proposal by the Trump administration would limit the price of some drugs covered by Medicare that are administered in a clinic or doctor’s office — expensive medications used for serious illnesses like cancer — by tying them to an index based on the price of the drugs in other countries. The United States pays higher prices for drugs than any other country does, a situation that Mr. Trump describes as ‘global free-riding.’” (Katie Thomas, “Drug Prices Are A Populist Campaign Issue. Here Are The Latest Proposals To Lower Costs.,” The New York Times, 6/16/19)

Allowing Drug Importation

In December 2019, The Trump Administration Announced A Plan To Allow The Importation Of Cheaper Drugs From Canada And Other Countries To Reduce Prescription Drug Costs. “The Trump administration is moving forward on a plan to allow the importation of cheaper drugs from Canada and other countries as part of its effort to reduce prescription costs. The Food and Drug Administration will announce a rule letting states develop plans to import certain prescription drugs from Canada, federal officials said. About a dozen states, including Colorado and Florida, have pressed for permission to import drugs that meet U.S. quality standards.”  (Stephanie Armour and Thomas M. Burton, “U.S. Advances Plan to Allow Imports of Some Drugs in Bid to Cut Prices., The Wall Street Journal, 12/18/19)

  • The Plan Followed A Similar Release In July 2019 That Could Lead To The Importation Of Lower-Cost Prescription Drugs From Canada. “The Trump administration on Wednesday said it was taking steps that might eventually lead to the importation of some lower-cost prescription drugs from Canada, an idea supported by President Trump but long opposed by many Republicans, including some of his own aides.” (Asmeen Abutaleb and Laurie McGinley, “Trump Administration Outlines Plans For Eventual Importation Of Cheaper Drugs,” The New York Times, 7/31/19) 

In July 2020, President Trump Signed An Executive Order On Increasing Drug Importation To Lower Prices For American Patients. (“Executive Order On Increasing Drug Importation To Lower Prices For American Patients,” The White House, 7/24/20)

  • President Trump’s Executive Order Increases The Trade Of Prescription Drugs Between Nations With Lower Prices. “One way to minimize international disparities in price is to increase the trade of prescription drugs between nations with lower prices and those with persistently higher ones.  Over time, reducing trade barriers and increasing the exchange of drugs will likely result in lower prices for the country that is paying more for drugs.” (“Executive Order On Increasing Drug Importation To Lower Prices For American Patients,” The White House, 7/24/20)

Improving Access To Insulin And Other Life Saving Medications

In July 2020, President Trump Signed An Executive Order That Will Grant Lower Income Americans Access To Affordable Life-Saving Medications. (“Executive Order On Access to Affordable Life-Saving Medications,” The White House, 7/24/20)

  • President Trump’s Executive Order Allows Qualified Lower Income Americans To Have Access To Decreased Prices Of Insulin, Epinephrine, And Other Medication Through Federally Qualified Health Centers. “To the extent permitted by law, the Secretary of Health and Human Services shall take action to ensure future grants available under section 330(e) of the Public Health Service Act, as amended, 42 U.S.C. 254b(e), are conditioned upon FQHCs’ having established practices to make insulin and injectable epinephrine available at the discounted price paid by the FQHC grantee or sub-grantee under the 340B Prescription Drug Program (plus a minimal administration fee) to individuals with low incomes.” (“Executive Order On Access to Affordable Life-Saving Medications,” The White House, 7/24/20)

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