President Donald Trump tried Thursday to make good on a campaign vow to lower drug prices — attacking “foreign freeloaders” and proposing significant changes to how Medicare pays for many drugs. But his populist proposal didn’t appear likely to budge the national debate around health care, just days ahead of the midterm elections.
Early indications are that it won’t be an immediate game changer — it’s too wonky for Republicans playing defense in local races, it gave Democrats a fresh opportunity to slam the administration‘s attacks on patient protections and it won’t help most voters pay less for prescriptions at local pharmacies.
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To date, Democrats have dominated the health care air wars, running hundreds of thousands of TV ads that hammer Trump and Republicans on their efforts to repeal Obamacare and strike down protections for patients with pre-existing conditions. As of last week, Democrats had an 18 point advantage among voters on health care compared to Republicans, according to a Washington Post/ABC News poll.
Determined to counter that messaging, the White House held a summit on Wednesday to celebrate its work combating the opioid crisis before orchestrating Trump’s speech on drug prices on Thursday.
But Trump’s attempt to strengthen Republicans’ messaging on health care may even have backfired, as Democrats quickly reminded voters that the GOP’s worked to weaken the Affordable Care Act’s patient protections. “Trump is promoting insurance policies that aren’t required to cover any prescription drugs,” said Andy Slavitt, who ran Medicare under President Barack Obama.
Trump’s moves on drug pricing have so far largely been overlooked by the public. Only about a quarter of adults had heard about a previous drug pricing plan Trump announced in May — and most who heard of it thought it wouldn’t help bring down prices, according a POLITICO-Harvard T.H. Chan School of Public Health poll.
Some analysts argued that Trump’s late October stumping on drug prices — a bipartisan source of frustration — gave the GOP a tool that could still prove to be useful. Seventy-one percent of respondents in Kaiser Family Foundation’s tracking poll say it’s “very important” for their votes, the top-ranked issue this year.
“We believe this is a politically shrewd move,” Rick Weissenstein of Cowen Washington Research Group wrote in a note to clients. “The timing, less than two weeks before the mid-term elections clearly gives him the high ground on a topic that is as populist as they come. It also puts the Dems on the defensive on an issue they have used to hammer Republicans for years.”
In a speech at his health department, Trump framed the plan — which goes against Republican orthodoxy on how to rein in drug costs and includes some measures that the GOP derided when the Obama administration proposed them — as a bold move to deliver on promises to lower U.S. drug prices, which are the highest in the world.
“Nobody’s had the courage to do it, or even wanted to do it,” Trump said, ignoring that his predecessor, Obama, proposed some similar reforms.
But Trump’s sweeping proposal mostly landed with a thud in Washington and on the campaign trail. The handful of Republicans to release statements issued mild remarks saying only they would take a look at it.
Under Trump’s plan, which POLITICO first reported, Medicare would benchmark some drug prices to the typically lower prices in nations like France and Germany, with a goal of lowering U.S. drug prices over time. Trump’s plan also would encourage more private sector negotiations between vendors and drugmakers as well as change incentives to encourage doctors to prescribe less expensive drugs.
For many Republicans, Trump’s plan was not only wonky but anathema to their belief in competition as the solution to high prices. It also barely registered. “It’s not even on our radar,” said one GOP staffer for a competitive Senate race. “There are other things we’re worried about here.”
Some GOP leaders also are angry that Trump would bypass Congress and use a pilot approach made possible by an Obamacare provision that many revile. The president is planning to use Medicare’s innovation center to accomplish his reforms — a vehicle criticized by Sen. Orrin Hatch, Rep. Greg Walden and even then-Rep. Tom Price, who attacked Obama in 2016 when he proposed a similar idea.
The Trump administration decided not to “presocialize” their new plan with Congress, HHS Secretary Alex Azar told reporters.
“I think a lot of Republicans are struggling to grasp that this could be real,” said Rodney Whitlock, who served as a GOP congressional aide and now works on drug pricing issues in the private sector. “Importing price controls are things Republican ideology would say, ‘this is inconceivable,’” he added.
Trump’s proposal was also too little, too late for many Democrats, who support many of the ideas but want to hammer the president on his Obamacare repeal efforts in the waning days of their campaigns.
“I introduced a bill to do what President Trump said he wanted during the campaign … and I met with the President in the Oval Office to seek his support,” said. Rep. Elijah Cummings, the top Democrat on the House Oversight Committee. “Instead, President Trump and congressional Republicans have spent the last two years sabotaging our health care system and targeting protections for people with pre-existing conditions.”
White House allies tried to rally support on Thursday afternoon.
“This administration’s top goal in health care is bringing down drug costs,” said Alex Campau, who served as a health care adviser to Trump before leaving the White House this summer. “They will continue to take big actions until patients see their costs come down.”
Sarah Karlin-Smith, Sarah Owermohle and Rachel Roubein contributed to this report.