President Donald Trump plans to issue a series of executive orders on Friday aimed at lowering drug prices — a signature promise of his 2016 campaign that he’s yet to fulfill.
But a sweeping proposal to eliminate rebates from seniors’ drug plans won’t be among them.
Trump shelved the ambitious proposal during a meeting this week with top officials, 10 people with knowledge of the decision told POLITICO. It marks the second time in two years that the president has rejected a policy that once served as the centerpiece of his administration’s blueprint for slashing pharmaceutical costs.
Instead, Trump is now expected to roll out several other orders on Friday afternoon. They include a demand to cut Medicare’s drug payments so they’re linked to lower prices that other countries pay by a so-called favored nations rule. The orders are also likely to address drug importation and the 340B program that gives hospitals access to deeply discounted medicines.
Executive orders are not immediately enforceable, meaning the administration would be left to finalize regulations following through on them — a process that can take months. Prior Trump administration efforts to link drug prices to what is paid by countries abroad and allow greater drug importation have stalled in the face of Republican opposition.
A White House spokesperson declined to comment on the timing and content of the executive orders, saying only that Trump “continues to explore any and all options that will deliver lower drug costs.”
But in a meeting on Wednesday to finalize the orders, Trump rebuffed efforts to revive the so-called rebate rule over concerns about its cost, and Congressional Budget Office projections that it would raise seniors’ Medicare premiums. The proposal would also do little to rein in the profits of a drug industry that Trump has criticized in the past as “getting away with murder.”
It was about “politics with Trump,” said one person familiar with the debate. “He was aware that it’s a big win for pharma.”
Trump tabled the rebate rule over similar political worries roughly a year ago — siding with top White House officials including former acting chief of staff Mick Mulvaney and against HHS Secretary Alex Azar.
Several officials opposed to the plan have since left the administration, prompting the idea’s resurrection amid efforts to develop a package of drug pricing orders. But Azar and chief of staff Mark Meadows — who has long backed the proposal — nevertheless encountered resistance inside and outside the White House.
On the heels of news this week that the rebate rule had been revived, the pharmacy benefit managers’ lobby PCMA swiftly rolled out an ad campaign on top-ranking Fox shows including Tucker Carlson, Sean Hannity and Fox & Friends, warning that the rule would raise seniors’ premiums — and offering the not-so-subtle reminder that the election is fast approaching and a pandemic is going on.
Vice President Mike Pence and officials from the Office of Management and Budget and Domestic Policy Council, meanwhile, were among those who expressed skepticism of reviving the rebate rule just four months out from Election Day, one person with knowledge of the debate said.