Donald Trump is resurrecting one of his controversial first-term policies to supposedly hack prescription drug prices—but the whole effort is such a nothingburger that he very nearly forgot to sign the executive order enacting it.
“Starting today the United States will no longer subsidize the health care of other countries, that’s what we were doing,” Trump said at a White House press conference Monday, referring to the European Union. He then claimed that low drug prices outside the U.S. were because the federal government had been financially offsetting would-be high prices in other countries.
But that’s detached from reality—the U.S. pays more for drugs because it’s an outlier among high-income, first world countries, which predominantly support universal, public health coverage.
Trump’s first term rule—“Most Favored Nation”—was focused on lowering the cost of Medicare payments on certain drugs, but it barely made it out of the White House. The policy was blocked by federal courts shortly after it was announced in late 2020, and was then rescinded by President Joe Biden in 2021.
This time around, Trump’s order sets a 30-day deadline for drugmakers to negotiate lower prices. If there is no deal, then the U.S. will tie its drug prices to those paid by other countries. But as of now, nothing has changed.
Trump reiterated that the U.S. would no longer “subsidize” drug prices in other countries, telling reporters that the “game is up” while alluding to potentially increasing auto tariffs if they don’t comply.
“If they want to get cute they don’t have to sell cars into the United States anymore. They won’t get cute,” Trump said. “I’ll defend the drug companies from that standpoint.”
He was also characteristically vague on how much prices would change.
“Drug prices will come down by much more really if you think,” Trump said. “But between 59 and 80 and I guess even 90 percent.”
“We’re getting them down 60, 70, 80, 90 percent. But actually more than that if you think about it in a way, mathematically.”
Other things that researchers point to as potentially resolving high drug prices in the U.S. include restricting pharmaceutical monopolies within the country, reworking insurance benefits to restrict out-of-pocket costs, and re-centralizing price negotiations through the leverage of a single-payer system (such as Australia, Germany, the U.K., or any number of other wealthy nations), according to a report by the Commonwealth Fund, a private American foundation focused on health care reform.
But none of that was on Trump’s radar. Instead, the president took time out of his morning to deride Obamacare, which (as of 2024) provided public health insurance to some 45 million Americans. Trump, however, claimed that it “doesn’t work.”
In a post on Truth Social Sunday, Trump pledged that the initiative would save the government trillions of dollars and falsely claimed that Democrats had stood in the way of this kind of pharmaceutical reform, ignoring the fact that health care and pharmacy drug reform has been a pillar of the progressive platform in recent years (see: Representative Alexandria Ocasio-Cortez’s “Medicare for All” 2021 revival, which would have created a single-payer system in this country.)
“Campaign Contributions can do wonders, but not with me, and not with the Republican Party. We are going to do the right thing, something that the Democrats have fought for many years,” Trump wrote.
But in 2006, Republicans were the ones who adamantly stood in the way of federal drug price negotiations, ripping the teeth out of a bill that would have mandated drug companies to negotiate lower drug prices with Medicare officials.
“Instead of actually tackling the issues that concern average American families, the Republicans have passed legislation to help their wealthy friends and the huge corporations that support their campaigns,” said former North Carolina Representative G. K. Butterfield at the time before the measure passed.
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