The ongoing debate over Medicare’s drug pricing negotiations, particularly regarding weight loss medications like Ozempic, is raising questions about the future of the program under a potential Trump administration. Set to release a list of 15 additional drugs up for price negotiations by February 1, the program, established under the Inflation Reduction Act of 2022, represents the first time the U.S. government will directly negotiate with pharmaceutical companies to lower drug prices.
In 2023, Medicare reached agreements to reduce the prices of 10 high-cost medications, including heart and cancer drugs. The upcoming round of negotiations could include high-demand medications like Ozempic, a weight loss drug with growing popularity, and Wegovy, which contains the same active ingredient, semaglutide. Other drugs under consideration include Ibrance (for breast cancer), Trelegy (for asthma), and Tradjenta (for diabetes).
While the negotiations aim to make medications more affordable for seniors on Medicare, the program’s future could be jeopardized depending on who controls the White House. President-elect Donald Trump, along with some of his allies, has shown reluctance toward the program. Although it would require Congressional approval to dismantle the negotiation structure, Trump’s administration could put significant pressure on lawmakers to repeal the program.
Juliette Cubanski, deputy director of the Medicare policy program at KFF, noted that there was a significant push in the last Congress from Republicans to eliminate the Inflation Reduction Act, which includes the drug price negotiations. Additionally, Project 2025, a Republican initiative, has featured the repeal of these negotiations as part of its broader policy agenda. This political climate suggests that Trump, or his allies, may favor scrapping the program as part of their broader legislative strategy.
Medicare’s negotiations aim to save taxpayers billions, but the pharmaceutical industry has vigorously fought the initiative through lawsuits, with limited success. Even if negotiations remain in place, the drug industry has expressed concerns over the long-term impacts of the price reductions.
So far, Trump has not been vocal about whether he plans to support or oppose the Medicare drug price negotiations, nor has his health team offered clear guidance on the issue. However, Trump’s history of opposing Democratic achievements, such as his efforts to dismantle the Affordable Care Act, suggests he may attempt to undo the negotiations as a symbolic move against President Biden’s signature legislative accomplishment.
From a political standpoint, eliminating the program could backfire for Trump. A recent survey by KFF revealed that a quarter of adults struggle to afford their medications, with some even skipping prescriptions due to cost concerns. Scrapping Medicare’s ability to negotiate prices could alienate voters who rely on affordable medications, particularly seniors. Health economist Andrew Mulcahy of the Rand Corporation pointed out that simply restoring high prices could create negative optics for Trump, especially among Medicare beneficiaries who benefit from price reductions.
In an unexpected twist, keeping the negotiation program could actually serve as a political win for Trump. If Ozempic is included in the upcoming round of negotiations, Trump could present it as a victory for consumers, especially considering the drug’s popularity among individuals struggling with weight and diabetes, common concerns among his base, including rural voters. Lawrence Gostin, a health law expert at Georgetown University, argued that supporting price reductions for Ozempic could align with Trump’s previous stance on lowering drug prices and resonate with voters in need of affordable weight loss and diabetes medications.
Moreover, the law authorizing Medicare’s price negotiations is already on the books, meaning that expanding the program might be politically easier for Trump than attempting to undo it entirely. As the next election approaches, the debate over Medicare drug pricing negotiations and Trump’s stance on the issue could have significant implications for his political future and the well-being of millions of Americans relying on affordable medications.
