It wasn’t so long ago that Bernie Sanders (I-VT) comfortably occupied the left flank of health care policy. His Medicare For All bill was sufficiently costly, coercive and utopian to set him apart from the pack.

Times have changed. When it comes to drug pricing, Bernie faces unexpected intruders on his left:  Republicans.

In recent months, Bernie has yielded socialist turf to two Republicans of impeccable capitalist pedigree. First, it was President Trump, who last fall announced a plan to incorporate drug prices set by foreign governments into Medicare. Then Sen. Rick Scott (R-FL) last week introduced a bill pegging U.S. retail prices for prescription drugs to those set by five foreign governments.

We don’t know what will emerge as President Trump’s plan to replace Obamacare, which he has promised to unveil immediately after the 2020 elections. But he has recently endorsed several proposals, and they could provide clues. A group of conservative health policy experts has developed a health care proposal that would hand states blocks of money and a few rules, and encourage them to develop their own health care systems. The plan would require that government-subsidized systems offer every American a choice of a private health plan, a requirement that would probably foreclose a liberal state from enacting a single-payer program and that might require restructuring of some state-run Medicaid programs.

Acting White House chief of staff Mick Mulvaney said Sunday that the White House plans to release an Obamacare replacement plan before the 2020 election, after hosting top administration officials at Camp David over the weekend for a meeting on health care. “I do think you’ll see a plan here fairly shortly,” Mulvaney said. White House aides and administration officials—including HHS Secretary Alex Azar and Seema Verma, CMS administrator—huddled at the historic Maryland property on Saturday to discuss the general path forward for President Trump’s health care policy, White House aides said. The talks ranged from messaging strategies to lowering drug prices to individual health insurance marketplaces.

On Tuesday, Americans for Tax Reform held a Capitol Hill briefing on the Department of Health and Human Services (HHS) proposal to subject Medicare Part B drugs to an “International Pricing Index” (IPI).

As ATR has written extensively, the IPI payment model will effectively import foreign price controls into the United States, lowering quality and access to lifesaving medicine. In November, ATR led a coalition of 56 conservative groups in opposition to the IPI.

ATR President Grover Norquist opened the panel by highlighting the effects of the proposal on trade, saying: “Under this rule, every time we win on trade, the administration would have to raise drug prices on Americans. This is a truly bad idea.”

“If the Supreme Court rules that Obamacare is out,” President Donald Trump said last week, “we’ll have a plan that is far better than Obamacare.”

A look at his fiscal year 2020 budget shows that the president has a plan to reduce costs and increase health care choices. His plan would achieve this by redirecting federal premium subsidies and Medicaid expansion money into grants to states. States would be required to use the money to establish consumer-centered programs that make health insurance affordable regardless of income or medical condition.

The president’s proposal is buttressed by a growing body of evidence that relaxing federal regulations and freeing the states to innovate makes health care more affordable for families and small businesses.

Senate Democrats, including several of the party’s presidential candidates, have savaged President Trump for proposing to reduceMedicare spending by several hundred billion dollars over the next decade.

Senator Kamala Harris of California said the proposed changes in Medicare “would hurt our seniors.”

Senator Elizabeth Warren of Massachusetts tweeted, “The Trump administration wants to cut hundreds of billions of dollars from the #Medicare budget, all while giving billionaires and giant corporations huge tax breaks.”

If the president is looking for a government to blame for distorted U.S. drug prices, he need look no further than our own. The federal government requires manufacturers to pay rebates, grant discounts, and comply with various price-distorting directives across a range of programs.


Legal challenges aren’t slowing down the Trump administration’s push to reframe Medicaid as something closer to a welfare program.

Driving the news: The Centers for Medicare & Medicaid Services on Friday approved Ohio’s proposal to add work requirements to its Medicaid program.

  • Just a day earlier, Justice Department lawyers were back before the same federal judge who ruled against work requirements last year, urging him to let the policy move forward now.

The CMS rolled out new tools on Thursday to help states get approval to make changes to Medicaid such as implementing work requirements.

The CMS Administrator Seema Verma defended the administration’s push to get more states to pursue 1115 demonstration waivers even as the agency faces criticism over coverage losses due to work rules.

The CMS is asking the public for ideas and advice on how to make it easier for health insurers to sell policies across state lines. The agency issued a request for information on Wednesday for recommendations on eliminating barriers and enhancing insurers’ ability to sell individual insurance coverage from state-to-state. The request, which the CMS said is meant to promote competition and choice for consumers, follows President Trump’s October 2017 executive order on cost and competition in the health sector. CMS said it is interested in feedback about how states could use Section 1333 of the ACA, which allows insurers to enter into a “healthcare choice compact,” to sell out-of-state coverage if state regulators agree.