President Trump says his success in negotiating lower prescription drug prices is such a huge win that Republicans should win the midterms on that alone.
Many voters will not know whether they are benefiting from the discounts, however, and overall inflation and foreign wars have overshadowed the issue, creating a mismatch between Mr. Trump’s hopes and campaign realities.
“It’s eclipsed by Iran, tariffs — all the other aspects of the affordability concerns,” said Douglas Holtz-Eakin, a former director of the Congressional Budget Office and the current president of the American Action Forum, a center-right nonprofit.
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Mr. Trump struck deals with more than 30 drugmakers to cut prices to the levels other developed nations pay, a policy known as most-favored-nation pricing.
Getting Big Pharma to slash prices in the U.S. at all is a big win, and the White House projects that applying discounted prices to Medicaid — the state-federal program for 71 million low-income Americans — will save more than $64 billion over 10 years.
“I mean, this one thing alone should win us the midterm,” Mr. Trump said recently.
Still, political forecasters say Democrats have the upper hand this cycle, including on healthcare costs.
Mr. Trump might have oversold the discounts’ political impact.
Many voters will not be affected by the policy, which primarily impacts the Medicaid program for the poor and medicines sold on TrumpRx, a website for direct-to-consumer purchases that do not involve insurance.
“Most people with Medicaid don’t really pay anything for medication, so while that model might produce some savings for states, it’s really not going to benefit people on Medicaid directly,” said Juliette Cubanski, KFF’s deputy director of its Program on Medicare Policy.
Some Americans will save money on Ozempic and other pricey drugs through TrumpRx, but many people use insurance and will not browse the site.
“For most people, what they notice in their healthcare costs is their insurance premiums. That’s a very visible thing, and the actual price of the drugs behind that? They don’t know. They don’t care,” Mr. Holtz-Eakin said.
With the midterm elections looming, Republicans get high marks on topics such as border security, but they are underwater in polling on healthcare despite Mr. Trump’s drug discounts.
The Republican National Committee said it is not for lack of trying.
It pointed to nearly two dozen instances in which Republican candidates highlighted Mr. Trump’s pricing deals, called for drug price parity with other nations or pushed to codify Mr. Trump’s discounts.
“Republicans have been shouting our wins for working families from the rooftops — including the rapid decline in drug costs — but the failing liberal media won’t print a word of it,” said Republican National Committee spokeswoman Natalie Baldassare.
Some Republicans are latching onto the most-favored-nation concept, even if they do not use the arcane term.
“Why do your prescription drugs cost so much more in Michigan than they do in Canada?” former Rep. Mike Rogers, the Republican Senate nominee in Michigan, says in an ad. “I’ll make sure our healthcare is more affordable.”
Rep. Dan Meuser, a Republican defending his seat in Pennsylvania, is pushing for a legislative stamp on the issue. He filed a bill to write Mr. Trump’s deals into law, saying it “would lock in MFN savings for years to come and ensure that all Americans can purchase drugs at lower prices.”
Some lawmakers are talking about potential legislation rather than latching onto Mr. Trump’s deals for a glaring reason.
“If you’re a member of Congress, you want to talk about what you did,” Mr. Holtz-Eakin said. “This is all executive action, so they don’t really get anything out of it.”
The White House said Mr. Trump wants to work with Congress to extend the discounts in perpetuity.
“Countless Americans have already saved over $1 billion thanks to President Trump’s most-favored-nation framework through TrumpRx.gov and the Medicare Bridge program,” White House spokeswoman Allison Schuster said. Independent health policy organizations such as KFF and the Congressional Budget Office have not independently verified the figure. “The White House continues to work with Congress to pass the President’s Great Healthcare Plan to codify his most-favored-nation deals and expand drug pricing savings for everyday patients.”
Whether that message gets votes for Republicans remains to be seen.
Republicans trail Democrats by at least 20 percentage points in multiple polls asking which party is better on healthcare costs.
The Democratic National Committee said that “voters are going to hold Republicans accountable for hiking healthcare costs and elect Democrats across the board who are fighting to lower costs and make healthcare affordable.”
Mr. Trump used the threat of massive tariffs to prod drugmakers into signing voluntary deals that slashed some prices.
Health experts said Mr. Trump’s confidential arrangements make it hard to study the policy or draw a direct line between the discounted price and what other countries pay for the same drug.
A KFF study from September found that Americans using TrumpRx might pay less or they might pay more than the average price in other developed countries, depending on which drug they choose.
KFF studied 32 brand-name drugs and found the TrumpRx price was lower than the average foreign price for 17 of them. Eight drugs cost at least $100 less than the foreign average.
For the other 15 drugs, the TrumpRx price was higher than the average price in other countries.
Pharmaceutical companies received tariff relief or expedited reviews for their products as part of the negotiations, and they hope the discounts will increase sales and revenue for certain drugs.
“The drug companies actually are making just as much, if not more, money than they were before,” said Avik Roy, president and co-founder of the Foundation for Research on Equal Opportunity. “They’re not worried about losing money from these deals at all.”
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