What Happens to Medicare Price Negotiations Under Trump?

In 2022, the Biden administration passed the Inflation Reduction Act (IRA), which allowed Medicare to negotiate prescription drug prices for the first time -- a reform long sought by progressive Democrats. Under President-elect Trump, the future of the program is less certain.

But if there's one thing that experts agree on, it's that whole-cloth repeal of the law won't be easy.

"I don't think there's any upside to Republicans saying they're going to repeal the IRA, because that means repealing the cap on out-of-pocket [costs], and that is political suicide," said Douglas Holtz-Eakin, PhD, president of the American Action Forum, a conservative think tank, referring to the key provisionopens in a new tab or window of a $2,000 cap on out-of-pocket costs for covered prescription drugs for Medicare enrollees.
However, Andrea Ducas, MPH, vice president of health policy at the left-leaning Center for American Progress, took a different view.

"That program was in the bull's eye of Project 2025opens in a new tab or window," she told MedPage Today. "We still have every reason to believe that that is the policy blueprint that a future Trump administration was looking to." (Despite many of the authors being former Trump officials, the president-elect has repeatedly attempted to distance himself from the policy paper.)

On the other hand, drug price negotiation "enjoys tremendous public support," she noted. So, to say, "'Hey seniors ... we're going to take away Medicare's ability to negotiate prescription drug prices,' it's a bad look, particularly when the Trump campaign ran on not touching people's Medicare."

In August, the Centers for Medicare & Medicaid Services (CMS) revealed the negotiated pricesopens in a new tab or window of the 10 drugs selected for inclusion in the program a year earlier.opens in a new tab or window All were single-source brand-name drugs with no therapeutically equivalent generic or biosimilar competition that were targeted for negotiation based on their total expenditures in the Medicare Part D program -- they are costly, widely used, or both.

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