A big announcement widely expected to come on Thursday should tell us a lot about one of the Biden administration’s most important policy achievements: a reform with the potential to touch the lives of millions of seniors, alter the pharmaceutical market and, just maybe, affect the November elections as well.
The Department of Health and Human Services is about to publish the final prices for 10 prescription drugs that Medicare covers, following negotiations between the federal government and the pharmaceutical manufacturers. The drugs include expensive, widely used blood thinners and diabetes treatments, as well as a cancer therapy medication.
Such negotiations are routine in most other economically advanced countries ― it’s the way their governments set drug prices — but they have never before taken place in the U.S. That’s changing this year thanks to the Inflation Reduction Act, which Democrats passed on a party-line vote and President Joe Biden signed into law last year.
Under the law, the annual, yearlong negotiation process ends with the publication of the new prices by Sept. 1. And while the administration has not said publicly exactly when it plans to publish the new prices, the White House has announced that Biden and Vice President Kamala Harris are appearing together in Maryland on Thursday “to discuss the progress they are making to lower costs for the American people.”
As Politico reported late last week and sources familiar with planning have since confirmed to HuffPost, the purpose of the joint appearance is to tout the new prices, following some kind of announcement before markets open on Thursday morning.
Thursday’s appearance is a White House event, not a campaign stop. But it’s safe to assume that in the lead-up to the November election, Harris and her fellow Democrats will continue to talk about these new prices while hailing plans (including those in the latest Biden-Harris budget proposal) for extending and strengthening the government’s new negotiation power.
Democrats, especially more liberal Democrats, have traditionally championed giving the government direct leverage over drug prices. The drug industry has opposed that idea, as have most Republicans.
Whether any of this shapes voter perceptions in the fall would depend on getting them to notice and pay attention to the new negotiating process now underway. So far, that’s been difficult for Biden, Harris and their allies to do. Polling has shown that a large number of Americans are unaware that the federal government has already started to shape drug prices, although the vast majority of Americans support the idea.
A Big Change That’s Hard To See
One reason for the low public awareness may be that the negotiating power is quite limited. The new prices apply only to Medicare and not private insurance for non-elderly, non-disabled Americans. And the negotiations cover only a limited set of drugs, starting with the 10 medications this year.
Also, the new prices won’t actually take effect until Jan. 1, 2026. How much the new prices will then save individual seniors ― as opposed to the Medicare program as a whole — will depend on whether seniors actually take those drugs as well as which variety of Medicare drug coverage they have.
Even figuring out the magnitude of the likely savings could be difficult, or at least take some time. The newly negotiated prices for these 10 drugs are going to be much lower than the official list prices, but Medicare insurers already get discounts on those prices for their customers. And those discounts are proprietary information.
But there are ways to estimate the impact of newly negotiated prices ― for example, by comparing them to publicly available industry averages and indexes. The administration may publish some of those as part of Thursday’s announcement.
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It’s certainly possible that some seniors could end up paying significantly less for their drugs, depending on their specific circumstances and how much they save from other reforms that were part of the same legislation.
“The drug price negotiations program, along with the $35 insulin cap, the inflation rebate and the $2,000 out-of-pocket cap on drug costs, should go a long way toward helping to make medications more affordable for millions of people with Medicare who have been struggling to pay for them,” Tricia Neuman, vice president for policy at the health care research organization KFF, told HuffPost.
Neuman also called the negotiated prices “an important milestone for Medicare and seniors.”
Although negotiations cover only 10 drugs this year, the number expands over time, meaning that an ever larger collection of drugs will be subject to negotiation. Expensive new weight-loss drugs are likely to fall into that category soon.
Both Biden and Harris have called for expanding the power further to apply to even more drugs and to find ways of extending negotiating power beyond Medicare.
A Question Of Trade-Offs — And Political Power
Whether all of this would represent a benefit or loss for American society as a whole is a separate question.
Roughly one in four older Americans struggle with drug costs, according to KFF polling, with those in fair or poor health even more likely to report difficulties. That situation is a big reason liberals have pushed so hard for the U.S. to adopt the sort of negotiation practices common in other countries.
But conservatives have long argued that “negotiating” drug prices is really just a nicer way of saying “setting” drug prices, and that reducing pharmaceutical company revenue will reduce innovation by making it harder for those companies to attract investors.
Plenty of mainstream analysts think the relationship between revenue and innovation is real, although, even among them, there’s disagreement over whether the specific kinds of changes in the Inflation Reduction Act could hinder the development of meaningful treatments.
“We simply cannot ever know what drugs we may have had in the absence of the IRA price setting,” Ian Spatz, an adviser at Manatt Health who worked previously for pharmaceutical company Merck and is now an adjunct instructor at the University of Southern California, told HuffPost.
But if the policy debate is complex and muddled, the political battle lines are clear.
Republicans, along with some more conservative Democrats, have long opposed giving the federal government more leverage over prices. Project 2025, the governing manifesto from the right-wing Heritage Foundation, calls explicitly for repealing the new negotiating power and other elements of the Inflation Reduction Act. The document’s authors include multiple current and former Donald Trump aides.
Trump, who has said he knows nothing about the document, previously signed some executive orders designed to lower drug prices while he was president. He also has a history of criticizing the pharmaceutical industry and bemoaning the high prices Americans pay relative to Europeans, and during the 2016 presidential campaign he promised to “negotiate like crazy” with manufacturers.
However, when House Democrats passed a bill similar to what became the Inflation Reduction Act, Trump attacked it and backed Republican leaders in charge of the Senate when they refused to take up legislation.
Harris is sure to point out Trump’s record in the coming months as proof that Americans can count on her and her party to deliver on lower drug prices. But that argument will resonate a lot more if voters see and understand the changes already underway.
