Trump once promised to back Medicare negotiating drug prices. Now he's the one blocking it
Donald Trump is a liar. Shocking, I know. But I’m not talking about the thousands of lies—actually it’s now well over 10,000—he has told in the course of his time occupying the Oval Office. Today I’m going to focus on one very specific lie: the lie of a broken promise, on a matter of great importance to the pocketbooks and wallets of tens of millions of Americans. This lie, this repudiation of a campaign promise he made in 2016, clearly contrasts The Man Who Lost The Popular Vote’s policies with those of Democrats. This contrast is one that our party must make central to the 2020 campaign.
First, let’s take a look at the promise, made Jan. 25, 2016:
Donald Trump said tonight he could save Medicare billions of dollars by allowing it to negotiate drug prices directly with pharmaceutical companies -- embracing a position Democrats have championed and Republicans have opposed for years.
The Associated Press quotes Trump as telling a crowd in Farmington, N.H., that Medicare, a huge buyer of prescription drugs, could "save $300 billion" a year if it negotiated discounts.
"We don't do it," he said. "Why? Because of the drug companies.”
Hey, look at that. This guy was going to go against Republican orthodoxy and back the people against corporations. A different kind of Republican, he was. A man of the people, even. And if you believed that, well, you probably also believe that Trump’s spectacularly unhealthy orange hue is all the fault of the environmental lobby and their pesky ole’ energy-efficient lightbulbs.
As crazy as it may seem now, please note that prior to his taking office, Trump was seen by voters as far more moderate than other Republican presidential nominees, including Mitt Romney, John McCain, and both Bushes.
According to a Gallup poll from September 2016 (see the graphic to the right), a full 41% of those surveyed saw Trump as either moderate or liberal (and just under half of those actually saw him as liberal. Please pick up your jaw now). That’s more than the 37% who, by contrast, saw Hillary Clinton as either moderate (25%) or conservative (12%). Promises like the one he made on Medicare negotiating drug prices as well as on infrastructure spending and trade, among others, broke from typical Republican positions. Separate from voter surveys, FiveThirtyEight cited an analysis done by OnTheIssues which found that, at the time of his election, Trump’s stated policy proposals placed him as closer to the center than any incoming president over the past four decades other than George H.W. Bush.
But that was 2016. Since then, the Orange Julius Caesar has revealed his true colors on economic issues—and that’s in addition to having confirmed our worst fears about being a racist demagogue who plays and preys on white anxiety. In 2018, the Trump White House announced, as part of its proposal on drug prices, that it was going to break its promise on supporting legislation to give Medicare the authority to negotiate the price of prescription drugs.
Asked if the plan would include direct negotiations by Medicare, the [senior White House] official said, “No, we are talking about something different.”
“We are not calling for Medicare negotiation in the way that Democrats have called for,” the official said later.
Thanks, but no thanks. Trump still claims he wants to reduce prescription drug costs, but he won’t do the one thing that would have the greatest impact—even though he promised to do it on the campaign trail.
This September, when House Speaker Nancy Pelosi declared that House Democrats had a bill to mandate that Medicare negotiate drug prices, Trump even said it was “great to see Speaker Pelosi’s bill today.” Right. I’ve learned that Trump’s use of the word “great” doesn’t always comport with my understanding of its definition.
Over the past three months, the House has been working out the details of that bill. Progressives won a number of major victories in the process, and made the bill even more effective than it could have otherwise been, although not every progressive priority found its way into the legislation. On Thursday, the House passed the Elijah Cummings Lower Drug Costs Now Act, named in honor of the beloved, recently deceased representative from Baltimore. Here are its major provisions, as per Vox:
The final bill enables the HHS secretary to negotiate the prices of as many as 250 drugs annually. Additionally, it would penalize companies that do not negotiate with HHS with a fine starting at 65 percent of a drug’s gross sales from the prior year. For every quarter that the company does not engage, the penalty goes up by 10 percentage points, until it hits 95 percent of a drug’s gross sales.
The proposal would also address pricing hikes that have been applied to different drugs covered by Medicare Parts B and D, requiring companies to either undo any increases that surpass the rate of inflation, or rebate the entirety of those hikes since 2016 to the Treasury. An amendment from Jayapal would also make sure that people covered by private plans could obtain rebates as well.
Additionally, the bill would cap out-of-pocket prescription drugs costs for those covered by Medicare Part D to $2,000 annually. Currently, there is no cap.
The bill passed with unanimous support from Democratic House members, while every Republican vote but two was cast in opposition (four members from each party were not present). As for Trump and his promise? He announced his opposition to the House plan in October, condemned the plan as one that would “harm seniors,” and stated that he would veto the bill if it reached its desk (which Senate Majority Leader Mitch McConnell would never allow anyway).
Polling shows that the vast majority of the American people support allowing Medicare to negotiate drug prices, with support consistently ranging around 85-90% according to the Kaiser Family Foundation’s tracking poll, as well as other polling. Yet Trump fell right in line with the pro-corporate priorities of the party he leads, and abandoned his pledge to put the needs of regular people, in this case Medicare beneficiaries, first.
Why do this? Because the primary purpose for the existence of the Republican party is to protect the great wealth of corporations and the top 1%. The fact that anyone believed Donald Trump would be different is absurd, but unfortunately it did happen.
This is what Republicans do, as we saw this week on multiple other health care-related fronts as well. Since the George W. Bush administration, one the major priorities of their party has been to push Medicare recipients into private plans, the so-called “Medicare Advantage” plans. It turns out that someone has been taking advantage of those plans, and it is the corporations who administer them. They’ve taken advantage of our taxpayer dollars, according to a report issued Thursday by a federal watchdog, namely the inspector general’s office:
A government report released Thursday found health insurance companies had combed through patient charts to obtain billions of dollars of additional payments from the federal Medicare program.
The report, from the federal inspector general’s office, examined payments billed by insurers for those covered by private Medicare Advantage plans, which are increasingly popular and heavily promoted by the Trump administration. The findings showed that insurers were adding on conditions like diabetes and even cancer, reporting that patients were sicker, to receive higher payments from Medicare.
[snip] An earlier report from the inspector general’s office also raised concerns about Medicare Advantage, concluding last year that plans were inappropriately denying medical claims as a way to increase profits.
We are talking about tens of billions of dollars here. In another finding, the report stated that around 50% of the Medicare Advantage insurance companies got paid more money for illnesses they claimed patients were suffering from even though—wait for it—“no documentation that medical care for those conditions had been provided” even existed.
Here’s the big picture: With one hand, Trump and his cronies reject Nancy Pelosi’s plan on Medicare and drug prices—in order to protect Big Pharma—while with the other hand they support the continued growth of their pet Medicare privatization project that allows Big Insurance to rip off taxpayers. And then there’s also what they did with their other, other hand: This time, we’re talking about a combined state-federal effort to screw people facing difficult economic times.
In South Carolina, the Republican-dominated government became the 10th state to win approval from the Trump administration to impose work requirements on Medicaid recipients. This one, however, was especially cruel:
It is the first time the Trump administration has approved such rules in a state whose working-age Medicaid population consists almost entirely of poor mothers. Unlike most of the other states that have won approval for work requirements, South Carolina chose not to expand Medicaid to most of its low-income adult population, as the Affordable Care Act had encouraged.
[snip] As in other states, exemptions will be granted to certain people, including those who can prove that they are the primary caregiver of a child or disabled adult and those identified as medically frail.
“You’re going to have to raise your hand and report and prove you are the primary caregiver,” said Joan Alker, the executive director of the Georgetown Center for Children and Families. “So this is creating a mountain of paperwork that we know will result in huge coverage losses.”
What exactly is the point of all this, if virtually everyone should end up qualifying for an exemption anyway? Are Republicans really going through the trouble of creating all this paperwork and administration so that the couple of dozen South Carolinians on Medicaid who aren’t primary caregivers get thrown off coverage? And let’s remember that not working just to get Medicaid is not going to feed or house anyone. You can’t eat health care. You can’t live in health care.
Clearly, that’s not their goal. Look at the quote from Joan Aiker. This is about making sure that lots of people, a disproportionate number of whom will likely be black, end up thrown off Medicaid—even those who are eligible for the exemption—because they can’t fight their way through the process.
Contrast what Trump and South Carolina Republicans are doing with Medicaid to the Medicare Advantage scam described above, and you’ll see what their party is all about. They want to want to stop poor people from getting a benefit that costs thousands of dollars, while allowing big, for-profit companies to get away with stealing billions. Their opposition to allowing Medicare to negotiate on drug prices demonstrates their priorities just as clearly.
Health care is just one of the issues where Democrats must draw a stark distinction between their policies and, more importantly, their values, and those of Trump and the Republicans. It’s very simple: Democrats are on the side of Americans who, at best, have to think twice every time they fill a prescription, or, at worst, have to choose between filling that prescription and not getting enough to eat. The party of Trump is on the side of those who never have to think about money at all.
Ian Reifowitz is the author of The Tribalization of Politics: How Rush Limbaugh's Race-Baiting Rhetoric on the Obama Presidency Paved the Way for Trump (Foreword by Markos Moulitsas).