President Trump is searching for a health care victory ahead of the 2020 election, and has turned to executive action to try to achieve it.
The administration is looking to fend off attacks from Democrats, who see the president as particularly vulnerable on health care.
Trump’s coronavirus response has put him on the defensive. More than 175,000 people have died in the U.S. as the virus continues to spread, and the economy is stymied.
In addition, the administration is actively pursuing a lawsuit at the Supreme Court to completely overturn ObamaCare, which would result in more than 20 million people losing health insurance.
Trump has no replacement plan if his lawsuit is successful.
Facing that backdrop, Trump in the past month has taken executive action, signing four orders aimed at lowering drug prices.
Three orders would move toward allowing states to develop plans to import cheaper drugs from Canada, eliminate a system of drug discounts known as rebates in a bid to simplify the system, and seek to make EpiPens and insulin more affordable for patients of community health centers.
Trump also announced a fourth, more sweeping order, to require drug companies to sell certain high-cost injectable drugs in America for the lowest price that they offer in a handful of other countries, something Trump called “most favored nation” status for the U.S.
Trump has long cast himself as “Big Pharma’s” main villain. He recently said drug prices will fall dramatically because of his actions.
“With what I am doing in the fight with the Drug Companies, drug prices will be coming down 50, 60, and even 70 per cent. The Democrats are fighting hard to stop me with big ad buys, plus. Likewise, Big Pharma. FAVORED NATIONS AND REBATES ARE BRINGING PRICES DOWN NOW. We will win!” Trump tweeted earlier this week.
It is unclear, though, when the moves can be finalized and take effect.
Even if Trump moves forward to implement the orders quickly, it would just mark the beginning of what would likely be a lengthy process that could be further stalled or halted by drug industry lawsuits.
GOP strategist Ford O’Connell said the administration officials are aware of the limitations, and are not trying to enact a sweeping policy change just ahead of the election.
Instead, O’Connell said voters should view the effort as Trump signaling a second-term policy.
“This is not necessarily reaching for a health care victory right now,” O’Connell said. “I find he is less vulnerable if he is making the case that [if] you reelect me, I’m going to make drug prices lower.”
Joel White, a health care industry consultant, said some of the executive orders have the potential to resonate with the public, even if the impact may be limited at best.
Trump has made lowering drug prices a top priority of his presidency, but to date has little to show for it. White said the flurry of executive action is a way to show that he hasn’t let go of the issue.
“[Trump] thinks drug prices are too high and he wants to deliver on these policies,” White said, but he has not had any big ticket drug pricing successes he can point to.
“If you’ve got a rule that says your average out of pocket costs at the pharmacy counter are going to go down by 20 percent … that’s big,” White said.
The timing of the executive actions coincides with a critical stretch for Trump in his reelection bid. He is trailing Democratic nominee Joe Biden in many polls, and strategists say Trump’s path to victory is largely dependent on the state of the pandemic and the economy.
Longtime GOP operative Doug Heye said the announcement of the drug pricing orders, which featured women in lab coats, a backdrop of American flags and shelves full of colorful boxes, was a typical Trump spectacle.
“One of the things that we’ve seen pretty consistently from the administration is a big announcement, and then things get lost in the details,” Heye said. “[Trump] both cynically and shrewdly understands that when he finds something and holds it up, people see him doing something.”
The problem, Heye said, is that anything Trump says on health care has to be taken in the context of the pandemic, which makes it harder for other issues to break through.
“It’s why it’s very difficult for the White House to effectively change the conversation on anything, because it always goes back to another death toll that is reached, or more [bad] economic news,” Heye said.
Democrats have been successfully hammering Republicans on ObamaCare repeal for years.
The administration’s COVID-19 response has given them a new line of attack.
The liberal health care advocacy group Protect Our Care recently launched a $2 million ad campaign in three battleground states, hitting Trump for his coronavirus response, and highlighting how his years-long campaign to undermine ObamaCare has made it harder to tackle the virus.
The issue will be especially big on the campaign trail.
During his acceptance speech at the Democratic National Convention on Thursday, Biden made clear that Trump’s handling of the coronavirus pandemic would be a central part of his campaign going forward.
“Five million Americans infected by COVID-19. More than 170,000 Americans have died. By far the worst performance of any nation on earth … if he’s reelected, you know what will happen. Cases and deaths will remain far too high,” Biden said.
“Our current president has failed in his most basic duty to the nation: He’s failed to protect us,” Biden added. “He’s failed to protect America. And my fellow Americans, that is unforgivable.”