President Donald Trump in his State of the Union address on Tuesday called on lawmakers to pass legislation to lower prescription drug prices and derided single-payer healthcare reform as "socialist."
"I am calling for bipartisan legislation that achieves the goal of dramatically lowering prescription drug prices. Get a bill to my desk, and I will sign it into law without delay," Trump said.
Senate Finance Chair Chuck Grassley (R-Iowa) has said he wanted more vocal support from Trump for a bipartisan package to lower prescription drug costs Grassley authored with Senate Finance ranking member Ron Wyden (D-Ore.). The bill has stalled so far because conservative Republicans oppose a provision that would force drugmakers to pay back the government for price hikes that outpace inflation.
Trump called out Grassley by name, but did not explicitly call for passage of his and Wyden's bill.
Despite his tough rhetoric on lowering prescription drug prices, Trump's biggest ideas have stalled or are still in early stages in the regulatory process. A Kaiser Family Foundation poll published Jan. 30 found that just 30% of adults surveyed approved of how Trump handles prescription drug costs.
Trump did not mention banning surprise medical bills, another contentious issue in Congress. Leaders of the Senate health and House Energy & Commerce committees worked on a bipartisan proposal to ban balance billing, but it stalled at the end of 2019 despite White House support.
Sens. Maggie Hassan (D-N.H.) and Bill Cassidy (R-La.), who have been actively engaged in shaping legislation on surprise billing, said they wished Trump would have brought up the issue.
"I was disappointed that the president did not highlight the need to pass bipartisan legislation to end surprise medical bills, however, which I will keep fighting for in the year ahead," Hassan said in a statement.
Marc Samuels, founder of the consulting firm ADVI Health, said that Trump could still outline new healthcare policy ideas in his upcoming 2021 budget request, which is expected Feb. 10.
"Though we may have expected more specificity, I think we understand the mechanics of any massive overhaul are harder than we might think and are more suited for a document like the budget or a standalone announcement," Samuels said.
As he prepared for his re-election campaign, Trump claimed that he would guarantee protections for patients with pre-existing conditions, even though his administration is pursuing a lawsuit that could doom the entire Affordable Care Act, including such protections.
"We will always protect patients with pre-existing conditions — that is a guarantee. And we will always protect your Medicare and your Social Security," Trump said.
Democratic leaders in both chambers of Congress joined forces before Trump's speech to blast him for pursuing the lawsuit and failing to support House Democrats' drug-price negotiation bill.
"The president swears that he supports protections for people with pre-existing conditions, but right now he is fighting in federal court to eliminate this lifesaving protection," House Speaker Nancy Pelosi (D-Calif.) said.
Trump criticized Democrats who support single-payer healthcare reform and expanding Medicaid to cover undocumented adults.
"We will never let socialism destroy American healthcare," he said.
Trump also called for Congress to provide an additional $50 million to fund neonatal research and ban late-term abortion.
HHS Secretary Alex Azar said the agency will shift its focus next year to improving maternal health and healthcare in rural areas.
Looking back over the first three years of his presidency, Trump highlighted several healthcare victories. Trump touted his administration's actions on kidney care, funding to fight childhood cancer and AIDS, and legislation to support the fight against the opioid epidemic. In his 2019 State of the Union address, Trump announced an initiative to reduce new HIV infections by 90% by 2030.
The president also hailed the release of two rules that increase price transparency for both hospitals and insurers. Hospitals sued in December to stop one of the rules, which would force them to disclose the rates they negotiate with insurers.
A federal judge allowed the administration's expansion of short-term, limited-duration health insurance policies to move forward. The plans, which Trump branded on Tuesday as "affordable alternatives" to exchange plans, don't have to cover people with pre-existing conditions, nor are they subject to the ACA's mandates such as coverage for the 10 essential benefits, including mental healthcare, maternity care and prescription drugs.