It was not the centerpiece, however well being was a persistent theme in President Donald Trump’s State of the Union handle on the Capitol on Tuesday night time.
Although the administration has targeted extra on problems with commerce, taxes and immigration, the president laid out a sequence of health-related objectives, together with some that even Democrats indicated might be areas of bipartisan negotiation or compromise. Trump vowed to tackle prescription drug costs, pursue an finish to the HIV epidemic and enhance funding for childhood cancers.
He additionally took a victory lap for objectives promoted by his administration that had been achieved. “We eliminated the very unpopular Obamacare individual mandate penalty,” he stated, referring to the requirement within the Affordable Care Act that most individuals will need to have medical insurance or pay a high-quality. It was eradicated as a part of the 2017 GOP tax invoice, regardless of backlash from critics that it may undercut Obamacare, after many failed makes an attempt by Republicans to repeal the legislation.
And Trump famous congressional passage of a “right to try” invoice that was alleged to make it simpler for terminally ailing sufferers to realize entry to experimental drugs, however so far few patients have been capable of make the legislation work for them.
The almost certainly floor for bipartisanship would be the difficulty of drug costs, the place Democrats are as keen because the president to do one thing to rein in costs which might be spiraling upward.
“It is unacceptable that Americans pay vastly more than people in other countries for the exact same drugs, often made in the exact same place. This is wrong, this is unfair, and together we will stop it. We will stop it fast,” he stated. “I am asking the Congress to pass legislation that finally takes on the problem of global freeloading and delivers fairness and price transparency for American patients.”
Democrats are cautiously optimistic on the drug worth entrance. “I really am hopeful about making strides on prescription drug legislation this year on a bipartisan basis,” Wendell Primus, high well being aide to House Speaker Nancy Pelosi, stated at a convention for well being coverage researchers hours earlier than the speech.
But not all of Trump’s claims Tuesday about his efforts on drug pricing stand as much as shut scrutiny. He proclaimed that “in 2018 drug prices experienced their single-largest decline in 46 years.” The drug-price portion of the buyer worth index (CPI) declined barely final 12 months for the primary time since 1972, however costs for a lot of particular person medication are nonetheless rising sharply.
Factors past the administration’s actions seem to have performed the most important function within the total slowdown. Drug worth will increase have slowed largely as a result of patents have expired on costly, blockbuster medication and a number of other years have handed for the reason that introduction of pricy medicines to deal with hepatitis C, in accordance with impartial analysts.
But whilst shopper drug costs have moderated, drug spending per hospital admission soared 19 p.c from 2015 to 2017, a research sponsored by hospital commerce teams discovered final month. That consists of anesthesia medication, chemotherapy infusions and different medicines that aren’t counted within the CPI.
Some well-placed Republicans praised the drug worth effort. “I expect deep-pocketed interests to oppose anything and everything to protect the status quo,” stated Sen. Chuck Grassley (R-Iowa), chairman of the highly effective Senate Finance Committee. “But the moment is ripe for action and Americans expect us to work together to get the job done.”
After Shereese Hickson’s physician prescribed her a brand new a number of sclerosis drug final 12 months, the whole invoice got here to only over $123,000. Her portion was about $three,620.
News organizations together with Kaiser Health News have reported on dozens of instances of shock hospital payments, unaffordable prices for life-sustaining medication and different health-expense shocks for sufferers. Shereese Hickson, whose expertise with a $123,000 invoice for a number of sclerosis medication was covered by KHN and National Public Radio, was watching the speech.
“I’m glad he mentioned it,” she stated of Trump’s promise to carry transparency and competitors to pharmaceutical costs. “But I would like to see if it really will come true. If you do that — that’s going against the drug companies. They’ll be losing money and they’re not going to let that happen.”
Paul Davis — a retired physician from Findlay, Ohio, whose household’s expertise with a $17,850 invoice for a easy urine check was detailed in a KHN-NPR “Bill of the Month” feature final 12 months and who met with Trump about shock billing final month — stated he was disenchanted Trump didn’t go into additional element about his well being care proposals.
“He didn’t say anything,” he stated.
Davis stated he would have favored to have heard extra concerning the administration’s not too long ago introduced plan to get rid of drug rebates negotiated by middlemen within the Medicare drug program, in addition to the not too long ago carried out coverage requiring hospitals to listing their costs on-line.
“If he wanted to use the podium to talk about the wonderful things that he’s done, that’s one of the things he’s gotten accomplished,” Davis stated.
Elizabeth Moreno was billed $17,850 for a urine check. After Moreno’s insurer declined to pay any of the invoice as a result of the lab was out-of-network, her father, Dr. Paul Davis, paid the lab $5,000 to settle the invoice.
In their official responses to the speech, Democrats have been extra combative. “In this great nation, Americans are skipping blood pressure pills, forced to choose between buying medicine or paying rent,” stated Stacey Abrams, former Georgia House minority chief and a rising star within the nationwide Democratic Party. “Maternal mortality rates show that mothers, especially black mothers, risk death to give birth. And in 14 states, including my home state where a majority want it, our leaders refuse to expand Medicaid, which could save rural hospitals, economies and lives.”
California Attorney General Xavier Becerra, who gave the Spanish-language Democratic response, reminded viewers that whereas the Trump administration is searching for to have the Affordable Care Act overturned in court docket, Democrats would offer “medical care for your family that no politician can take away from you.”
In one other outreach to Democrats, Trump vowed that his funds “will ask Democrats and Republicans to make the needed commitment to eliminate the HIV epidemic in the United States within 10 years. Together, we will defeat AIDS in America,” he stated.
Groups which have been combating HIV praised the promise.
“While we might have policy differences with the president and his administration, this initiative, if properly implemented and resourced, can go down in history as one of the most significant achievements of his presidency,” stated Michael Ruppal, govt director of The AIDS Institute.
Trump additionally promised that his funds, which has been delayed by the current authorities shutdown, will search new funding to increase analysis into cures and coverings for childhood most cancers.
He stated he’ll search “$500 million over the next 10 years to fund this critical lifesaving research.” The National Institutes of Health has lengthy been a bipartisan favourite in Congress, though Trump in his first funds did seek cuts in NIH funding.
The one space during which bipartisanship will clearly not prevail is that of abortion. Trump reiterated a promise he made to anti-abortion teams as a candidate in 2016 and pushed for a federal invoice to ban abortions after 20 weeks of being pregnant.
“Let us reaffirm a fundamental truth: All children — born and unborn — are made in the holy image of God,” he stated.
Senate Republicans voted on such a invoice in 2018; it did not advance by a big margin. The invoice nonetheless lacks the votes within the Senate, and the House now has a majority that supports abortion rights.
Abortion opponents praised the president’s feedback. “Once again, President Trump has proved he is our nation’s most pro-life president ever and he is keeping his promise to the voters who fueled his victory,” stated Marjorie Dannenfelser of the Susan B. Anthony List.
Abortion-rights supporters, in the meantime, chastised Trump’s feedback.
“Shame on the president for using the State of the Union to vilify people who have abortions and the providers who care for them,” stated Megan Donovan of the Guttmacher Institute. “Make no mistake: This is part of a larger agenda to eliminate access to abortion altogether.”
Staff writers Jay Hancock, Emmarie Huetteman and Ana B. Ibarra contributed to this report.