The Trump administration wants to do a lot with healthcare. Hints about what it actually will do are scattered in the Financial Year 2019 budget documents released by the White House on February 12. It is clear that Trump wants to abolish in entirety the Affordable Care Act and refurbish Medicaid with a harsher version of Graham-Cassidy. The replacement plan has a close resemblance with the plan thrust forward by Senators Bill Cassidy and Linsey Graham. Both are Republicans. If the plan succeed, then majority of the ACA funding now being spent in premium subsidies and Medicaid expansion would be turned into states' block grants. The states could then create own healthcare programs. Medicaid can also be overhauled with a spending plan created on a per person basis.
Reducing drug prices
The first of these proposals involve the state Medicaid programs to be given the requisite power to establish the drug formularies. These are tiered systems which offers preferential treatments to a few particular drugs over others. Private insurers use them to negotiate the prices with the concerned drug companies. Experts in drug pricing are wondering whether the Trump led government will approve the Massachusetts' waiver do that such kind of Medicaid formulary can be set up.
There is a catch in the proposal. According to Trump administration, it needs the assistance of Congress to approve changes in Medicaid. This is why even though the budget seems to be on the side of proposals, it means that the waiver may actually not be approved. The Trump administration has also envisaged more cuts to Medicare and Medicaid. This may involve denying benefits to individuals
The original plan was projected to lead about 20 million Americans to survive without any kind of health insurance by 2026 when compared to the ACA. The federal healthcare spending will be slashed by $215 billion over a span of 10 years. This proposal by the Trump administration represents the deepest cuts for Graham-Cassidy and Medicaid block grants. This picks lowest of possible growth rates for block grants. Thus net result is a cut of $765 billion in federal spending cuts within 2028.
President Donald J. Trump has until now did not follow through one of his principal campaign pledges: lowering the prices of drugs and countering the supposedly rapacious practices of large pharmaceutical companies. Trump's budget does have a number of new proposals concerning drug costs.