Trump Tackles Drug Costs, HIV, Cancer, Abortion in State of the Union

Alicia Ault


February 06, 2019

In his second State of the Union address, President Donald J. Trump focused on how his administration intends to lower the cost of prescription drugs, boost funding to end childhood cancer and HIV/AIDS, and secure the passage of legislation to ban what he called "late-term" abortion.

A year ago, Trump promised in his first State of the Union speech to address both rising drug costs and the opioid crisis. Prescription drug costs received even more attention in this year's speech.

"The next major priority for me and all of us should be to lower the cost of healthcare and prescription drugs and to protect patients with preexisting conditions," said Trump, about 45 minutes into the speech.

The president said that in 2018, drug prices had, as a result of his administration's policies, "experienced their single largest decline in 46 years."

He said it was unacceptable that Americans pay more for the same drugs than people in other nations. "This is wrong, this is unfair, and together we will stop it," said Trump, who said he'd seek legislation that "finally takes on the problem of global freeloading."

He also called for price transparency from drugmakers, insurers, and hospitals, saying disclosures would foster competition and bring prices down.

Trump will likely find plenty of bipartisan support for the effort to reduce drug prices. In the congressional work year that began after the government shutdown ended on January 25, legislators already began delving into the issue.

On January 29, both the House Oversight and Reform Committee and the Senate Finance Committee held hearings addressing drug costs. Then, the day before the State of the Union speech, Senate Finance Committee Chairman Chuck Grassley (R-IA) and the committee's top Democrat, Ron Wyden (D-OR) publicly invited seven major pharmaceutical companies to testify at a February 26 hearing.

"Patients and taxpayers deserve to hear from leaders in the industry about what's behind this unsustainable trend and what can be done to lower costs," Grassley and Wyden said in a joint statement.

In his State of the Union address, the president briefly highlighted his administration's efforts to contain the opioid crisis, mentioning the legislation signed into law in October 2018, the SUPPORT (Substance Use–Disorder Prevention that Promotes Opioid Recovery and Treatment) for Patients and Communities Act.

He also celebrated what he viewed as other accomplishments in healthcare. "We eliminated the very unpopular Obamacare individual mandate penalty — and to give critically ill patients access to lifesaving cures, we passed right to try," said Trump, referring to legislation that allows patients to access medications that have not yet been approved by the US Food and Drug Administration.

Trump said he would seek to end HIV/AIDS in America within 10 years. "My budget will ask Democrats and Republicans to make the needed commitment to eliminate the HIV epidemic in the United States within 10 years," he said.

"Together, we will defeat AIDS in America and beyond."

Turning to one of his guests — 10-year-old Grace Eline, who sat in First Lady Melania Trump's box — the president said he was also asking lawmakers to get behind the fight against childhood cancer. Eline had received treatment for brain cancer, said Trump, adding that he'd be asking Congress for $500 million over the next decade to fund research into pediatric cancers.

Next, Trump touched on abortion. "To defend the dignity of every person, I am asking the Congress to pass legislation to prohibit the late-term abortion of children who can feel pain in the mother's womb," he said.

The White House had released information that the president would at least mention abortion in the speech.

Ahead of the speech, the American College of Obstetricians and Gynecologists (ACOG) issued a statement emphasizing that the phrase "late-term abortion" has no medical definition and is not used in a clinical setting. Abortions in the third trimester are extremely rare, accounting for less than 1% of abortions, but may be necessary owing to fetal anomalies or to address complications that threaten a woman's health, said ACOG in the statement.

"Women, in consultation with their physicians, must be able to evaluate all appropriate treatments and make informed choices about what's best for their health and their pregnancies," the group said.

Democrats Push Back

The Democrats' formal response came from Stacey Abrams, the former House minority leader of the Georgia legislature.

She narrowly failed in her November 2018 bid to become the state's and the nation's first black female governor.

Abrams said that Democratic leaders would do more to ensure Americans have access to healthcare. "Rather than suing to dismantle the Affordable Care Act, as Republican attorneys general have, our leaders will protect the progress that we've made and commit to expanding healthcare and lowering costs for everyone," said Abrams.

She noted that with her father's ongoing prostate cancer treatments, "to cover the costs, I found myself digging deeper into debt," and added that many people were being forced to choose between "buying medicine or paying rent."

Abrams also noted the high rates of maternal mortality, especially for African American women, and the ongoing refusal of 14 states to expand Medicaid. Accepting federal money to expand those programs "could save rural hospitals, save economies, and save lives," Abrams said.

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