Trump Takes On Multiple Health Topics in State of the Union

Alicia Ault


February 05, 2020

President Donald J. Trump took on multiple healthcare issues in his State of the Union address, imploring Congress to avoid the "socialism" of Medicare-for-all, to pass legislation banning so-called late-term abortions, and to protect insurance coverage for preexisting conditions while joining together to reduce rising drug prices.

Trump said his administration has already been "taking on the big pharmaceutical companies," claiming that in 2019, "for the first time in 51 years, the cost of prescription drugs actually went down."

That statement was called "misleading" by the New York Times because such efforts have excluded some high-cost drugs, and prices had risen by the end of the year, the publication noted in a fact-check of the president's speech.

A survey issued in December found that the United States pays the highest prices in the world for pharmaceuticals, as reported by Medscape Medical News.

But the president did throw down a gauntlet for Congress. "Working together, the Congress can reduce drug prices substantially from current levels," he said, stating that he had been "speaking to Senator Chuck Grassley of Iowa and others in the Congress in order to get something on drug pricing done, and done properly."

"Get a bill to my desk, and I will sign it into law without delay," Trump said.

A group of House Democrats then stood up in the chamber and loudly chanted, "HR3, HR3," referring to the Lower Drug Costs Now Act, which the House passed in December.

The bill would give the US Department of Health and Human Services (HHS) the power to negotiate directly with drug companies on up to 250 drugs per year, in particular, the highest-costing and most-utilized drugs.

The Senate has not taken up the legislation, but Senators Grassley (R) and Ron Wyden (D-OR) introduced a similar bill, the Prescription Drug Pricing Reduction Act. It has been approved by the Senate Finance Committee but has not been moved to the Senate floor.

"I appreciate President Trump recognizing the work we're doing to lower prescription drug prices," Grassley said in a statement after the State of the Union. "Iowans and Americans across the country are demanding reforms that lower sky-high drug costs. A recent poll showed 70% of Americans want Congress to make lowering drug prices its top priority."

Rep. Greg Walden (R-OR), the ranking Republican on the House Energy and Commerce Committee, said he believed Trump was committed to lowering drug costs. "I've never seen a President lean in further than President Donald Trump on lowering health care costs," said Walden in a statement after the speech.

Trump touted his price transparency rule, which he said would go into effect next January, as a key way to cut healthcare costs.

Preexisting Conditions

The president said that since he'd taken office, insurance had become more affordable and that the quality of healthcare had improved. He also said that he was making what he called an "iron-clad pledge" to American families.

"We will always protect patients with preexisting conditions ― that is a guarantee," Trump said.

In a press conference before the speech, Speaker of the House Nancy Pelosi (D-CA) took issue with that pledge. "The president swears that he supports protections for people with preexisting conditions, but right now, he is fighting in federal court to eliminate these lifesaving protections and every last protection and benefit of the Affordable Care Act [ACA]," she said.

During the speech, Rep. G. K. Butterfield (D-NC) tweeted "#FactCheck-Claiming to protect Americans with pre-existing conditions, Trump and his Administration have repeatedly sought to undermine protections offered by the ACA through executive orders and the courts. He is seeking to strike down the law and its protections entirely."

Larry Levitt, executive vice president for health policy at the Kaiser Family Foundation, pointed out in a tweet that insurance plans that Trump touted as "affordable alternatives" are in fact missing those protections.

"Ironically, the cheaper health insurance plans that President Trump has expanded are short-term plans that don't cover pre-existing conditions," Levitt said.

Socialist Takeover

Trump condemned the Medicare-for-all proposals that have been introduced in Congress and that are being backed in whole or in part by all of the Democratic candidates for president.

"As we work to improve Americans' healthcare, there are those who want to take away your healthcare, take away your doctor, and abolish private insurance entirely," said Trump.

He said that 132 members of Congress "have endorsed legislation to impose a socialist takeover of our healthcare system, wiping out the private health insurance plans of 180 million Americans."

Added Trump, "We will never let socialism destroy American healthcare!"

Medicare-for-all has waxed and waned in popularity among voters, with generally more Democrats than Republicans favoring a single-payer system, with or without a public option.

Preliminary exit polls in Iowa that were conducted during Monday's caucus found that 57% of Iowa Democratic caucus-goers supported a single-payer plan; 38% opposed such a plan, according to the Washington Post.

Opioids, the Coronavirus, and Abortion

In some of his final remarks on healthcare, Trump cited progress in the opioid crisis, noting that in 2019, drug overdose deaths declined for the first time in 30 years.

He said that his administration was coordinating with the Chinese government regarding the coronavirus outbreak and noted the launch of initiatives to improve care for people with kidney disease, Alzheimer's, and mental health problems.

Trump repeated his 2019 State of the Union claim that the government would help end AIDS in America by the end of the decade.

The president also announced that he was asking Congress for "an additional $50 million" to fund neonatal research. He followed that up with a plea about abortion.

"I am calling upon the members of Congress here tonight to pass legislation finally banning the late-term abortion of babies," he said.

Insulin Costs?

In the days before the speech, some news outlets had reported that Trump and HHS were working on a plan to lower insulin prices for Medicare beneficiaries, and there were suggestions it would come up in the speech.

At least 13 members of Congress invited people advocating for lower insulin costs as their guests for the State of the Union, Stat reported. Pelosi invited twins from San Francisco with type 1 diabetes as her guests.

But Trump never mentioned insulin in his speech.

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