Trump reverses Biden-era drug pricing order. What it means for Michigan

• On his first day in office, President Trump reversed his predecessor’s executive order that the US find ways to reduce drug costs for Medicare and Medicaid recipients
• Michiganders aren’t likely to see an immediate change in out-of -pocket costs
• But what happens long-term — to coverage for obesity drugs, for example — is less clear

Michiganders aren’t likely to pay more at the pharmacy counter any time soon, despite President Donald Trump’s reversal Monday of his predecessor’s executive order to reduce drug prices for those covered by Medicare and Medicaid.

That’s because sweeping cost-cutting provisions that were already enshrined into law through the Inflation Reduction Act of 2022 remain in place. 

That law significantly reduced costs, especially for older Michiganders, by capping insulin for Medicare beneficiaries, ensuring recommended vaccines are free for Medicare and Medicaid recipients, allowing the federal government to negotiate drug prices and forcing drug manufacturers to pay rebates when they raised the prices of certain drugs faster than the rate of inflation. 

So, what was Biden’s executive order?

Under Biden’s Executive Order 14087, signed in October 2022, the administration took steps toward capping certain generic drugs at $2 for Medicare beneficiaries. The order also directed the Center for Medicare and Medicaid Innovation to find ways to expand access to high-cost treatment for Medicaid recipients and accelerate the process for moving medications to market.

Related:

• New for 2025: A cap on drug prices for nearly 2 million older Michiganders
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• Cheaper Medicare drugs bound for Michigan. By how much? It’s complicated
• Medicare’s $35-a-month insulin cap still leaves many residents out of luck

But these changes had not happened, said Dr. Mark Fendrick, a professor of health management and policy at the University of Michigan, who helped craft health policy during both the first Trump stint in the White House as well as Biden’s.

What does this mean for my prescription drug prices?

Monday’s move signals that Trump officially won’t be using the same playbook as Biden to reduce prices. In rescinding this and other Biden orders, the returning president called the Biden policies “deeply unpopular, inflationary, illegal, and radical practices.” 

But Biden’s executive order — like so many executive orders — wasn’t specific, said Fenrick, who also serves as director of U-M's Center for Value-Based Insurance Design.

Trump, he said, could still work toward the Biden administration’s goals of reducing out-of-pocket costs of certain drugs to $2 — a proposal that was still in the rule-making stage, or to make sure that weight loss drugs are covered by insurance when appropriate, as Fendrick has espoused.

“The Trump administration has to move it forward; they could just, they could yank it,” Fendrick said of those efforts.

And again, the Inflation Reduction Act, the sweeping legislation that keeps insulin prices capped for Medicare beneficiaries and allows the government to negotiate drug prices, remains in place. (Among the final announcements under  Biden, the US Centers for Medicare & Medicaid Services on Friday announced 15 drugs, including Ozempic, had been placed on the table for price negotiations.)

That means “beneficiaries are unlikely to feel major immediate changes because benefits are determined by a broader legislative and regulatory process rather than executive order,” said Chris Pope, a senior fellow at the Manhattan Institute, a New York-based conservative think tank.

What else did Trump change?

Lots.

Among dozens of executive orders, the returning president also took steps to withdraw from the World Health Organization, the United Nation’s agency tasked with global health, saying it mishandled the COVID-19 crisis and “continues to demand unfairly onerous” payments from the US.

At least one other move was less obvious than executive orders, but also signaled a dramatic ideologic shift in health care.

A federal web page, reproductiverights.gov, disappeared. The website had outlined rights to emergency care, birth control, and abortion among other things. 

Meanwhile, in Michigan, Gov. Gretchen Whitmer Tuesday signed more than a dozen bills into law that strengthen access to birth control and other reproductive health care. Among them is a new law allowing pharmacists to prescribe contraceptives.