Trump Wants Congress To Make His Drug Pricing Deals Law. It Won’t Be Easy.

In his State of the Union address on Tuesday, President Donald Trump acknowledged his deals with drugmakers may not last past his administration if Congress does not make them law. He then urged lawmakers to make that happen.

But whether they will comply is far from certain. While Republicans are generally reluctant to publicly oppose Trump, few have come out in favor of the effort.

One likely reason: the idea of heavy-handed government intervention – including price controls – has historically been anathema to pro-business Republicans and the corporate lobbyists who spend millions to court them. While members of Trump’s party backed the “most-favored-nation” drug price negotiations, which produced voluntary confidential deals with 16 large pharmaceutical manufacturers last year, making them law may be further than some want to go.

Conservative groups have already been exerting pressure against codification, with more than 50 leaders of GOP and free-market groups signing a letter to Congress arguing that turning the drug pricing deals into law would “import socialist price controls and values into our country. ”

And while some Republican lawmakers appear willing to consider the idea, they also say the secrecy around the deals presents an obstacle.

“He says he wants us to codify the deals, and I think we need to know and understand a little bit more what the deals are,” said Sen. Lisa Murkowski (R-Alaska).

Bipartisan support is also unlikely. Democrats who otherwise may support permanently lowering U.S. drug costs closer to what other countries pay — the aim of most-favored-nation deals — will undoubtedly be reluctant to hand Trump a win while they are hammering him on the cost of living ahead of the fall midterms.

Trump’s pitch during his address was indirect.

“I’m not sure it matters, because it’s going to be very hard for somebody that comes along after me to say, ‘Let’s raise drug prices by 700 or 800 percent,’” Trump said.

“But, John and Mike, if you don't mind, codify it anyway,” he added, referring to Senate Majority Leader John Thune (R-S.D.) and House Speaker Mike Johnson (R-La.).

Nick Shipley, a longtime drug industry lobbyist who previously worked for both the Biotechnology Innovation Organization and PhRMA, the Washington lobbies for drugmakers, questioned if Republicans on Capitol Hill will have much appetite to take Trump up on that request.

Trump “only devoted 3 minutes to drug pricing out of 107 minutes total, and like a lot of the traditionally left-leaning ideas he has embraced, it’s just hard to see the congressional GOP getting on board without a better sales pitch, especially if you’re openly saying, ‘I’m not sure it matters,’” said Shipley, now the founder of Cronus Consulting.

Some Trump loyalists say they are willing to work with Trump to pass legislation.

“I believe in it,” Sen. Rick Scott (R-Fla.) said of the push to codify the most-favored nation agreements. “I actually did it with my business life. I ran the largest hospital company, and I told the companies that I dealt with because I had four hospitals in Europe, I'm not paying more than I pay in Europe. It didn't make any sense to me at the time, it doesn't make any sense to me today.”

The White House argues that the deals gave Congress a "model of how to actually get this done without compromising lifesaving innovation," said spokesman Kush Desai.

Sen. Bernie Moreno (R-Ohio) pushed back at the idea that codification would buck traditional Republican free market orthodoxy.

“Is it a free market when the U.S. taxpayer funds research and development for a drug, that drug is produced here and then we sell it to other countries for a fraction of what we charge our own citizens?” Moreno told POLITICO on Wednesday.

But more, like Murkowski, appear to be taking a wait-and-see approach. An effort by top Trump administration officials to persuade Republican lawmakers on the Senate Finance Committee to push for legislation met with some skepticism, according to a report by STAT.

“We ought to see what the proposal is quite frankly,” Sen. James Lankford (R-Okla.) told POLITICO Wednesday. “If we are talking about a socialist market like they have in France clearly that is not who we are, but that is not what he is proposing either.”

Last year, Sen. Bill Cassidy (R-La.) floated a most-favored nation draft bill that would allow Medicare to claw back money from drugmakers that sell medicines to other affluent nations at a lower price than in the U.S., but the proposal did not get included in the One Big Beautiful Bill Act the Republicans passed in July.

Some Republicans were quick to praise Trump’s push to lower drug prices, but believe additional reforms to pharmacy benefit managers, which oversee drug benefits for employer and Medicare plans, are poised to more easily move in the near future. This is because they’ve been under consideration longer and already have bipartisan support. Congress also included a slate of reforms affecting the benefit managers in the government spending bill enacted earlier this month.

“I think our focus should be mostly on the pharmacy benefit managers and taking them out of the picture,” said Sen. Roger Marshall (R-Kan.) to POLITICO Wednesday.

Some Democrats were also skeptical of the push to codify the drug price deals, making bipartisan support unlikely.

“He is always calling for people to do something,” said Sen. Ron Wyden (D-Ore.) to reporters Wednesday. “The reality is ever since Trump won when it comes to doing the nuts and bolts of putting together the legislation there ends up being no there there.”

Wyden and other Democrats were in favor of getting the best price possible for Americans but questioned how to do that with the confidential nature of the deals.

“That is a problem. We’ve got to see what the deal is,” Sen. Peter Welch (D-Vt.) told POLITICO Wednesday.

CMS Administrator Mehmet Oz asked drugmakers at their annual forum last week to work with the Trump administration to codify the confidential deals.

“There’s a strong argument to be made to grab something from people who are proven trustworthy, to get something that you own, you crafted in a way that can preserve the needs of industry while not hurting the American people,” Oz said.

But lobbyists for drugmakers have been staunchly opposed.

Pharmaceutical Research and Manufacturers of America CEO Stephen Ubl has thrown cold water on the idea that the brand drug industry is ready to support codifying anything that resembles Trump’s most-favored nation deals.

“There's a big difference between voluntary agreements and individual companies having discussions with the administration and codifying, on a broad basis, price controls in legislation,” Ubl told reporters last week at a press conference.