Drug Pricing and the Uncertain Future of the IRA Under Trump

Based on the search results, here are the key points about drug pricing and the uncertain future of the Inflation Reduction Act (IRA) under the Trump administration:

Current Status of the IRA

• The IRA, passed in 2022 under Biden, allows Medicare to negotiate prices for certain high-cost drugs for the first time1013.

• CMS has already selected 10 drugs for the first round of negotiations, with prices to take effect in 20261013.

• In January 2025, CMS announced 15 additional drugs selected for the second round of negotiations, with prices to take effect in 2027913.

Trump Administration Actions So Far

• Trump revoked a Biden executive order aimed at lowering prescription drug costs615.

• Trump issued an executive order pausing spending on IRA clean energy components1415.

• However, the core Medicare drug price negotiation provisions of the IRA remain unchanged so far15.

Uncertainty Around IRA's Future

• The Trump administration has not yet announced specific plans for the IRA's drug pricing provisions1215.

• There is uncertainty about whether Trump will attempt to repeal, modify, or keep the Medicare negotiation program912.

• Some analysts believe a full repeal is unlikely, but modifications are possible915.

Factors Influencing Potential Changes

• Many Republican districts have benefited from IRA investments, which may make full repeal politically difficult17.

• There is bipartisan public support for expanding Medicare drug price negotiations1518.

• The pharmaceutical industry opposes the negotiation provisions and may push for changes9.

Potential Scenarios

• Partial repeal or modification of some IRA provisions, rather than full repeal17.

• Slowing implementation or enforcement of certain provisions812.

• Keeping core negotiation program but changing details like timelines or drug selection criteria12.

• Using budget reconciliation to make changes, as a full repeal would likely require 60 Senate votes15.

In summary, while the Trump administration has signaled opposition to some IRA provisions, the future of the Medicare drug price negotiation program remains uncertain. The administration will likely face both political pressure and practical challenges in making major changes to the law. Stakeholders are closely watching for more concrete policy announcements in the coming months.

Sources:

6. https://www.duanemorris.com/alerts/medicareprescriptionpricingfacesuncertaintyrevocationexecutiveorder14087_0125.html

8. https://tax.thomsonreuters.com/news/executive-order-targets-green-new-deal/

9. https://www.biospace.com/policy/drug-pricing-and-the-uncertain-future-of-the-ira-under-trump

10. https://www.medicare.gov/about-us/prescription-drug-law

12. https://www.mintz.com/insights-center/viewpoints/2146/2025-02-13-future-medicare-drug-price-negotiation-program

13. https://www.cms.gov/inflation-reduction-act-and-medicare/medicare-drug-price-negotiation

14. https://www.utilitydive.com/news/president-trump-inflation-reduction-act-executive-order-ev-mandate/738001/

15. https://www.managedhealthcareexecutive.com/view/trump-impact-on-medicare-drug-price-negotiations-uncertain

17. https://www.clf.org/blog/can-they-do-that-deflating-the-inflation-reduction-act/

18. https://medicareadvocacy.org/drug-cost-savings-rollbacks/