Trump To Sign Executive Order Aimed At Health Care Costs

As a candidate, President Trump argued that the government should work to lower drug prices. As president, his administration is finding that his promise is more complicated to keep than expected.

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Later today, President Trump plans to sign an executive order aimed at the cost of health care. He's been talking about high prescription drug prices in particular since his campaign. NPR White House correspondent Tamara Keith has this look at how and why President Trump turned his focus to that issue.

TAMARA KEITH, BYLINE: It was the night before the New Hampshire primary 2016. With snow falling outside, President Trump was giving one of his usual stem-winding campaign speeches in an arena in downtown Manchester. Then, in the midst of mocking his opponent's debate performance, he started talking about something new.

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PRESIDENT DONALD TRUMP: We're going to bring down the price of health care. We're going to bring it down big league - big, big league.

KEITH: In particular, prescription drug prices.

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TRUMP: My friend calls me up - a great doctor - he says, you know, Donald you're running, and you're doing great, and I'm so proud of you. I love to hear. I say, say it again. And he said...

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TRUMP: ...But you know, with the medical and with the drugs, the United States, the largest purchaser, and they don't negotiate price.

KEITH: The idea of Medicare negotiating to reduce the price of prescription drugs had long been pitched by Democrats. But here was a Republican presidential candidate - albeit an unorthodox one - making the same populist pitch.

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TRUMP: If we competitively bid drugs in the United States, we could save as much as $300 billion a year.

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TRUMP: Think of that. No, think of it.

KEITH: His numbers were way off. But for the businessman candidate, talking about competitive bidding was on brand. A White House official tried to figure out who Trump's doctor friend was but was unable to provide a name to NPR.

Barry Bennett, an adviser to the Trump campaign in early 2016, says Trump sat down with voters out of view of the press before most of his rallies and would have gotten an earful about prescription drug prices, especially in New Hampshire.

BARRY BENNETT: It's one of those border states where they send people to Canada to get their prescription drugs at a cheaper price. And you know, they see it on the news all the time, and they're angry about it.

KEITH: At the time Trump started talking about drug prices, outrage had been in the air for months.

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UNIDENTIFIED REPORTER #1: Since 2008, the price pharmacies pay for an EpiPen two-pack has shot up from $100 to...

UNIDENTIFIED REPORTER #2: This is basically the same product it was in 2009. And yet, the price has gone up 300 or 400...

UNIDENTIFIED REPORTER #3: The so-called pharma bro now being called the smirking CEO as he scoffs his way..

MARTIN SHKRELI: I probably would have raised the price higher.

KEITH: High prescription drug prices are one of those rare issues where voter concern crosses party lines evenly. Mollyann Brodie heads public opinion research for the Kaiser Family Foundation.

MOLLYANN BRODIE: Everybody can agree that they're too high, that they're unreasonable and that they're a big problem and that something needs to be done about them. And in fact, they agree on a lot of potential solutions. A lot of things that have been put out there are things that Republicans, Democrats and independents all agree about.

KEITH: She says one of the solutions that is overwhelmingly popular is having the government negotiate with drug companies to get a better price for people on Medicare. And that's exactly what Trump was pitching in his campaign. Never mind that it was out of sync with Republican orthodoxy, all the better for Trump, says Bennett - himself a longtime Republican consultant, aide and now lobbyist.

BENNETT: He's totally untethered by 40 years of protecting pharma. He heard people angry. They had a perfectly good case, and he started talking about it and I think now is, you know, still talking about it.

KEITH: Two-and-a-half years into his presidency, Trump hasn't carried out his promise to have Medicare negotiate with drug companies. And an administrative action that would tiptoe in that direction is in a holding pattern after thousands of public comments poured in. But people in the health care industry say Trump and his administration are putting pressure on drug companies. And Trump is once again campaigning on the issue.

Tamara Keith, NPR News.

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