Trump to Announce Medicaid MFN Drug Pricing in All 50 States
The policy extends a pricing model tied to international benchmarks across every state Medicaid program, with the administration framing the rollout as a midterm campaign asset for Republican...
President Trump is set to announce Friday that all 50 state Medicaid programs will receive most favored nation (MFN) pricing on select prescription drugs, according to an administration official cited by The Hill. The announcement is scheduled to take place in the Oval Office, with several governors present.
MFN pricing is a reimbursement model that ties what the federal government pays for certain drugs to the lowest price paid for the same drugs by peer nations, typically members of the Organization for Economic Cooperation and Development. The mechanism has been debated in federal health policy circles for more than a decade without full national implementation.
The administration official, speaking to The Hill without being named, said the pricing structure will apply to Medicaid, the joint federal-state program that provides health coverage to approximately 80 million low-income Americans, according to the Centers for Medicare and Medicaid Services' most recent enrollment data.
The White House has not yet released the text of the executive order or administrative rule underlying Friday's announcement. It is unknown from available public records which specific drug classes are covered, which manufacturers are affected, or what the projected federal and state savings figures are. A formal regulatory filing in the Federal Register or a CMS rulemaking document would contain those details.
Republicans are eyeing drug pricing as a political asset ahead of November's midterm elections, according to The Hill's reporting. Prescription drug costs ranked among the top concerns for voters across party lines in multiple 2025 and 2026 polling cycles, including surveys conducted by KFF, formerly the Kaiser Family Foundation. Affordability of medications has consistently appeared in the top five concerns in KFF Health Tracking Polls published between January 2025 and June 2026.
The MFN model was previously advanced during Trump's first term. In November 2020, the Centers for Medicare and Medicaid Services published a final rule in the Federal Register (85 Fed. Reg. 76180) that would have applied MFN pricing to Medicare Part B drugs. That rule was challenged in federal court by the Pharmaceutical Research and Manufacturers of America and other industry groups. A federal district court issued a preliminary injunction in January 2021, and the Biden administration subsequently withdrew the rule in December 2021 via a CMS rulemaking action published in the Federal Register (86 Fed. Reg. 67717).
The current announcement applies to Medicaid rather than Medicare Part B, which represents a structural difference in the program targeted. Medicaid drug reimbursement is already subject to mandatory rebates under the Medicaid Drug Rebate Program, established by the Omnibus Budget Reconciliation Act of 1990. How MFN pricing interacts with or supersedes existing rebate calculations has not been specified in available public materials as of the time of publication.
Governors attending the Oval Office event have not been named in available reporting. Their participation is relevant because Medicaid is administered by states under federal guidelines, and any pricing change would have implementation consequences for state Medicaid agencies and their contracted managed care organizations.
The pharmaceutical industry response to Friday's announcement had not been reported in available sources at the time of publication. In the 2020 MFN rulemaking, the Pharmaceutical Research and Manufacturers of America argued in court filings that the model would reduce manufacturer revenue and lead to reduced drug access. Whether similar legal challenges will follow the current announcement is unknown.
Several material facts remain unresolved in public records. The specific executive or administrative authority cited for the Medicaid MFN pricing expansion has not been published. The list of covered drugs, the baseline international prices being used for comparison, and the estimated savings to federal and state budgets are not yet available. A published CMS rule, an executive order posted to the Federal Register, or a White House fact sheet would contain those figures. This story will be updated when those documents are released.