Trump touts lower drug costs and anti-fraud measures in lengthy State of the Union

STAT News · Feb 25, 2026 · Collected from RSS

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WASHINGTON — In the first State of the Union address of his second term, President Trump on Tuesday touted economic wins, including on health care, even as more than half of Americans say health care has become more unaffordable for them and their families. In his speech, Trump claimed he had brought prescription drug costs from the highest in the world to the lowest, thanks to his “most-favored nation” policy. And he implored congressional Republicans to codify the policy into law. “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%.’ But John and Mike, if you don’t mind, codify it,” he said, directly addressing Senate Majority Leader John Thune (R-S.D.) and House Speaker Mike Johnson (R-La.). Most-favored nation pricing is not popular among Republican lawmakers, who’ve shied away from addressing the issue. The trade group PhRMA has also opposed the policy, with the group’s president and CEO, Stephen Ubl, saying in a statement Tuesday night, “Government-imposed Most Favored Nation policies would undermine U.S. competitiveness while doing nothing to address insurance practices that deny care and raise costs for patients.” Just a few days ago, Centers for Medicare and Medicaid Services Administrator Mehmet Oz made the opposite argument when selling the idea to a room full of drugmakers, saying that most-favored nation legislation would protect drugmakers from a future administration pressing for prices that were too low. Democrats have made health care affordability central to their midterm campaign messaging after Congress failed to renew enhanced Affordable Care Act tax credits, sending premiums soaring for millions of Americans during an election year. The One Big Beautiful Bill Act, passed by Republicans last summer, also cut more than $1 trillion from government health care spending, mostly from Medicaid, but those cuts will not go into effect until after midterms. For the speech Tuesday night, several Democrats brought constituents from their states who they say have struggled to pay rising health care costs. Trump unveiled his “Great American Health Plan” in January, and the administration has been retooling its message on health care to focus on topics that are popular with voters, including nutrition and drug prices. The administration launched its TrumpRx website this month, a tool that displays cheaper prices for certain prescription drugs to consumers who pay cash without using insurance. A STAT analysis of the tool found that many of the brands on TrumpRx are available as cheaper generics elsewhere, even as Trump on Tuesday night touting TrumpRx and his other drug pricing policies as a “big achievement.” The president’s speech included a few other health care policy pitches as well, including: Less money for insurance companies, more for HSAs Trump alluded to his desire to shift more government funding from premium tax credits to health accounts that resemble the health savings accounts available from some employers. That would give enrollees money to spend on health care bills they incur before hitting deductibles, but the money could not be used to cover monthly premiums. The president complained that the Affordable Care Act has resulted in insurance companies receiving “hundreds and hundreds of billions of dollars a year,” and he said that money should instead go directly to individuals. “I want to stop all payments to big insurance companies and instead give that money directly to the people,” Trump said. Amping up the war on fraud Trump briefly mentioned his administration’s crackdown on fraud in government programs, including federal health care and child care programs. In his speech, Trump said Vice President JD Vance will be leading fraud investigations in Minnesota, Maine, and California. The president particularly lambasted fraud in Minnesota, which he attributed to the state’s sizable Somali immigrant population. In December, the Department of Health and Human Services froze child care funds to Minnesota after YouTuber Nick Shirley posted a video in which he claimed he had discovered widespread fraud at Minnesota child care centers, many run by Somali immigrants. Minnesota state officials have acknowledged concerns about potential fraud but have also said that the child care facilities highlighted in Shirley’s video had been recently visited by state regulators, who did not find evidence of problems. Shirley was in attendance at the State of the Union on Tuesday. Since then, HHS has zeroed in on other Democrat-led states that it says are complicit in high rates of health care fraud, which those states have denied. Oz has been a big part of those efforts, traveling to Los Angeles and trading barbs with California Gov. Gavin Newsom (D), as were Deputy Secretary and acting CDC Director Jim O’Neill and HHS General Counsel Mike Stuart, both of whom have since left the department. An attack on gender-affirming care At one point, Trump introduced guest Sage Blair, a Virginia teen whose family is suing her school district for allegedly concealing information about Blair’s gender identity. Trump said that states should not be allowed to make decisions on issues like gender-affirming care without parental consent. It’s a regular line of attack for the president and his party. In the last year, the Trump administration has relentlessly pursued restrictions that would create a de facto ban on gender-affirming care for young people. Those efforts include an early executive order; dozens of wide-reaching Department of Justice subpoenas to hospitals and clinics that provide gender-affirming care; an attempted ban on Medicare and Medicaid coverage both in congressional bill drafts and a proposed CMS rule; another proposed rule that would refuse participation in Medicare and Medicaid to any hospital that provides youth trans care; and at least a dozen referrals of hospitals and community health centers for investigation by HHS’ inspector general. While some critics of transgender health care cite a low certainty evidence base, Trump administration officials often rely on more explosive, ideological language. Official HHS documents refer to puberty blockers, hormones, and surgery as “sex-rejecting procedures,” and the executive order refers to “chemical and surgical mutilation.” While many of the administration’s moves are still pending or being challenged in court, clinics are feeling the pressure. Dozens of institutions have restricted or ended gender-affirming care for young people since January 2025. What Trump didn’t mention The nearly two-hour speech was the longest State of the Union delivered at least since 1964, when The American Presidency Project began keeping records. Even so, the president steered away from some of the more controversial health care topics that have animated his administration and lawmakers over the last several months. Vaccines Noticeably absent was any mention of vaccines, particularly the childhood vaccine schedule the president ordered overhauled in December in a presidential directive. Before that directive, Trump had occasionally railed against what he described as an excessive number of vaccines received by children in doctor’s offices, including a news conference in September when he questioned the safety of the shots. In January, health secretary Robert F. Kennedy Jr. and other top health officials unilaterally announced they’d reduced the number of recommended pediatric vaccines, alarming public health experts. There’s been a steady drumbeat of changes to vaccine policy since Kennedy became health secretary. He fired every member of the Advisory Committee on Immunization Practices and re-formed the committee primarily with vaccine skeptics, who then recommended delaying when most babies get immunized against hepatitis B. Kennedy announced that the Centers for Disease Control and Prevention would no longer recommend Covid-19 vaccines for healthy children and during pregnancy. Kennedy has taken steps to overhaul a program that compensates people hurt by vaccines. But in recent weeks, the White House has seemingly tried to steer HHS away from the vaccine issue, which is politically divisive, and toward what it considers more politically popular wins, like food safety and drug policy. In doing so, HHS has elevated some officials to more senior roles and ousted others, including O’Neill, aimed at zeroing in on its midterm agenda. Still, vaccine policy continues to rear its head at HHS: The Food and Drug Administration’s top drug regulator recently told staff she would scrutinize shots used to protect babies against respiratory syncytial virus. The agency also drew attention this month for rejecting an application by Moderna to review its new influenza vaccine and then reversing course. Enhanced ACA subsidies The Jan. 1 expiration of the enhanced Affordable Care Act premium tax credits has sent health care costs for millions soaring during an election year. A small group of moderate Republicans in tight races tried to resurrect the credits, but that effort failed. While Trump talked about making health care more affordable in his speech, he did not mention the tax credits directly. Medicaid cuts Trump obliquely referred to Medicaid by talking about Republican efforts to fight fraud in health care. But he didn’t mention the One Big Beautiful Bill Act, one of his signature achievements, which could result in as many as 10 million people losing their Medicaid coverage, experts estimate. Work requirements are one of the ways that Republicans cut Medicaid access, and while it’s not an unpopular policy, Trump didn’t mention it. DOGE cuts Also missing from the speech: The Trump administration’s major cuts to the health workforce, and to science funding. HHS’ workforce was slashed this year. The FDA, CDC, and National Institutes of Health underwent major layoffs. Smaller centers that took a hard hit include the Subst