This week the president signed several executive orders under the umbrella of his “America First Health Plan” during a campaign stop in North Carolina. The first executive order simply declares that it is national policy to protect coverage of those with preexisting conditions, but did not offer specifics. The second order states that the Administration will ban surprise billing if Congress does not come up with a solution by the end of the year. Simultaneously, the FDA released a final rule that clears the way for states to import prescription drugs from Canada. 

The final rule implements a provision of federal law that allows FDA-authorized programs to import certain prescription drugs from Canada under specific conditions that ensure the importation poses no additional risk to the public’s health and safety. The HHS final rule said the government will “in the future” allow pharmacists to directly import drugs from Canada. The final guidance describes procedures drug manufacturers can follow to facilitate importation of prescription drugs, including biological products, that are FDA-approved, manufactured abroad, authorized for sale in any foreign country, and originally intended for sale in that foreign country. The final rule is scheduled to take effect in 60 days. NAHU submitted comments on the proposed rule back in March where we emphasized that, while we support the intention behind the rule, importing prescription drugs from outside the United States does nothing to address why medications are so expensive when purchased within the United States.

The president’s executive orders come after polling indicates that the majority of Americans favor Biden on healthcare issues, as congressional Democrats across the country use Texas v. US in their campaign messaging. Trump noted “our opponents, the Democrats, like to constantly talk about” healthcare and pre-existing conditions, but “now we have it affirmed, this is affirmed, signed and done.” The order is symbolic and does not contain language that would implement protections against pre-existing conditions; rather, the order states that it is national policy to protect those with pre-existing conditions.

The other order states that Congress must pass a solution to balance billing before January 1 or the Administration will regulate the problem. This is not the first time the Trump Administration has flirted with putting an end to surprise bills itself. The White House released a plan back in May which would make it illegal for a patient to receive a surprise bill but does not specify how a billing dispute would be negotiated or resolved between the insurer and the provider. Billing disputes would have to be worked out on a case-by-case basis, an outcome that few stakeholders support. NAHU supports federal legislation that would provide new patient safeguards related to emergency care while implementing a fair market-based benchmark for out-of-network provider rates as an alternative to other proposals.

In addition to these executive orders, President Trump announced that the Administration is planning on sending $200 drug discount cards to over 33 million seniors in an effort to lower drug costs for older Americans. Some policy analysts claim that sending coupons to that many Medicare beneficiaries could cost an estimated $6.6 billion. White House staff noted that the cost could be covered through the 402 demonstration waivers, which tests innovations that could save money or improve quality of care for Medicare beneficiaries. The White House also said it would use savings from the “most favored nation” plan - which has not been enacted - to offset the cost of the drug coupon cards.