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yesterday

Trump Extends Most‑Favored‑Nation Drug Prices to All State Medicaid Programs

The GENEROUS Medicaid Payment Model will let states use manufacturer supplemental rebates to cap Medicaid net prices to international benchmarks while key contract terms, state opt‑ins and independent checks of the administration’s savings estimates remain pending.

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WASHINGTON, DC - AUGUST 31: U.S. President Donald Trump, accompanied by (L-R) Astellas Pharma President Michael Putrasis, Commerce Secretary Howard Lutnick, Health and Human Services Secretary Robert F. Kennedy Jr., and Administrator for the Centers for Medicare & Medicaid Services Dr. Mehmet Oz, holds up a poster that displays "Pharmaceutical Investment Commitments" as he speaks during a healthcare affordability event in the Oval Office at the White House on August 31, 2026 in Washington, DC. President Trump announced that nearly a dozen pharmaceutical manufacturers have agreed to lower the price of their medications to match their prices outside of the United States. (Photo by Kevin Dietsch/Getty Images)
President Trump holding a chart showing child poverty rates.

Overview

  • The White House announced on Friday that every state, the District of Columbia and Puerto Rico will be able to access most‑favored‑nation (MFN) prices for hundreds of branded drugs through the GENEROUS Medicaid Payment Model.
  • Under GENEROUS, participating manufacturers provide supplemental rebates intended to ensure Medicaid’s final net price for eligible drugs does not exceed an agreed MFN benchmark and states can choose which drugs to enroll.
  • The administration says it has agreements with 26 drugmakers that cover roughly 89–90% of the branded U.S. market and cites Council of Economic Advisers estimates of about $64.3 billion in Medicaid savings and up to $600 billion total over a decade.
  • Health policy experts and reporters note major unknowns: which exact drugs are covered, how MFN rebates will interact with existing statutory Medicaid rebates and state supplemental deals, and that the administration’s savings figures have not been independently verified.
  • Consumers have seen roughly $700 million in discounts so far through TrumpRx and manufacturers have pledged U.S. manufacturing investments, but the program’s real effects will depend on published contracts and individual states’ decisions to opt in.