President Trump on Friday outlined his long-awaited plan to lower drug prices, stopping short of a full-scale assault on the pharmaceutical industry while floating several ideas that could give companies heartburn.

Trump stepped back from the some of the sweeping proposals he offered on the campaign trail, like having Medicare negotiate drug prices, but still leveled pointed criticism at the industry.

“The drug lobby is making an absolute fortune at the expense of American consumers,” Trump said in remarks from the White House Rose Garden. “We are putting American patients first.”

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Republicans have often won support in recent elections by promising to repeal the Affordable Care Act. This year, Democrats hope to turn the tables by pushing the opposite goal—not just keeping the health law, but expanding government’s role in health care.

The tactic, which carries political risk as well as opportunity, is playing out in places such as Minnesota, a state won narrowly by Hillary Clinton in 2016 that is facing a governor’s race, two Senate contests and five close House races. Democrats need to gain 23 House seats to retake the chamber, so the state is critical.

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Americans should be able to reap the rewards of living in the country that has brought the world more new drugs than any other. President Trump has made fixing high drug prices a top priority. He will give a speech on the topic today. HHS is taking on this challenge focused on 1) increasing competition in drug markets, 2) giving Medicare Part D plans better tools to negotiate prices, 3) creating new incentives for drug manufacturers to lower list prices, and 4) new options to lower patients’ out-of-pocket spending.

By better focusing the Affordable Care Act’s subsidies on the subset of individuals who are uninsurable in an actuarially priced market, STLDI deregulation would increase overall insurance enrollment. Reductions in premiums for individuals able to enroll in STLDI plans are likely to greatly exceed the slight increase in costs for higher-income unsubsidized individuals remaining on the exchange. STLDI deregulation might even save taxpayers a little money too.

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The Senate’s two top Republican proponents for individual market exchange stabilization measures are in talks with CMS Administrator Seema Verma about making 1332 state innovation waivers easier to obtain.

Early insurance rate filings from Maryland and Virginia have shown huge premiums spikes, leading Republicans and Democrats on Capitol Hill to question which party is to blame for the hikes months before midterm elections. Sen. Lamar Alexander (R-Tenn.) said he and Verma are discussing speeding up the waiver application process, although he conceded that most of the measures he and Sen. Susan Collins (R-Maine) proposed to keep rates in check for next year would need to be enacted by Congress.

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Sen. Lamar Alexander (R-Tenn.) wrote in a recent letter that bipartisan efforts to fix ObamaCare have failed and he is now turning to focus on additional actions the Trump administration can take on its own regarding the health-care law.

Alexander worked for months with Sen. Patty Murray (D-Wash.) on a bipartisan effort to provide funding to bring down ObamaCare premiums, but the effort fell apart in March.

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Some Republican lawmakers continue to try to work around the federal health law’s requirements. That strategy can crop up in surprising places. Like the farm bill.

Tucked deep in the House version of the massive bill — amid crop subsidies and food assistance programs — is a provision that supporters say could help provide farmers with cheaper, but likely less comprehensive, health insurance than plans offered through the Affordable Care Act.

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The Trump administration announced Monday that it is rejecting Kansas’s request to impose lifetime limits on Medicaid benefits, drawing a line against a new level of conservative changes to the program.

The administration has already approved work requirements in Medicaid, a controversial move in itself, but Monday’s decision indicates that time limits on Medicaid coverage go too far for the Trump administration.

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Insurers are proposing double-digit premium increases in Maryland’s individual-health-plan market, a consequence of what the state’s health insurance commissioner called a “death spiral.”

CareFirst BlueCross BlueShield requested an 18.5 percent increase on the HMO plans used by the vast majority of its individual-plan members — and a whopping, 91.4 percent increase on its PPO plans. Kaiser Permanente requested a 37.4 percent increase on its HMO plans. The average rate increase requested, across insurers and plans, was 30 percent.

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Americans are active shoppers. Whether purchasing a car, a dishwasher, or a jar of salsa, we rarely buy anything without comparing the price and quality of available options. These days, shoppers have access to a wide array of tools online to inform our quest for value. Our demand for value is the engine that drives competition which, in turn, lowers prices and inspires innovation to improve the quality of the products we purchase.

Yet, when it comes to one of the most important services we receive — our health care — this consumer driven engine sputters.

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