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STAT+: Trump touts pharma deals to offer cheaper drugs to state Medicaid programs
Confirmed
In Short: President Trump announced Friday that all 50 states, Washington, D.C., and Puerto Rico will participate in the GENEROUS drug pricing model, which aims to offer lower drug prices to Medicaid programs.
The GENEROUS model, part of broad drug pricing deals with the Trump administration, will see more than two dozen pharmaceutical companies sell drugs to state Medicaid programs at prices available in peer countries.
The initiative is a key component of Trump’s plan to lower drug prices and has become central to his messaging on affordability.
(MFN) drug-pricing agenda, which seeks to reduce the gap between U.S. prescription drug costs and prices paid in other developed countries.
Under the model, the Centers for Medicare and Medicaid Services (CMS) calculates an MFN price for participating drugs using manufacturer-reported pricing data from eight countries: the United Kingdom, France, Germany, Italy, Canada, Japan, Denmark, and Switzerland.
The five-year model launched in January and was initially voluntary for both states and manufacturers.
The initiative could reduce pharmaceutical spending for state and federal Medicaid programs through new manufacturer rebates, though analysts say the actual level of savings will depend on which drugs and manufacturers ultimately participate.
The CMS calculates the MFN price and then negotiates supplemental rebates intended to bring Medicaid's net price down to that level.
The program focuses on brand-name drugs, including single-source and innovator multiple-source medicines.
STAT reported that states have until the end of the month to sign agreements, with 40 states and Puerto Rico already signed up.
KFF’s analysis found that savings will depend heavily on which manufacturers participate, what drugs are included, the size of existing Medicaid rebates, and confidential international pricing information that is not publicly available.
The GENEROUS model is part of broader efforts by the Trump administration to lower drug prices, including work requirements for Medicaid eligibility in certain states.
The new public charge rule, which will take effect on September 18, could affect immigrants using Medicaid and other public assistance programs, potentially impacting enrollment in these programs.
Background
At the Republican National Convention in Dallas, several Republican state party chairs expressed mixed views on data center development, with some supporting the trend and others raising concerns.
What's confirmed
- The GENEROUS model, part of broad drug pricing deals with the Trump administration, will see more than two dozen pharmaceutical companies sell drugs to state Medicaid programs at prices available in peer countries.
- The initiative is a key component of Trump’s plan to lower drug prices and has become central to his messaging on affordability.
- (MFN) drug-pricing agenda, which seeks to reduce the gap between U.S. prescription drug costs and prices paid in other developed countries.
- Under the model, the Centers for Medicare and Medicaid Services (CMS) calculates an MFN price for participating drugs using manufacturer-reported pricing data from eight countries: the United Kingdom, France, Germany, Italy, Canada, Japan, Denmark, and Switzerland.
- The five-year model launched in January and was initially voluntary for both states and manufacturers.
- The initiative could reduce pharmaceutical spending for state and federal Medicaid programs through new manufacturer rebates, though analysts say the actual level of savings will depend on which drugs and manufacturers ultimately participate.
- The CMS calculates the MFN price and then negotiates supplemental rebates intended to bring Medicaid's net price down to that level.
- The program focuses on brand-name drugs, including single-source and innovator multiple-source medicines.
- STAT reported that states have until the end of the month to sign agreements, with 40 states and Puerto Rico already signed up.
- KFF’s analysis found that savings will depend heavily on which manufacturers participate, what drugs are included, the size of existing Medicaid rebates, and confidential international pricing information that is not publicly available.
- The GENEROUS model is part of broader efforts by the Trump administration to lower drug prices, including work requirements for Medicaid eligibility in certain states.
- The new public charge rule, which will take effect on September 18, could affect immigrants using Medicaid and other public assistance programs, potentially impacting enrollment in these programs.
What's still developing
- Test your knowledge with our new weekday mini crossword WASHINGTON — President Trump made an announcement Friday to tout one of his initiatives to lower drug prices.
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- The 2025 reconciliation law, once called the “One Big Beautiful Bill,” signed by President Trump on July 4, 2025, requires 44 states (including DC) to condition Medicaid eligibility for adults in the Affordable Care Act (ACA) Medicaid expansion group and certain enrollees in 1115 waiver programs on meeting work requirements starting January 1, 2027.
- To implement Medicaid work requirements, states will need to make important policy and operational decisions, implement needed system upgrades or changes, develop new outreach and education strategies, and hire and train staff, all within a relatively short timeframe.
- KFF’s policy research provides facts and analysis on a wide range of policy issues and public programs.
- KFF Health News is a national newsroom that produces in-depth journalism about health issues and is one of the organization’s core operating programs.
- Currently, 41 states (including DC) have expanded their Medicaid programs under the ACA to nearly all adults with income up to 138% FPL ($21,597 for an individual in 2025).
- In June 2026, CMS released a list of states with 1115 waiver programs that include individuals who will be subject to work requirements.
- The list identifies waiver programs in three non-expansion states Georgia, Tennessee, and Wisconsin, as well as in five expansion states, Hawaii, Massachusetts, New York, Oregon, and Utah (Figure 1).
- Photo credit: Ed Reed/Mayoral Photography Office on Flickr Mayor Zohran Mamdani announced on Monday that New York City will join several cities in a lawsuit against the Trump administration over a new rule that lets officials deny green cards to immigrants who use government‑funded assistance programs.
- As reported by Pix 11, the Department of Homeland Security states that the rule is intended to ensure that immigrants remain self‑sufficient rather than being dependent on taxpayer‑funded benefits.