The Dictatorship
Americans finally have some details about how ‘TrumpRx’ will work
The Trump administration announced an effort to improve prescription drug prices for the American people, but it is unclear when, or to what extent, Americans will feel relief.
On May 12, Trump signed an executive order titled “Delivering Most-Favored-Nation Prescription Drug Pricing to American Patients,” which directed the administration to work to reduce prescription drug costs by bringing them in line with what other nations pay. Yet the order’s broad strokes had few details about what this would look like.
On May 12, Trump signed an executive order titled “Delivering Most-Favored-Nation Prescription Drug Pricing to American Patients.”
With the unveiling of “ Trumprx” this week, Americans got some answers.
Partnering with Pfizer, beginning in 2026 the federal government will have a website, TrumpRx.gov, through which Pfizer’s prescription drugs can be sold directly to consumers at discounts, without the intermediaries of pharmacy benefit managers such as CVS Health’s Caremark and UnitedHealthcare-owned OptumRx.
To be clear, improving prescription drug affordability is critical. In a 2023 KFF poll, more than 60% of U.S. adults reported taking at least one prescription drug. Almost the same share — 55% — were worried about affording those prescription drugs. Nearly a third said they did not take their drugs as prescribed because of costand such rationing or eschewing of even lifesaving drugs like insulinleads to worse health outcomes.
Americans’ problems affording prescription drugs are attributable in no small part to the fact that we typically pay more for our drugs than other wealthy countries do. Why is that? Some of it is because of access to cutting-edge treatments that come with price tags to develop, but it also comes down to the relatively deregulatory environment of American health care delivery, with the pharmaceutical industry facing limited regulatory constraints on drug pricing.
So, just as the Inflation Reduction Act’s negotiation with insulin manufacturers brought needed relief to Medicare patients dependent on insulin, the cost of which was capped at $35 per monthso, too, would government negotiation with drug manufacturers provide needed relief to Americans of different ages dependent on a broader swath of prescription drugs.
The question is how it will actually work, and there remains ample uncertainty even with Trump’s recent announcement.
At the heart of the White House policy is a concept known as “most-favored-nation” (MFN) drug pricing, which works to bring the cost of prescription drugs in line with what other Organization for Economic Cooperation and Development countries pay.
The White House fact sheet specified that, thanks to the White House’s negotiation with Pfizer, every state Medicaid program would be able to access MFN prices for its prescription drug products via TrumpRx.gov, resulting in “many millions of dollars in savings.”

That promise seems a little less grand when you consider that, by the White House’s own admission, “more than 100 million patients are impacted by the diseases Pfizer’s medicines treat.” The fact sheet specifies savings for just three drugs — with Eucrisia, Xeljanz and Zavzpret becoming available at 80%, 40% and 50% discounts, respectively — and other phrases in the order, like “tangible cost savings,” leave the typical savings unclear. All we can say with any confidence is that the White House has pulled back from Trump’s mathematically impossible promise of “1,000%” reduction in prescription drug costs.
And what, if any, benefit will be enjoyed by the millions of patients taking drugs developed by Eli Lilly (which manufactures widely used drugs such as Prozac and Humalog insulin), Johnson & Johnson, AbbVie, Merck, Amgen and others?
What’s more, it is unclear exactly what the benefit will be for Medicaid patients. Their copayments are already capped under federal law at $4 for preferred drugs and $8 for non-preferred drugs — and are often even lower.
It is unclear exactly what the benefit will be for Medicaid patients.
Among the exact drug discounts in the fact sheet, Xeljanz (which used to treat autoimmune conditions) has a list price over $6,000. While privately insured patients’ out-of-pocket prescription drug costs often are difficult to shoulder, reducing a $6,000 list price by 40% still leaves patients with a $3,600 drug in a country where most Americans cannot afford a $1,000 emergency expense. It’s also far above the roughly $1,400 the average American spends on prescription drugs every year (well above what is spent in other high-income countries). The negotiated price of the migraine drug Zavzpret — around $750 per dose, versus a $1,500 list price — is similarly costly, especially when you account for patients taking multiple doses over the course of a year.
Thus, while these are big cost reductions, the cash prices would most likely remain higher than the insured population would face and prohibitively expensive for the uninsured. What’s more, as with private direct-to-consumer platforms like GoodRx, such payments would not count toward insured patients’ deductibles or out-of-pocket maximums. Thus, in some situations they can lead to more health care spending in a year.

More broadly, there is a fundamental contradiction between TrumpRx’s promise and its namesake’s record. While this is hardly the first time Trump has expressed concern about prescription drug affordability, it is difficult to square that concern with his opposition to the Inflation Reduction Act (which capped insulin at $35 for Medicare patients), his support for cuts to Medicaid and the Affordable Care Act (both of which help ensure health care access) and his recent imposition of 100% tariffs on pharmaceuticals (which increases prescription drug costs).
So does this new policy rollout prioritize cost savings for American patients, or will it largely operate as a means for select pharmaceutical companies to avoid those newly announced tariffs?
For many Americans, a trip to the pharmacy means the stresses of figuring out which drugs are covered or how to afford those drugs at all. Reducing high prescription drug costs is vital in improving health equity and outcomes, and despite threats from this administration, the Inflation Reduction Act and health policies such as Medicaid and the Affordable Care Act have worked to expand access to prescription drugs. TrumpRx advertises dramatic reductions in out-of-pocket costs for many prescription drugs, but the jury is still out on what relief it will bring Americans.
Miranda Yaver
Miranda Yaver is an assistant professor of health policy and management at the University of Pittsburgh and a health care fellow at the Roosevelt Institute.
The Dictatorship
Labor Secretary Lori Chavez-DeRemer is leaving Trump’s Cabinet
WASHINGTON (AP) — Labor Secretary Lori Chavez-DeRemer is out of President Donald Trump’s Cabinet, the White House said Monday, after multiple allegations of abusing her position’s power, including having an affair with a subordinate and drinking alcohol on the job.
Chavez-DeRemer is the third Trump Cabinet member to leave her post after Trump fired his embattled Homeland Security Secretary Kristi Noem in March and ousted Attorney General Pam Bondi earlier this month.
In a statement posted on social media, Chavez-DeRemer praised Trump and wrote, “I am proud that we made significant progress in advancing President Trump’s mission to bridge the gap between business and labor and always put the American worker first.”
Unlike other recent Cabinet departures, Chavez-DeRemer’s exit was announced by a White House aide, not by the president on his social media account.
“Labor Secretary Lori Chavez-DeRemer will be leaving the Administration to take a position in the private sector,” White House communications director Steven Cheung said on the social media site X. “She has done a phenomenal job in her role by protecting American workers, enacting fair labor practices, and helping Americans gain additional skills to improve their lives.”
He said Keith Sonderling, the current deputy labor secretary, would become acting labor secretary in her place. The news outlet NOTUS was the first to report Chavez-DeRemer’s resignation.
Labor chief, family members faced multiple allegations
Chavez-DeRemer’s departure follows reports that began surfacing in January that she was under a series of investigations.
A New York Times report last Wednesday revealed that the Labor Department’s inspector general was reviewing material showing Chavez-DeRemer and her top aides and family members routinely sent personal messages and requests to young staff members.
Chavez-DeRemer’s husband and father exchanged text messages with young female staff members, according to the newspaper. Some of the staffers were instructed by the secretary and her former deputy chief of staff to “pay attention” to her family, people familiar with the investigation told the Times.
Those messages were uncovered as part of a broader investigation of Chavez-DeRemer’s leadership that began after the New York Post reported in January that a complaint filed with the Labor Department’s inspector general accused Chavez-DeRemer of a relationship with the subordinate.
She also faced allegations that she drank alcohol on the job and that she tasked aides to plan official trips for primarily personal reasons.
Late Monday, on her personal X account, Chavez-DeRemer posted, “The allegations against me, my family, and my team have been peddled by high-ranked deep state actors who have been coordinating with the one-sided news media and continue to undermine President Trump’s mission.”
Both the White House and the Labor Department initially said the reports of wrongdoing were baseless. But the official denials got less full-throated as more allegations emerged — and when Chavez-DeRemer might be out of a job became something of an open question in Washington.
At least four Labor Department officials have already been forced from their jobs as the investigation progressed, including Chavez-DeRemer’s former chief of staff and deputy chief of staff, as well as a member of her security detail, with whom she was accused of having the affair, The New York Times reported.
“I think the secretary demonstrated a lot of wisdom in resigning,” Sen. John Kennedy, R-La., said Monday after her departure was made public.
She enjoyed union support — rare for a Republican
Confirmed to Trump’s Cabinet on a 67-32 vote in March 2025, Chavez-DeRemer is a former House GOP lawmaker who had represented a swing district in Oregon. She enjoyed unusual support from unions as a Republican but lost reelection in November 2024.
In her single term in Congress, Chavez-DeRemer backed legislation that would make it easier to unionize on a federal level, as well as a separate bill aimed at protecting Social Security benefits for public-sector employees.
Some prominent labor unions, including the International Brotherhood of Teamsters, backed Chavez-DeRemer, who is a daughter of a Teamster, for Labor Secretary. Trump’s decision to pick her was viewed by some political observers as a way to appeal to voters who are members of or affiliated with labor organizations.
But other powerful labor leaders were skeptical when she was tapped for the job, unconvinced that Chavez-DeRemer would pursue a union-friendly agenda as a part of the incoming GOP administration. In her Senate confirmation hearing, some senators questioned whether she would be able to uphold that reputation in an administration that fired thousands of federal employees.
She was a key figure in Trump’s deregulatory push
Aside from reports of wrongdoing in recent months, Chavez-DeRemer had been one of Trump’s more lower-profile Cabinet picks, but took key steps to advance the administration’s deregulatory agenda during her tenure.
For instance, the Labor Department last year moved to rewrite or repeal more than 60 workplace regulations it saw as obsolete. The rollbacks included minimum wage requirements for home health care workers and people with disabilities, and rules governing exposure to harmful substances and safety procedures at mines. The effort drew condemnation from union leaders and workplace safety experts.
The proposed changes also included eliminating a requirement that employers provide adequate lighting for construction sites and seat belts for agriculture workers in most employer-provided transportation.
During Chavez-DeRemer’s tenure, the Trump administration canceled millions of dollars in international grants that a Labor Department division administered to combat child labor and slave labor around the worldending their work that had helped reduce the number of child laborers worldwide by 78 million over the last two decades.
In her statement Monday, Chavez-DeRemer said, “While my time serving in the Administration comes to a conclusion, it doesn’t mean I will stop fighting for American workers.”
The Labor Department has a broad mandate as it relates to the U.S. workforce, including reporting the U.S. unemployment rate, regulating workplace health and safety standards, investigating minimum wage, child labor and overtime pay disputes, and applying laws on union organizing and unlawful terminations.
___
Associated Press writers Steven Sloan and Will Weissert in Washington and Cathy Bussewitz in New York contributed to this report.
The Dictatorship
The Latest: US Navy seizure of Iranian ship casts doubt on fresh talks in Pakistan
-
World
TOP STORIES
-
U.S.
TOP STORIES
-
Politics
SECTIONS
TOP STORIES
-
Sports
SECTIONS
TOP STORIES
-
Entertainment
SECTIONS
TOP STORIES
-
Oddities
TOP STORIES
- 1 million bees make for bumper-to-buzzer traffic on a Tennessee highway ramp
- Humanoid robots run a Chinese half-marathon alongside flesh-and-blood competitors
- Hot dogs and steaks and bacon, oh my! Meat raffles keep a beloved Midwest tradition alive
- Fatou, the world’s oldest gorilla living in captivity, celebrates her 69th birthday at Berlin Zoo
- Viral phenomenon in Argentina has young people identifying themselves as animals
- California homeowner rolls out ‘unwelcome’ mat for black bear living under his house
-
Photography
SECTIONS
TOP STORIES
-
Climate
TOP STORIES
-
Health
TOP STORIES
- Dr. Oz announces a 50-state audit of Medicaid program oversight
- What to know about psychedelic retreats, a booming business with few safety guardrails
- A small but growing movement wants you to put down your phone. But first read this
- Trump signs order to speed review of psychedelics, including the controversial drug ibogaine
- Easily distracted? How to improve your attention span
- Younger adult colon cancer deaths are concentrated in people with less education, study says
-
Tech
SECTIONS
-
Religion
TOP STORIES
-
MORE
The Dictatorship
GOP’s Mills faces expulsion effort launched by one of his Republican colleagues
Republican Rep. Cory Mills of Florida was already dealing with multiple, overlapping scandals when a judge issued a restraining order against the congressman last fall after one of his ex-girlfriends accused him of threatening and harassing her. Soon after, Mills found that even some of his allies were keeping him at arm’s length.
In December, Rep. Byron Donalds, a fellow Florida Republican, conceded“The allegations against Cory, to me, are very troubling. I’m concerned about him. I hope he gets his stuff worked out and cleaned up, but it has to go through ethics [the Ethics Committee]. And he has to, you know, basically do that hard work to clear his name, if it can be cleared.”
Donalds, a leading gubernatorial candidate in Florida, had previously suggested he saw Mills as a possible running mate, making the comments that much more potent.
It didn’t do Mills any favors when The Washington Post published a new report a few days ago highlighting body camera footage that showed police officers in Washington, D.C., who were prepared to arrest the GOP congressman after a woman accused him of assault last year, before a lieutenant ultimately ordered them not to when she changed her account. (Mills refused to comment, except to say that the woman’s initial claim was “patently false.”)
Two days after the Post’s report reached the public, one of Mills’ Republican colleagues announced an effort to kick the congressman out of office. NBC News reported:
Rep. Nancy Mace, R-S.C., introduced a resolution Monday to expel Rep. Cory Mills, R-Fla., from Congress over accusations that include sexual misconduct.
Mills is being investigated by the House Ethics Committee in connection with allegations of ‘sexual misconduct and/or dating violence’ and campaign finance violations. He has denied any wrongdoing.
“The swamp has protected Cory Mills for far too long and we are done letting it slide,” Mace said in a statement. “We tried to censure him and strip him from his committee assignments. Both parties blocked it, but we are not backing down.”
By way of social media, the Floridian expressed confidence that he’d prevail if Mace’s resolution reached the floor, encouraging the South Carolinian to “call the vote forward.”
Time will tell whether the expulsion vote actually happens, but in the meantime, after NOTUS reported that Mills intends to respond with an expulsion resolution of his own targeting Mace, the congresswoman wrote online“Cory Mills lied about his military service, has been accused of beating women, has a restraining order against him, and has allegedly been stuffing his own pockets with federal contracts while sitting in Congress. As a survivor, I will always stand up and right the wrongs of others. He is only coming after me because he knows he’s next.”
It’s not often that Americans see members of Congress launch dueling efforts to kick each other out of office, but this is proving to be an unusually awful term.
Indeed, amid growing GOP anxieties about the upcoming midterm elections, there’s fresh evidence that the House Republican conference is both divided and unraveling.
Steve Benen is a producer for “The Rachel Maddow Show,” the editor of MaddowBlog and an MS NOW political contributor. He’s also the bestselling author of “Ministry of Truth: Democracy, Reality, and the Republicans’ War on the Recent Past.”
-
Politics1 year agoFormer ‘Squad’ members launching ‘Bowman and Bush’ YouTube show
-
The Dictatorship1 year agoLuigi Mangione acknowledges public support in first official statement since arrest
-
Politics1 year agoFormer Kentucky AG Daniel Cameron launches Senate bid
-
The Dictatorship1 year agoPete Hegseth’s tenure at the Pentagon goes from bad to worse
-
Uncategorized1 year ago
Bob Good to step down as Freedom Caucus chair this week
-
Politics1 year agoBlue Light News’s Editorial Director Ryan Hutchins speaks at Blue Light News’s 2025 Governors Summit
-
The Dictatorship7 months agoMike Johnson sums up the GOP’s arrogant position on military occupation with two words
-
The Josh Fourrier Show1 year agoDOOMSDAY: Trump won, now what?






