ArcaMax

Donald Trump is executing a shock and awe strategy, burying the public in a smoky cloud of flamboyant proposals. Some, like ending birthright citizenship, are quickly slapped down in the courts. Some, like threatening to invade Greenland, are dismissed as moronic. But all are radical enough to provide news media with easy entertainment.

The problem for Democrats is that these flashbangs distract from plans that would hit Americans, in Bill Clinton's words, "where they live." Democrats need to focus.

Start with actions to weaken Biden-era programs to restrain the prices drugmakers may charge for their products. His first day back in office, Trump canceled the Biden order to test new models for lowering drug costs.

When Trump ran for president in 2016, he promised to have Medicare negotiate drug prices. Why? It was a very popular idea. Upon election, the vow promptly vanished. Trump named Alex Azar, a top executive at Eli Lilly, to head Health and Human Services. (Under Azar, Eli Lilly tripled the price of its top-selling insulin drug.)

But Joe Biden's Inflation Reduction Act did follow through. As a result, 10 popular drugs covered under Medicare Part D (the prescription drug benefit) were selected for price reductions by 2026. They include such popular medications as Jardiance (diabetes), Enbrel (rheumatoid arthritis) and Eliquis (blood clots).

In its last days, the Biden administration targeted another 15 Part D drugs for price negotiations. They include Trelegy Ellipta (asthma, COPD) and three big-name drugs for weight loss, diabetes and heart disease: Rybelsus, Ozempic and Wegovy. These negotiations would have to be implemented by the Trump administration. Don't bet the farm on much relief.

Novo Nordisk, maker of Ozempic and Wegovy, has been charging Americans outlandish prices for these blockbusters. Wegovy's list price in the U.S. is over $1,300 for a month's supply. It is five times the price in Canada ($265) and 14 times the price in Britain ($92).

The right-wing argues, as Project 2025 puts it, that government negotiations on Medicare drugs amount to "price controls" that will reduce patient access to new medication. That's news to the citizens of just about every other advanced country. And no, other countries don't let drugmakers charge their people whatever they want.

In Novo Nordisk's home country of Denmark, Wegovy costs only $186 a month. It should surprise no one that 72% of the company's sales come from the United States. We are the land of suckers.

Thanks to Biden, the catastrophic coverage tier for Part D begins when a beneficiary's out-of-pocket spending reaches $2,000. Project 2025 calls for "eliminating the coverage gap in Part D, reducing the government share in the catastrophic tier, and requiring manufacturers to bear a larger share." (You may laugh at the "requiring manufacturers" part.)

It's true that Trump has yet to reverse the caps already in place on seniors' drug costs, and so beneficiaries won't notice much change right off. He's certainly too clever to mess with the $35 limit on the monthly price of insulin, one of Biden's marquee achievements. Doing so might break through the smoke.

However, Project 2025 has its own ideas, and Trump is stocking his administration with Project 2025 folk. Furthermore, as Republicans comb through the budget for ways to pay for tax cuts, Medicare would seem a ripe place to slash spending. Trump did vow to leave Medicare alone. Then again, he vowed to have Medicare negotiate drug prices.

Why would Trump be OK with forcing Americans to pay more than the rest of the world for their drugs? The answer is simple: Because the drug companies want them to.

Democrats, step around some of those rabbit-hole distractions. You have an issue.

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Follow Froma Harrop on Twitter @FromaHarrop. She can be reached at fharrop@gmail.com. To find out more about Froma Harrop and read features by other Creators writers and cartoonists, visit the Creators webpage at www.creators.com.

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