The following content is sponsored by Americans for Limited Government and written by the organization’s Executive Director, Robert Romano.
For decades, Washington promised to fix health care and delivered nothing but higher prices, more paperwork and a maze of middlemen getting rich while patients paid the bills. President Trump is doing what career politicians like Joe Biden and Kamala Harris would never do: cutting out the middlemen and putting patients back in charge.
This is the objective behind Trump’s push on direct-to-consumer health care solutions like Trump RX. Instead of forcing Americans to ask for permission from insurers, pharmacy benefit managers (PBMs) and bureaucrats, Trump RX lets patients access drugs directly from manufacturers with transparent pricing and fewer layers off the top. It’s simple, easy to understand and long overdue.
The real villains in the system are not doctors or drug manufacturers – they are the middlemen. Pharmacy benefit managers, or PBMs, sit between patients, pharmacies, insurers, and manufacturers, quietly manipulating the system to their advantage. Their business model rewards higher list prices, bigger discounts, and greater complexity. Patients lose. PBM victory
President Trump is attacking that system hard.
Trump recently signed legislation prohibiting PBM payment plans from tying their compensation to drug list prices. This matters because when PBMs benefit from higher list prices, they steer insurance plans toward expensive drugs even when cheaper, equally effective alternatives exist. By breaking that link, Trump is attacking the perverse incentives that have driven up prices for Americans.
This is not an abstract policy conversation. This is a direct attack on the rigged system.
And the efforts do not stop here. Under Trump’s leadership, the Federal Trade Commission has refocused on protecting consumers rather than appeasing corporate gatekeepers. With Chairman Andrew Ferguson serving as an enforcer of health care competition, the FTC is moving aggressively to rein in PBM abuses that distort competition and drive up costs.
This includes actions to prevent major PBMs like Express Scripts from gaming formularies – prioritizing higher-priced drugs over lower-cost counterparts because the discounts are larger. When PBMs use their market power to stifle competition and profit, it is not a free market. This is cartel behavior, and Trump’s FTC is treating it that way.
Predictably, the swamp is raging.
PBMs and their allies have warned that the reforms would “disrupt the system.” Translation: This will disrupt their revenue flow. They’ve spent years hiding behind complexity, hoping Americans won’t notice who’s really driving up the costs at the pharmacy counter. Trump saw – and he acted.
This is what America First health care looks like. Less middlemen. More transparency. Real competition. Patient under control.
While Democrats are standing by their big insurance political donors, Trump is doing what he has always done: challenging vested interests and taking the side of everyday Americans. Be it negotiating better trade deals, exposing the markup schemes of middlemen, or empowering consumers through direct outreach, the goal is the same – lower costs and better care.
Health care doesn’t need more Washington “experts.” It needs a wrecking ball aimed straight at the middlemen who broke it in the first place. Trump promised to make change – and he’s doing it. Americans are in a better position for this.
