New Bill Wipes Out Medicaid Cost-Sharing Changes and Restores Orphan Drug Rules

The “Repealing the Trump Sick Tax Act” is a piece of legislation that does exactly what its title suggests: it hits the ‘undo’ button on two specific changes made by a previous reconciliation act concerning healthcare policy. Specifically, it completely eliminates Section 71120, which dealt with changes to Medicaid cost-sharing requirements, and Section 71203, which created an exception for orphan drugs within the Drug Price Negotiation Program. For busy people, this means fewer hurdles for those relying on Medicaid and a return to the original rules for negotiating prices on specialized medicines.

Clearing the Medicaid Cost Hurdle (SEC. 2)

This section is a big deal for anyone relying on Medicaid, especially those facing chronic conditions. The bill completely wipes out Section 71120 of the prior law, meaning that any new cost-sharing requirements—like co-pays or deductibles—that were supposed to be implemented under that section are now gone. The law specifically directs that Title XIX of the Social Security Act (which governs Medicaid) should be read as if those changes were never made. In real-world terms, this means that Medicaid recipients won't face those potentially increased financial burdens, making healthcare access smoother. If you’re a parent whose child needs regular specialist visits covered by Medicaid, this repeal ensures your out-of-pocket costs won't suddenly jump up due to that previous change. Furthermore, the bill officially rescinds any money that was set aside to implement those now-repealed cost-sharing rules, effectively closing the book on that policy.

Orphan Drugs Back in the Negotiation Pool (SEC. 3)

Section 3 tackles the complex world of prescription drug pricing, specifically targeting “orphan drugs”—medicines developed to treat rare diseases. The bill repeals Section 71203, which had created a specific exclusion for these orphan drugs from the federal Drug Price Negotiation Program. By eliminating this exclusion, the bill restores the rules to their previous state, meaning these specialized, often very expensive, drugs can once again be subject to price negotiation under the program. For consumers and taxpayers, this is a move aimed at controlling the costs of high-ticket medications. For example, if a drug company developed a new treatment for a rare genetic disorder, this bill ensures that the government can negotiate its price down, rather than having it automatically excluded from the process.

What This Means for the System

Overall, this bill is a legislative reset button. It restores prior statutory language concerning both Medicaid cost structures and the scope of federal drug price negotiation. While the clarity is high—the bill simply deletes two sections—the impact is significant. It ensures that Medicaid beneficiaries retain favorable cost-sharing rules and re-expands the government’s ability to negotiate drug prices. This move will likely be welcomed by patient advocacy groups and those who rely on public health programs, as it removes potential financial barriers to care and broadens the scope of cost-saving measures in drug purchasing.