Nineteen States Apply for Medicaid Drug Pilot as 7 Sign Onto Trump’s MFN Pricing Model
Updated
Updated · The Washington Post · Sep 14
Nineteen States Apply for Medicaid Drug Pilot as 7 Sign Onto Trump’s MFN Pricing Model
3 articles · Updated · The Washington Post · Sep 14
Summary
Nineteen states applied to the Trump administration’s GENEROUS Medicaid drug-pricing pilot by last week’s deadline, and seven — Alaska, Arkansas, Colorado, Indiana, Massachusetts, Oregon and Pennsylvania — have already signed participation agreements.
The voluntary model lets states review CMS-negotiated most-favored-nation prices tied to wealthy-country benchmarks, then choose drug-by-drug whether to join while keeping existing rebate deals when those are cheaper.
States say applying carried little downside because it unlocked pricing details before any final commitment, though confidentiality agreements now obscure how much savings participating states may actually realize.
The pilot’s appeal is uncertain because Medicaid already cuts gross drug spending by an average 53% through rebates, yet a July JAMA study found 82 major brand-name drugs were cheaper abroad and projected billions in savings across 47 states and Washington, D.C.
CMS still has to reveal overall drugmaker participation, and states have until Sept. 30 to finalize agreements; analysts say Gilead, Novo, Eli Lilly, Johnson & Johnson and AbbVie face the biggest Medicaid MFN pressure from the fourth quarter of 2026.