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Every state applies to a Medicaid drug pricing program with undisclosed terms
September 19, 2026
All 50 states have applied to join the Trump administration's Medicaid most favored nation drug pricing program, a voluntary pilot whose company agreements remain undisclosed.
Medicaid is the health program that states and the federal government pay for together, covering 66 million Americans. What it spends on prescription drugs after rebates rose 46% from 2019 to 2024.
Key facts
- KFF, a nonpartisan group that researches health policy, counts 66 million Americans on Medicaid and reports that net spending there on prescription drugs climbed 46% from 2019 to 2024, reaching $46 billion for taxpayers that year.
- He put it this way on September 30, 2025: "Today Pfizer is committing to offer all of their prescription medications to Medicaid,"
- Applications from states were due September 10, and the White House says every one of the 50 states filed.
- Eli Lilly said "any" of its "eligible covered outpatient drugs " could be chosen, apart from the GLP-1 medicines it has entered in a separate Medicare pilot.
- NPR contacted Pfizer along with 16 other large pharmaceutical firms that reached pricing agreements with the Trump Administration during the past year.
NPR reports that every state met the September 10 application deadline, according to the White House, and that the pilot depends on voluntary participation by drug companies and by each state. AP News carries the same count of states joining the Medicaid drug pricing model. The New York Post reports Trump's Oval Office claim that the program will save states billions of dollars per year, and it quotes the country's Medicare and Medicaid administrator, Dr. Mehmet Oz, saying, "We are rescuing state budgets with this program."
The Washington Post ties the drug pricing deals to contracts kept secret, which matches NPR's account that the administration has refused to release the pharmaceutical agreements. The New York Times presents the same event as Trump promoting a program to cut Medicaid drug prices. NPR reports that two companies called their Medicaid agreements confidential, that Genentech would say only that certain medicines are included, and that one filing covers any eligible covered outpatient drug apart from GLP-1 medicines already in a separate Medicare pilot.
The outlets corroborate the participation of every state, the voluntary design of the program, and Trump's most favored nation framing of the discounts. Unsettled is which medicines each manufacturer will discount for Medicaid, and by how much.
“Companies have every incentive to cherry-pick [for this program] the products for which they already give Medicaid the best discounts and for which the international price may not be that much lower,” said Hwang.
Hwang
Still developing
The terms of the pharmaceutical agreements, which the administration has refused to release, had not moved as of the draft.
How settled the reporting is
Sources
- NPR — A year ago, President Trump pledged to lower Medicaid drug prices. Has that happened?
- New York Post — Trump’s ‘favored nations’ drug discount gets buy-in from all 50 states — and will save billions for Medicaid
- AP News — Trump announces all 50 states are joining Medicaid drug pricing model
Toggle read the full reports of 2 of the 5 outlets counted on this event. The other 3 are counted from their headlines and opening sentences.