President Donald J. Trump is delivering on his promise to make healthcare more affordable for patients.

Last month, President Trump signed an Executive Order that mandates greater transparency and accountability in America’s broken healthcare system. President Trump is targeting the bad actors and middlemen that are inflating the real cost of care paid by patients. He’s also working to stop hospitals and other health care providers from inflating prices or steering patients to the most expensive treatment option. Most importantly, President Trump is focused on reducing the real out-of-pocket costs paid by patients.

President Trump’s Drug Price Executive Order is a major win for patients. It will mean lower out-of-pocket costs for cancer patients receiving chemotherapy and make insulin available to low-income and uninsured patients for a few pennies.

1. Increases Transparency of PBMs and Other Health Care Middlemen

Pharmacy benefit managers, known simply as PBMs, are healthcare middlemen that determine what drugs are covered under your insurance. They effectively control whether insured patients have access to medications. In 2023, just three PBM companies, CVS Caremark, Express Scripts, and OptumRx, managed 80 percent of all prescription claims in the U.S.

One way that PBMs drive up drug prices and limit access to essential medications is through rebates and kickback schemes. Last year, STAT News published its yearlong investigation into how PBM’s secretly pay off third party consulting firms that are unethical deals that increase costs for patients. President Trump’s executive order will require transparency around PBM kickbacks and require disclosure of “direct and indirect” payments made by PBMs.

2. Stops Hospitals from Marking Up Prescription Drugs & Other Services

President Trump’s executive order will stop hospitals from gouging patients on prescription drugs. Right now, hospitals are exploiting federal drug programs by buying drugs at a discounted price and then inflating the price charged to patients. During his first term, President Trump tried to stop hospitals from gouging patients. However, the American Hospital Association and other hospital groups sued to stop the Trump administration’s policy under a technicality. Ultimately, hospitals scored a $9 billion windfall – paid by taxpayers – as a result of the courts overturning President Trump’s first term action.

President Trump is now ordering the Secretary of Health and Human Services to conduct a survey of hospital acquisition costs for outpatient drugs. Following the study, the Department of Health and Human Services will force hospitals to charge patients the actual cost of acquisition.

3. Slashes Patients’ Real Out-of-Pocket Cost for Insulin & Epinephrine

President Trump’s executive order will reduce the cost of insulin and injectable epinephrine for uninsured and low-income patients. The President’s executive order requires hospitals and health centers that participate in the 340B Prescription Drug Program to provide insulin and injectable epinephrine at or below the discounted price paid by the health center.

For uninsured and low-income patients, that could bring the price of insulin to around 3 cents and the price of injectable epinephrine to just $15.

4. Blocks Providers from Steering Patients to More Expensive Treatment

Any patient knows that the moment you step inside a hospital, your bill’s going up. That’s because a treatment provided in a hospital setting has a higher Medicare reimbursement rate than the same treatment provided in a doctor’s office.

Hospitals know this, too. They frequently work to steer Medicare patients to more expensive hospital outpatient departments instead of the less costly physician office settings. For cancer patients, this can result in being overcharged by up to 60 percent. President Trump’s executive order will remove this incentive to steer patients to the higher cost option.

5. Creates Framework for Long-Term Congressional Action

Finally, President Trump’s executive order establishes a framework for reforming health care that prioritizes accountability, transparency and competition. With elaborate reimbursement networks and kickback agreements, large health care corporations take the savings meant for patients and split it amongst themselves. Hospitals, insurance companies, and pharmacy benefit managers all get a cut of savings that should go to patients.

President Trump has mandated a comprehensive report to drive a competitive, efficient, and transparent drug pricing system, ensuring lower costs for Americans. To get to the root cause of high prices, we must pull back the curtain to expose the shady actions of health care middlemen.

Video: President Trump Signs Executive Order: “Drug Prices Will Come Down”