President Trump has done more than any modern president to shake the swamp, take on the deep state, and put forgotten Americans first. As someone who proudly supported him, I appreciate his commitment to protecting the vulnerable while ensuring government programs deliver real value.
That's why it's troubling to see the president encouraging congressional Republicans to tie Medicaid drug reimbursements to the "most favored nation" (MFN) pricing model — an idea rooted not in conservative, free-market principles, but in the kind of centralized price-fixing we expect from European welfare states.
Under the MFN model, Medicaid would reimburse drugmakers at the lowest price paid for a drug among a group of other wealthy countries.
While this may sound like a clever way to contain spending without reducing access or slashing benefits, the truth is far more dangerous. MFN is nothing more than government-run price-fixing — central planning masquerading as reform — that would destroy competition and hand power to unelected bureaucrats.
It would discourage innovation, shrink the supply of life-saving medications, and import the same disastrous socialist healthcare playbook that’s left European patients waiting and dying while government bean counters call the shots.
This isn't speculation. We've seen how MFN-style price controls impact patient access around the world. In countries that use these models, patients often wait months or even years for new drugs to reach the market — if they arrive at all.
Since 2012, more than 8 in 10 newly approved medicines have been made available to patients in the United States, while fewer than 4 in 10 reach the market in Europe, where government-imposed price controls dominate.
For European patients battling cancer, the wait for cutting-edge treatments is, on average, two years longer than for Americans. Those aren’t just statistics; they represent heartbreaking delays that can mean the difference between life and death.
Implementing MFN in Medicaid would also gut the existing pricing structure that, while imperfect, is still rooted in market dynamics. Today, the Medicaid Drug Rebate Program includes a "best price" provision. This rule guarantees that Medicaid receives the lowest price offered by a drugmaker to any commercial buyer.
Replacing that system with MFN would delink reimbursement rates from the U.S. market entirely, substituting the judgment of foreign bureaucrats for private-sector competition.
Equally important, MFN would choke off the resources needed to develop the next generation of medicines. Bringing a new drug to market costs nearly $3 billion and can take a decade or more. If companies cannot recoup those investments because government-imposed price ceilings flatten returns across the board, they'll stop investing in new treatments.
It's already happening in countries with aggressive price controls — why would we import those failed models here?
Some proponents argue that MFN is a politically palatable way to find $1.5 trillion in savings without touching Medicaid eligibility or benefits. But this is a false choice. MFN may avoid direct cuts today, but it guarantees much deeper pain tomorrow.
Without structural reform, Medicaid will remain the unsustainable behemoth it has become: a program whose costs are projected to explode in the coming decade, crowding out other priorities and putting upward pressure on taxes.
As Rep. Chip Roy, R-Texas, and 19 other House conservatives rightly argued in a recent letter, failing to act now only ensures "massive tax increases and benefit cuts in the future."
Fortunately, there's a better path forward — one that puts patients first, respects taxpayers, and embraces the principles that have made American medicine the envy of the world. The reforms outlined by Rep. Roy include shifting Medicaid toward more flexible, state-driven models that empower local leaders to design systems that work for their populations.
It means prioritizing outcomes, accountability, and efficiency over one-size-fits-all mandates. It also means gradually reducing the program's dependency trap and helping able-bodied adults transition toward independence.
This approach offers real savings without rationing care, stifling innovation, or surrendering price-setting authority to foreign governments. And it allows us to preserve Medicaid's safety net for the truly needy, rather than using it as a blunt instrument to manage federal spending.
President Trump has shown time and again that he is open to better ideas when presented with principled alternatives. That's why conservatives should stand firm now — not in opposition to the president, but in support of the values he has championed.
We don't need European socialism in our healthcare system. We need American solutions rooted in freedom and innovation.
Drew Johnson is one of America's leading taxpayer advocates and government watchdogs. He was recently the Donald Trump-endorsed Republican nominee for Congress in Nevada's 3rd congressional district. Previously, Johnson exposed wasteful government spending as a budget policy scholar at think tanks, including the Taxpayers Protection Alliance, the National Taxpayers Union, and the National Center for Public Polic Research. Read More of His Reports — Here.