Author: AFHE Team

As a physician, I spent nearly thirty years in private practice, watching patients weigh their health against their bank account. Too often, they had to choose the bank account.

It’s sad to see Americans have to make that choice.

Congress has a real opportunity to improve our healthcare system, giving patients greater confidence, more choices, and meaningful relief.

With August recess upon us and campaign season right behind it, many voters will ask a simple question: How are Members improving our healthcare system?

A President Already Delivering Results

President Trump brought pharmaceutical companies to the table voluntarily to lower costs, launched TrumpRx, and expanded the platform to include generic medicines, giving patients a direct, transparent way to buy prescriptions without a middleman setting the price. He is now pushing for insurer transparency and to end decades of foreign governments exploiting the cost of American innovation and shifting the cost onto U.S. patients.

Those are real wins—proof that we can lower costs and put patients first while promoting American healthcare leadership and innovation.

The Polling is Nearly Unanimous

Now, Congress does not have to guess what policies patients want next. Our polling makes it clear.

At a time when Americans agree on very little, a McLaughlin & Associates survey found close to nine in ten voters support allowing manufacturers to offer co-pay cards to seniors in need on Medicare.

Picture a 74-year-old on a fixed income in Cincinnati filling five prescriptions a month. The ability to use a co-pay card could cut her pharmacy bill by more than half. That is money she could use for rent, groceries, or whatever else she may need, and it is just the first of several reforms voters want Congress to consider.

More Pocketbook Relief at the Pharmacy Counter

The same survey found voters just as eager for additional pocketbook solutions that put savings directly in patients’ hands. Eighty-six percent support expanding discounted cash-pay pricing through a government website, giving patients a simple way to compare their options and choose the lowest available price instead of guessing what insurance will cover.

Think of a self-employed contractor in Tampa on a high-deductible plan who needs cholesterol medication. His insurance may not cover it until he meets his deductible or other criteria. A government cash-pay website allows him to compare discounted cash-pay prices before visiting the pharmacy counter, rather than walking in without knowing what he will owe.

Making Savings Actually Count

Price transparency only goes so far if a single bad month at the pharmacy can still derail a patient’s budget. Eighty-three percent of Americans back a flat, income-adjusted out-of-pocket cap for each Medicare prescription, one trip to the pharmacy should not drain an entire month’s budget.

For a retiree in Des Moines managing a chronic condition, a $400 co-pay for one specialty medication can force a choice between treatment or groceries. An income-based cap would give her certainty before she visits the pharmacy counter.

Cash-pay credits need the same fix. Right now, if a patient buys medication through a direct-to-consumer platform like TrumpRx because it costs less than going through insurance, none of that spending counts toward her deductible or out-of-pocket maximum. Rep. Greg Murphy’s H.R. 8270 Every Dollar Counts Act closes that gap, so a patient who finds a better price on their own isn’t penalized for it. Eighty-three percent of voters back the idea.

Take a 54-year-old in Charlotte managing rheumatoid arthritis. Their insurance covers their biologic, but the copay through their plan runs $340 a month. They find the same drug for $210 through a cash-pay platform and switch to save money. By December, they’ve paid over $2,500 out of pocket — enough to have cleared their deductible if it counted. Because they paid cash, it doesn’t. They head into January owing the full deductible again, penalized for the exact behavior — shopping for a better price — the system should be rewarding.

Numbers like that are rare in Washington, showcasing that these are common-sense solutions that meet patients where they are. Members of Congress from either party and every part of the country can take these ideas home and show their constituents they are working to lower costs in a way people can actually feel.

End Foreign Exploitation

Fixing what happens at the pharmacy counter is only half the job. The other half is making sure American patients aren’t the ones covering costs not paid by other countries.

For years, other countries have priced American-made medicine below cost and let U.S. patients cover the difference. Seventy-three percent of voters have had enough and support legislation that finally end foreign exploitation on U.S. drug innovation. Rep. Jodey Arrington’s H.R. 4780 USTRx Act takes that fight head-on. Advancing legislation like this can help lower costs for American patients while protecting the innovation that produces new treatments and cures.

The Choice for Congress

Ask any Member up for reelection this fall whether they’d rather explain a ‘no’ vote or a ‘yes’ vote on cutting a senior’s pharmacy bill in half or holding foreign governments accountable for exploiting our research and innovation.

Congress can deliver affordable, world-class care for every American without surrendering America’s leadership in medical innovation. That happens through competition, transparency, and market-based reform, not bigger government programs. Congress has the polling, the legislation, and a President already leading the way. All that is left is the vote, and the chance to keep America the best place in the world to be a patient.

Six months in, TrumpRx is giving American patients something their insurance too often will not: a price they can actually pay, today, with no appeal to file and no prior authorization. 

TrumpRx is a government-facilitated cash-pay platform. Patients buy their prescriptions directly at lower prices, outside the denial-and-appeal cycle that can leave a medication sitting behind the pharmacy counter for weeks. Since its February launch, patients, pharmacists, and policy experts across the country have been putting that change into their own words. 

Here is what they are saying. 

Patients: Tired of Battling Their Insurance 

TrumpRx makes a difference: Joani Harlan learned that she had PCOS and insulin resistance in college and later found real relief on Wegovy, which stabilized her blood sugar and normalized her A1C. Her insurer denied coverage, treating a medically necessary prescription as a blanket GLP-1 exclusion. TrumpRx let her buy the medication at a price she could afford.  

“TrumpRx is making a real difference for patients who are tired of battling their insurance over access to medications.” — Joani Harlan

TrumpRx delivers lower prescription costs: Christine Verdier had been paying $499 a month out of pocket for Wegovy after her insurer discontinued coverage of weight-management prescriptions. She found the same medication listed on TrumpRx at a lower price and has used the program ever since. 

“TrumpRx is exactly the kind of patient-first solution we need more of.” — Christine Verdier

TrumpRx gives patients a lifeline: Walt and Rita Tuchalski faced an insurance denial the same day Rita went to pick up her prescription. TrumpRx had just launched, and the price they found there was more than 50% below the pharmacy’s list price. Rita bought her prescription outright while the appeal was still pending.  

“It fills the gap when insurance falls short.” — Walt and Rita Tuchalski

When insurance fell short, TrumpRx gave NJ patient access: Garrett Glass survived a heart attack in 2023 and has spent years fighting insurance delays and denials, most recently over a GLP-1 his doctor prescribed to manage his cardiovascular risk. He found the same medication on TrumpRx at an 85% discount off list price, with no prior authorization maze to navigate. 

“That kind of access isn’t just convenient, it’s essential.” — Garrett Glass

 Why the Same Drug Costs $600 Here and $35 in Italy 

Not every TrumpRx supporter arrived through a denial letter. Some arrived through the price gap itself when traveling overseas.  

 Averel Meden, a senior fellow at the Foundation for Government Accountability, wrote about the decades she spent managing asthma with a $600-a-month medication. An emergency in Italy forced her to find it locally and she filled the same prescription for just $35. That gap between what Americans pay and what the rest of the world pays is exactly why she sees the value in discounted cash-pay options, like TrumpRx. 

“Trump is fighting to fix this broken system.” — Averel Meden

 What Pharmacists Say about TrumpRx 

The people filling these prescriptions see the change up close. 

 The Flathead Beacon spoke with pharmacists in northwest Montana who described TrumpRx as a practical solution. Kimberly Murray, who owns two Flathead Valley pharmacies, said the site is easy for patients to use and has been a real breakthrough for people paying cash for drugs like Wegovy that insurance often doesn’t cover. 

“Now we have a solution for those people that thought that it was unattainable.” — Kimberly Murray

At the same time, Murray and other pharmacists in the area noted real limits: patients enrolled in Medicare or Medicaid are often ineligible for TrumpRx coupons. TrumpRx is one tool in the fight to lower prescription costs, not a complete fix.  There is more to be done before every patient feels this kind of relief. 

What Congress Can Do Next 

Congress has a straightforward fix available and conversations are happening across Capitol Hill.   

Right now, when patients use TrumpRx or pay cash for their prescriptions, that spending doesn’t count toward their deductible or out-of-pocket maximum, even when it’s the same medication their plan would have covered anyway, just at a higher price. It’s a gap in the rules, and one Congress can close.  

Jared Whitley made that case in the Washington Examiner, pointing to polling that found 70% of Americans want insurers to cover TrumpRx drugs without marking up the price.  

“Savings realized by lower-cost purchasing models such as TrumpRx should count toward patients’ deductibles.” — Jared Whitley

Representative Greg Murphy’s Every Dollar Counts Act (H.R. 8270) would do exactly that, allowing cash-pay purchases, including those made through platforms like TrumpRx, to count toward a patient’s deductible and out-of-pocket maximum. That solution polled at 83% support nationally. It’s a simple, common-sense fix that stops insurers from penalizing patients for finding lower-priced options.  

Patients shouldn’t have to choose between a lower price and credit toward their deductible. Congress can close that gap so more patients can access the medicines their doctor prescribed, at a price they can afford.