Medicaid Patients at Risk of Losing Ground Against Chronic Disease

There is no ignoring the facts.

The United States faces a chronic disease crisis, and the Trump administration is correct to prioritize addressing it.

Conditions like diabetes, cancer, and heart disease affect more than half of U.S. adults and account for 90% of health care spending. Meaningful reforms must prioritize prevention, improve access to recommended care, and support innovation in treatment and care delivery. A healthier America means lower health costs, better quality of life, and a stronger, more productive economy.

But another truth is undeniable: The drive to defeat chronic disease stalls if Medicaid patients are placed in the backseat.

That’s what makes a recent policy push so counterproductive.

The “most favored nation” (MFN) drug pricing proposal being floated in Washington threatens to sink access for millions of chronic disease patients. It would tie Medicaid drug reimbursements to the lowest prices set by foreign countries, where drug pricing is often based on criteria that discriminates against older people, people living with disabilities, and others whom Medicaid is designed to protect.

Medicaid currently guarantees the lowest price in the market, as manufacturer rebates reduce drug costs by more than 50% on average. Importing drug prices from countries with discriminatory coverage practices would upheave the system, exposing an already vulnerable population to increased medical complications.

Medicaid-enrolled adults (ages 19-64) report higher chronic condition rates than privately insured adults (75% vs. 66%), and nearly one-third report three or more chronic conditions. Medicaid provides essential health care to over 70 million Americans—including a reported 37 million children, millions of seniors, people with disabilities, veterans, caregivers, and low-income working families. It ensures children who need it can access home nursing care, helps veterans and caregivers manage chronic and mental health conditions, supports rural hospital operations, and enables seniors to live independently.

Today, the federal program is far from perfect, but it is a lifeline for those who need it, many millions of Americans who are among the most vulnerable in our country. For individuals living with chronic illnesses, intellectual disabilities, cancer, diabetes, or behavioral health conditions, Medicaid is often the only pathway to care. Women, particularly those facing serious diagnoses like breast cancer, and workers in low-wage jobs without employer health coverage, also rely heavily on the program.

Research shows Medicaid beneficiaries face provider shortages in every state. Low reimbursement rates make it difficult for patients to find doctors who accept Medicaid — and even harder to receive the consistent, high-quality care required to optimize medical outcomes. Disrupting reimbursement rates would only increase access barriers for low-income Americans.

The MFN approach also endangers the future of medical innovation.

The U.S. leads the world in drug discovery because of a market-based system that rewards the development of new therapies. Tying reimbursement to foreign price controls risks choking investment in research and development, just as chronic diseases are poised to rise.

Over the next five years, up to 15 million more Americans could be diagnosed with a chronic illness. An estimated 9 million could lose their lives to these diseases. Yet thousands of promising treatments are in development — therapies that could extend life, prevent hospitalizations, and reduce health care costs.

This is a time to encourage such discovery, not disincentivize it.

The Partnership to Fight Chronic Disease was founded in 2007. Across the nearly 20 years since, various administrations have been largely asleep at the wheel on chronic disease despite the rise in obesity and other related conditions that have worsened the strain on our health care system. The Trump administration’s grip on the wheel and eyes on the road are a welcome change of pace.

Still, wrong turns happen. This latest proposal would put the health, dignity, and economic security of these communities at serious risk—forcing hospitals to reduce services or close, eliminating preventive care, and pushing already vulnerable patients into crisis.

Medicaid isn’t just a program—it’s the foundation of health access for millions. Congress must dismiss this misguided, risky proposal that would severely jeopardize the vision to make America healthy again.