What insulin price reforms occurred under the Trump administration or its allies?
Executive summary
The Trump administration and its allies pursued a mix of executive actions, private-sector deals and agency directives that lowered some insulin costs for specific groups while leaving statutory caps from the Inflation Reduction Act (IRA) intact. Key actions include publicizing a $35 insulin copay in Medicare Part D plans (CMS/Trump-era Part D Senior Savings Model) and announcing commercial deals with manufacturers (Novo Nordisk, Eli Lilly) to cut retail prices through TrumpRX and other programs; independent fact‑checks say the $35 Medicare cap established by the IRA was not rescinded by the administration [1] [2] [3].
1. What the administration says it did: headline programs and deals
The White House and allied Republican offices framed multiple initiatives as reducing insulin costs: a Trump-era push to expand the Part D Senior Savings Model so Medicare beneficiaries could access a broad set of insulins at a maximum $35 copay, public fact sheets promising steep price cuts for low‑income/uninsured patients (as low as $0.03 plus fees), and November 2025 announcements of manufacturer deals—through “TrumpRX”—that cut list prices or provided lower-cost purchasing options for insulins and related drugs [1] [4] [2] [5].
2. The real mechanics: models, agency terms and 340B rules
Several of the most concrete steps were administrative and programmatic rather than changes to statute. CMS promoted the Part D Senior Savings Model and upgrades to Medicare Plan Finder to highlight plans offering a $35 maximum copay for some insulins; HRSA updated award terms so health centers must provide insulin at or below their 340B prices to low‑income patients, effectively lowering out‑of‑pocket costs at those centers [1] [6]. These actions rely on program rules and agreements, not on new legislation.
3. Private‑sector agreements: TrumpRX, manufacturer price commitments
The administration secured publicized commitments from Eli Lilly and Novo Nordisk to lower prices on GLP‑1s and some diabetes medicines when purchased through TrumpRX and to extend lower costs to selected drugs including NovoLog and Tresiba; fact sheets and reporting cite specific monthly price targets for GLP‑1s and mention insulin products among drugs covered by those deals [2] [7] [5]. Independent coverage notes the deals lower prices but may not match prices in other countries and may not be broad market price reforms [8].
4. What remained unchanged: the IRA $35 cap and negotiation authority
Fact checks and reporting show the statutory $35 monthly out‑of‑pocket cap for Medicare insulin created by the Inflation Reduction Act remained in force and was not reversed by executive order or administrative action. Reuters reported that, as of January 27, 2025, there had been no presidential action to remove the IRA’s $35 insulin cap [3]. Analysts and trade press also noted that Trump’s inauguration included reversals of some Biden rules but key IRA provisions like the insulin cap and Part D negotiation authority were described as still operative in reporting [9] [10].
5. Political context and competing narratives
The Trump White House and allied Republicans claim credit for lowering insulin and drug costs, pointing to program signups, manufacturer deals and administrative rule changes [11] [4]. Critics and fact‑checkers counter that many of the headline savings were rooted in prior laws (the IRA) or stemmed from voluntary manufacturer agreements—not sweeping legislative reform—and that some Republican plans (Project 2025) propose repealing the IRA, which would reverse statutory caps if enacted [12] [13]. Coverage from trade and health press underscores both the optics of high‑profile deals and the limits of those deals for systemic price levels [8] [7].
6. What this means for patients and policy
For Medicare beneficiaries, program changes and plan participation can create immediate, practical savings when plans adopt the $35 maximum copay model, but systemic price reductions for all payers require statutory or market‑structural change; HRSA’s 340B‑based requirement helps low‑income patients at federally funded health centers but does not change retail prices nationwide [1] [6]. Manufacturer deals tied to TrumpRX offer lower prices for consumers who use those channels but leave open questions about broader market pricing, durability of discounts and whether list prices or manufacturer behavior will shift [2] [8].
7. Limitations of available reporting
Available sources do not provide a comprehensive list of every regulatory tweak, state‑level action, or contractual detail behind each manufacturer agreement; they do not document any successful repeal of the IRA insulin cap [3]. Sources vary in emphasis—administration fact sheets tout broad gains [4] [5], while independent outlets and fact‑checkers underline that some savings were created by preexisting law or voluntary agreements [3] [12].
Bottom line: the Trump administration used a mix of Part D plan models, HRSA award terms and manufacturer agreements to lower out‑of‑pocket insulin costs for targeted groups and customers, but the IRA’s $35 Medicare cap remained in place according to fact checks and reporting; wider, statutory reforms or permanent market restructuring were not documented in the available sources [1] [6] [3].