Project 2025, a blueprint for a potential second Trump term that highlights the IRA as a potential target, took a starring role in this week’s Democratic National Convention.
Vice President Kamala Harris on Thursday night formally accepted her party’s nomination for president, capping off a big week at the Democratic National Convention in Chicago. A month after President Joe Biden ended his reelection campaign, Democrats rallied around Harris with a renewed sense of optimism. Whether Harris can maintain that momentum until Election Day 2024 on Nov. 5 remains to be seen. Despite national polls showing her slightly ahead of former President Donald Trump, Harris says she considers herself to be the underdog in the presidential race.
This is a wise approach. We all know that polls can’t always be trusted, as we learned in the 2016 presidential election when polls showing Hillary Clinton beating Trump turned out to be wrong. Political pundits agree this year’s hotly contested election is a toss-up in a country deeply divided along partisan lines. And independent presidential candidate Robert F. Kennedy Jr. is expected to drop out of the race and endorse Trump, which could hurt Harris and give the Republican nominee the boost he needs to secure a second term in office.
For the pharmaceutical industry, which has been hedging its campaign contribution bets, the compelling question remains: What would another Trump presidency mean for Big Pharma? The administration’s showdown with Big Pharma has been brewing ever since Harris cast the tie-breaking vote in the Senate for the Inflation Reduction Act (IRA) and Biden signed it into law in 2022, empowering Medicare for the first time to negotiate prescription drug prices with manufacturers.
There’s reason to believe that if Trump wins the presidential election, Republicans could seek to repeal the IRA—if for no other reason than it’s being touted by the Biden-Harris administration as its crowning legislative achievement. Last week, the administration announced negotiated prices for the first 10 prescription drugs under the law ahead of deadline and on the second anniversary of the law’s enactment. Project 2025, a blueprint for a potential second Trump term drafted by the conservative Heritage Foundation think tank, calls for repealing the IRA.
Harris said in her Thursday night speech at the DNC that Project 2025 lays out “what a second Trump term would look like,” adding that it was “written by his closest advisors.” While Trump again this week tried to distance himself from Project 2025, one of the authors of the document claimed the former president has “blessed” the organization behind it and is “very supportive of what we do.”
IRA in the Crosshairs
According to Project 2025’s chapter on the Department of Health and Human Services (HHS), the IRA’s Medicare Drug Price Negotiation Program “replaced the existing private-sector negotiations in Part D with government price controls for prescription drugs” that “will limit access to medications and reduce patient access to new medication.”
“This ‘negotiation’ program should be repealed,” Project 2025 states. “Until the IRA is repealed, an Administration that is required to implement it must do so in a way that is prudent with its authority, minimizing the harmful effects of the law’s policies and avoiding even worse unintended consequences.”
However, analyst Ethan Siegal said on a Thursday conference call hosted by Guggenheim Securities that legislative repeal of the IRA is unlikely, even if Trump is elected president and control of both the Senate and House goes to the Republicans.
“We think it’s very difficult to repeal the IRA,” said Siegal, founder of The Washington Exchange, which provides research to institutional investors and businesses regarding public policy. “Congress may make some smaller tinkering changes . . . We don’t see Trump outright repealing the law.”
Still, should the Republicans win control of the White House and Congress in November’s election, there will be attempts to repeal the IRA, according to Siegal. “I do think that Project 2025’s healthcare and pharma policies should be taken seriously,” he said. “It’s what the Republican congressional establishment has been behind for years.” Senate Majority Leader Chuck Schumer (D-N.Y.) warned in June that repealing the IRA “is no idle threat” from Republicans and “is very real.”
While Trump so far hasn’t made drug pricing a focus of his 2024 campaign as he did in the run-ups to the 2016 and 2020 presidential elections, it bears mentioning that not a single Republican in the House or Senate voted for the IRA and they have since been calling for repealing it. As reported earlier this month by The Hill, Trump has indicated he would support the repeal of some or all of the IRA if he wins a second term.
Siegal observed that “if you look at who staffed Project 2025, especially the three top power players, they’re all ex-Trump people from his presidency.” He surmised that if Trump’s elected, his chief of staff could come from Project 2025 and become the leader for moving such proposals forward. “Which individuals at the top of Project 2025 actually make it into the Trump administration I think will be very important.”
A lot is riding on November’s election, not the least of which the IRA. The future of the law that’s being touted by the current administration as a major victory in the drug pricing battle between Big Pharma and the government hangs in the balance.
