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What Trump Said About Health Care, And What He Is Likely To Do

MARY LOUISE KELLY, HOST:

For a moment during the State of the Union address last night, President Trump spoke about an issue that reaches beyond party lines.

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PRESIDENT DONALD TRUMP: I'm calling for bipartisan legislation that achieves the goal of dramatically lowering prescription drug prices. Get a bill on my desk, and I will sign it into law immediately.

KELLY: At that point, Democrats in the gallery stood up, held out three fingers and chanted HR 3, the name of the drug-pricing bill the House passed in December.

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UNIDENTIFIED PEOPLE: (Chanting) HR 3, HR 3.

KELLY: Here to talk us through that moment and a few others in the speech is NPR health policy reporter Selena Simmons-Duffin.

Hey there, Selena.

SELENA SIMMONS-DUFFIN, BYLINE: Hi, Mary Louise.

KELLY: Give me some context to start with about - I'm not sure I know where Congress is on drug-pricing legislation.

SIMMONS-DUFFIN: Well, Congress has kind of stalled on drug-pricing legislation right now. The bipartisan legislation that Trump mentioned there was - is from Senators Grassley and Wyden. It's actually quite similar to HR 3 except for one key thing. HR 3 allows Medicare to directly negotiate on drug prices. And President Trump used to talk about how it's crazy that we don't negotiate. Currently, that is illegal for Medicare to negotiate. He has not been saying that recently. Republicans generally say that idea is a nonstarter.

So that chanting during the speech was like a dare to the president. You want to be aggressive on drug prices? Support HR 3.

KELLY: Any chance he is going to support HR 3?

SIMMONS-DUFFIN: Almost certainly no. The question is now whether Senate Majority Leader Mitch McConnell allows a vote on that bipartisan bill from the senators. He's been resistant on that. So we'll have to see if President Trump prevails. Another health care issue that voters care about that came up last night is coverage for pre-existing conditions. Let's listen to that part of the speech.

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TRUMP: I've also made an ironclad pledge to American families. We will always protect patients with preexisting conditions.

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KELLY: An ironclad pledge there.

SIMMONS-DUFFIN: Yes.

KELLY: The significance of that pledge and that language.

SIMMONS-DUFFIN: Well, he kind of needs to make a pledge because the Trump administration is currently arguing in federal court in the Texas v. Azar case that the Affordable Care Act should be struck down as unconstitutional. And the Affordable Care Act, of course, is the law that protects people with preexisting conditions. So McConnell has made a similar promise that Trump made during his speech last night - don't worry; we'll protect this, you know, very popular provision of the Affordable Care Act.

KELLY: Yeah.

SIMMONS-DUFFIN: But they haven't come up with a plan or legislation that shows how they would do that. So they're aware that this is popular and that voters might be worried about the protection going away if Obamacare does get struck down.

KELLY: One other thing, Selena, before I let you go - a bit of a swipe that the president took last night. He mentioned socialism, which I think...

SIMMONS-DUFFIN: Yes.

KELLY: ...People heard as a not-so-veiled reference to "Medicare for All," the legislation championed by Bernie Sanders, among others. This going to be a central campaign theme for President Trump?

SIMMONS-DUFFIN: Yeah, it seems like it. It wasn't the first time he mentioned that. It's worth pointing out that Medicare for All is not a socialist system like the U.K. has, where there are government-run hospitals and government-employed doctors. It is a government-run health plan. So there would still be private doctors, private hospitals. But socialism is an old, old American attack line against universal insurance. Truman wanted that, and obviously, it had an impact. We don't have a single-payer health system today. So that criticism worked then, and Trump wants to see if it'll work now.

KELLY: NPR health policy reporter Selena Simmons-Duffin, thank you.

SIMMONS-DUFFIN: Thanks. Transcript provided by NPR, Copyright NPR.

Selena Simmons-Duffin reports on health policy for NPR.