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Here’s what to expect from Trump’s drug prices speech. At 2 p.m. President Trump will give a highly anticipated speech outlining his plan for tackling rising drug prices. Last night, the White House released a fact sheet on the proposals that will be included in the speech. Here are the key points:

Trump will hit familiar target: foreign governments. Dating back to at least to the 1980s, one Trump’s few consistent themes has been the idea that foreign governments are ripping off the U.S. It’s a theme he’s returned to on trade, on NATO, and today it will become a central part of his plan to combat drug prices. It’s no secret that the U.S. effectively subsidizes the rest of the world for new drugs. The U.S. system allows pharmaceutical companies to enjoy massive profits on new drugs, which help finance research and development. The huge payoff makes the risk of experimenting with new drugs worthwhile. Once the drugs are developed and approved, however, the marginal cost of manufacturing the drugs is relatively low. As a result, drug companies take what they can get overseas from socialist systems that have price controls. When this happens, it drives up the costs in the U.S. even more, meaning Americans are paying for much of the cost of development. In the speech, Trump will outline plans to address “foreign freeloading.”

Trump won’t let Medicare negotiate drug prices. One thing will be missing from Trump’s speech: A proposal to allow Medicare to directly negotiate. During the 2016 presidential campaign, Trump embraced the idea, putting him at odds with most Republicans, who traditionally have viewed the concept as a forerunner to socialized medicine. At one point, Trump was boasting in rallies that negotiation could save $300 billion a year (despite the fact that at the time, all U.S. spending on drugs was lower than that). It’s another example of how Trump has pursued more conventionally conservative policies as president than he indicated on the campaign trail.

Trump will crib a lot from his proposed budget. Many of the policies that Trump likely will touch on are from his proposed budget released earlier this year. Those include proposals to give low-income seniors on Medicare free generics and install a new out-of-pocket maximum for seniors on Medicare. Another proposal focuses on Medicare Part B, the portion of Medicare that pays for drugs that are traditionally administered in a doctor’s office such as chemotherapy. The budget seeks to limit payments for price increases that are above the inflation rate, which the administration says would remove an incentive for doctors to write high-price prescriptions.

But watch out for some surprises. There are some unknowns, however, going into the address, including specific actions for going after those “free-riding” countries. Another big focus of Trump’s speech is on lowering the list price of a pharmaceutical, but the administration isn’t sharing how exactly Trump is going to get drug companies to lower their prices. The likely solution he would propose appears to be greater competition in the generic drug industry, a common Republican approach to combating high prices.

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Hospitals are nervous about any reference to the 340B program. Be sure to keep an ear out for any mention from Trump about the 340B drug discount program, which is referred to several times in the White House fact sheet. The program is at the center of a brutal lobbying war between the pharmaceutical and hospital industries, with pharma having the advantage. The program requires drug makers to provide discounts to hospitals that offer a certain amount of charity care. The drug industry contends that the program has dramatically expanded in recent years and that hospitals aren’t passing along the savings from the discounts to patients. The hospital industry says 340B is one of the few programs that has led to lower prices for consumers and it has helped hospitals that offer charity care stretch thin resources. “Given the skyrocketing prescription drug price increases that have presented hospitals and health systems and patients with remarkable challenges, the 340B program is as critical as ever in helping expand and improve access to comprehensive healthcare services for vulnerable patients and communities,” said Tom Nickels, executive vice president of the American Hospital Association. But so far the hospital industry has been taking it on the chin. The Trump administration recently passed a $320 million cut to 340B payments and it delayed for one year a rule that would clamp down on drug companies overcharging hospitals in 340B. The rule has been in the works for seven years. Lobbyists say that the hospital industry is nervous. “There has been enough really strong hints that this administration is wanting to change the 340B program significantly,” a lobbyist told the Washington Examiner.

When will the speech be translated into action? Administration officials said that the Department of Health and Human Services could take some immediate actions based on Trump’s speech. “The president’s budget proposal that we outlined all requires legislative change,” an administration official said on the briefing. “The vast majority of what will be included in the blueprint are administrative actions that the president can direct the administration to take.”

Democrats highly skeptical of speech. Congressional Democrats are skeptical that Trump’s speech will amount to real change, noting that he hasn’t embraced their ideas. They pointed out during a press conference Thursday that Trump has said that pharmaceutical companies are “getting away with murder,” but he hasn’t translated that rhetoric into action. “He talked the talk, but he has failed at least so far to walk the walk,” said Senate Minority Leader Chuck Schumer.

Search for new VA head ‘far from over’ as Trump adds new name to candidate list. Trump has added a new name to the list of candidates for Veterans Affairs secretary, a sign that his search to fill the vacancy is nowhere near its conclusion, according to two sources close to the situation. Until this week, White House officials have been looking closely at acting VA Secretary Robert Wilkie, former House Veterans Affairs Committee Chairman Jeff Miller, R-Fla., Ron Nichol, a senior adviser to the Boston Consulting Group who worked on Trump’s presidential transition, and Sam Spagnolo, president of the National Association of Veterans Affairs Physicians and Dentists. But a White House official confirmed that Rep. Brian Mast, R-Fla., was also being considered for the position. The 37-year-old double amputee served in Afghanistan before making his way to Capitol Hill, later becoming the first lawmaker to open an office for constituents inside a VA medical center.

CDC: Most drug treatment facilities allow smoking. Most substance abuse treatment facilities allow residents to smoke, government findings show. The Centers for Disease Control and Prevention and the Substance Abuse and Mental Health Services Administration reported Thursday that 49 percent of mental health and 35 percent of substance abuse treatment facilities have smoke-free campuses. Oklahoma had the highest percentage of smoke-free mental health campuses in the country, at 77.7 percent, and New York had the highest percentage of smoke-free addiction centers, at 83 percent. Idaho had the lowest rates in both categories, with 19.9 percent of mental health facilities and 10 percent of addiction centers reporting they are smoke-free.

One dead from Ebola outbreak in Congo. The Democratic Republic of Congo said there has been one death from Ebola after a new outbreak was declared Tuesday. Health Minister Oly Ilunga confirmed that a nurse had died overnight from Ebola and that nine other people, who fell ill with a hemorrhagic fever, were suspected to have the deadly disease in the African country’s northwest region, according to an Associated Press report Thursday evening. Officials, including those from the World Health Organization, are in the area to help contain the spread of the disease. The news comes two years after the end of the worst Ebola outbreak in history of Ebola, and several others tested positive for the disease.

RUNDOWN

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