Category: Blog

Can TrumpRx Beat Big Pharma at Its Own Game?

On February 5, 2026, the Trump administration launched trumprx.gov, a government-linked prescription drug website intended to help Americans access discounted prescription medicines. The platform was unveiled by the Administration as part of a broader effort to make drug prices more affordable for U.S. patients. Rather than functioning as a traditional online pharmacy that dispenses medications directly, TrumpRx acts as a discount and price comparison portal that connects users to manufacturer or pharmacy discounts on prescription drugs. The site lists a curated set of around forty-plus brand-name drugs with reduced case prices and coupon codes that patients can use at participating pharmacies or manufacturer channels. According to the Administration, popular GLP-1 weight-loss medications and other pricier therapies are included on the list to illustrate potential savings for patients. 

Despite the White House’s promotional messaging, many health policy analysts and experts have expressed skepticism about TrumpRx’s broader effectiveness. Critics note that the site’s limited drug list — roughly 43 medications — is far smaller than what existing third-party discount tools like GoodRx or Cost Plus Drugs already offer, which cover thousands of drugs in the U.S. market. A recurring concern among experts is that many of the drugs featured on TrumpRx already have cheaper generic equivalents or lower prices available through other discount programs or traditional insurance plans, blunting the platform’s relative savings for many patients. Health policy researchers also emphasize that TrumpRx’s cash-price discounts do not generally count toward patients’ insurance deductibles or out-of-pocket maximums, a key factor in total insurance value that remains unaddressed by the site’s pricing model. 

Beyond technical critiques of the pricing model, many observers argue that TrumpRx does not tackle the systemic drivers of high prescriptions costs — such as opaque pricing negotiations, middlemen markups, and limited governmental negotiation authority — and instead delivers a limited workaround for a narrow patient segment. At the same time, early supporters of the platform contend that for some uninsured or underinsured individuals, TrumpRx may offer some relief on expensive medications — particularly those not commonly covered by insurance plans. The portal includes popular GLP-1 weight-loss drugs such as Wegovy, Ozempic, and Zepbound at significantly discounted cash prices compared with typical retail costs, which may make these treatments more accessible to patients who would otherwise pay full price out of pocket. Furthermore, the site also lists fertility medications like Gonal-F at steeply reduced prices — for example, some medications may be up to 84% off the list price — which could lower the immediate drug cost for some individuals undergoing fertility treatments, even if it does not substantially reduce the overall cost of procedures like in-vitro fertilization.  

Beyond these two categories of drugs, TrumpRx does little to tackle the deeper, structural issues in the prescription drug market, as it does not resolve prescription drug price transparency, negotiation powers, or insurance reform. In effect, TrumpRx is “a distraction from what we need to be doing” as the real world impacts for Americans’ drug costs will be modest or limited at best. 

AI & Medicare Coverage: The New WISeR Model 

On January 1, 2026, the Centers for Medicare and Medicaid Services (CMS) introduced the Wasteful and Inappropriate Service Reduction Model (WISeR). The goal of this model, according to CMS,  is to use artificial intelligence (AI) to encourage safe and effective navigation for Medicare participants on certain services, which will assist timely and appropriate payment. Additionally, the model hopes to reduce waste, fraud and abuse. 

There are two ways in which providers can seek coverage determinations through WISeR: by obtaining prior authorization by an authorized WISeR participant or by pre-payment medical review by an authorized WISeR participant. The model establishes new prior authorization requirements for services that have “little to no clinical benefit for certain patients.”  These services include skin and tissue substitutes, some nerve stimulator implants, and some services for knee osteoarthritis. This is important, because traditional Medicare historically has not required prior authorization.  However, CMS urges that WISeR does not change Medicare coverage or payment policy. Six states have been selected to test the WISeR model: New Jersey, Ohio, Oklahoma, Texas, Arizona, and Washington. The prior authorization will be determined by artificial intelligence, which is a huge concern for many people. Further, appeals are only available if a service is performed and the provider then submits a claim after not receiving prior authorization. It is unclear at this stage how long these appeals may take, however standard appeals can take months to reach a favorable decision.  

Many people within the health care industry have concerns and comments regarding the new WISeR model. For example, the American Hospital Association urged CMS to delay implementation of WISeR because of concerns with payment structure and the use of AI in Medicare. The Community Oncology Alliance expressed concerns about WISeR, stating that there are inadequate safeguards in place for the untested model, which experiments directly on Medicare beneficiaries. Further, the Center for Medicare Advocacy stated that instead of accomplishing the goals WISeR hopes to, WISeR will likely delay and even deny necessary care for some Medicare beneficiaries. The  Medicare Policy Initiative fears that WISeR will cause burdens for providers, and even cause some providers to exit traditional Medicare. At this point, it is hard to tell how the WISeR model is actually performing, but these concerns seem to be standard across the health care community. 

Further, multiple members of Congress have spoken up about the WISeR model. For example, a bill was introduced into the House of Representatives in November 2025 to prohibit the implementation of the WISeR model. Further, an amendment to the Health and Human Services, Education, and Related Agencies Appropriations Act was approved in the House in September 2025, but was not included in the final Act that was signed into law February 2026. Further, members of the Senate Committee on Finance wrote a letter to CMS in September 2025 urging them to provide further safeguards and transparencies surrounding WISeR. These safeguards include ensuring that the AI program is fully compliant with HIPAA, and that the AI will be unbiased. However, despite all of these concerns, WISeR was launched January 1, 2026.     

It will be important for CMS and the health care industry to closely monitor the new WISeR model, given all of the concerns. If it is shown that WISeR is inefficient, presents a new burden, and denies necessary medical care to Medicare beneficiaries, it will need to be reevaluated to ensure it is actually meeting the goals CMS hopes it will. Additionally, it is important that CMS constantly evaluates the safeguards and privacy considerations surrounding WISeR, to ensure beneficiaries are always protected.

The Politicization of Research: NIH Cuts, DEI Litigation, and the Future of Health Equity Research

Under the Trump administration, hospitals, medical schools, and academic research centers have faced an increasing wave of legal and regulatory challenges to diversity, equity, and inclusion (DEI) initiatives. What began as coordinated complaints to the U.S. Department of Health and Human Services Office for Civil Rights quickly expanded into a massive wave of National Institutes of Health (NIH) grant cancellations.  

According to a Congressional Research Service review of HHS data, as of November 28, 2025, the department had terminated 977 NIH grant awards, representing approximately $1.7 billion in obligated funding, pursuant to a presidential memorandum. As noted in a dissent authored by Justice Ketanji Brown Jackson, NIH grant terminations have been historically rare. From 2012 to January 20, 2025, the NIH terminated fewer than 6 grants midstream in the 13 years. However, starting in February 2025, the administration took a drastic departure from that when they terminated $1 billion in NIH grants focused on disparities research. In the termination letter from the NIH, researchers were informed that their grants were ended because the projects allegedly “harm the health of Americans,” “offer a low return on investment,” or “fail to improve health, extend or reduce disease.” Many researchers felt that their research “was not evaluated on its merits, but nixed because words like ‘race’ or ‘gender’ were in the project’s title or description.” Additionally, in August, the NIH Director, Dr. Jay Bhattacharya, announced a new unified strategy for research priorities, stating that “research based on ideologies that promote differential treatment of people based on race or ethnicity, rely on poorly defined concepts or on unfalsifiable theories, does not follow the principles of gold-standard science.”

In June 2025, two lawsuits filed in federal court in Massachusetts challenged actions by the Trump administration and resulted in the restoration of more than 2,000 previously terminated grants. In August, the Supreme Court held that the lower court likely lacked the jurisdiction to review the termination of research grants focused on disfavored topics and populations, but declined to block the district court’s ruling. In December 2025, an additional agreement with the plaintiff required the administration to reconsider certain DEI-related research proposals, leading to the release of over 100 grants whose reviews had been on hold, and stated that decisions on additional grants would be made in the coming weeks. However, in remarks on a podcast in December last year, NIH Director Jay Bhattacharya suggested that the reinstated June grants may only offer temporary relief and could be terminated in 2026. He stated that “when it comes to renewal, those grants no longer meet NIH priorities. . . So when they come up for renewal over the course of the year, we won’t renew them.”

Physicians and academic researchers worry that the NIH cuts may slow down innovation and ultimately undermine patient care. The Association of American Medical Colleges (AAMC) has argued that these developments threaten biomedical research and academic medicine more broadly. AAMC warns that the termination of NIH grants could risk access to treatment for clinical patients and slow scientific progress. Beyond immediate funding losses, legal scholars note that the uncertainty surrounding grant renewals, shifting research priorities, and ongoing litigation has created a chilling effect within academic medicine, prompting institutions to reevaluate compliance frameworks, research portfolios, and DEI-related programming to mitigate enforcement risk. 

According to recent coverage, the researchers have now moved to remove terms related to DEI and health disparities from research grants. Additionally, organizations have compiled lists of diversity-related language based on manual reviews of grant materials, which have since been circulated among research institutions and online forums frequented by scientists. Other reports have described researchers as self-censoring their language around diversity to secure grant funding. Experts have also stated that the termination of grant programs that support students from underserved backgrounds “could close off scientific careers for individuals who wouldn’t otherwise have access to research opportunities.”

From a legal perspective, these changes represent both regulatory and funding risks. According to the AHLA Fraud and Abuse Practice Group, board and compliance officers now have toevaluate DEI programs not only under Title VI and Section 1157 frameworks, but also in light of the sustainability of the research portfolio. Compliance Officers must now review all federally funded programs to ensure eligibility requirements and documentation are in place. They must ensure that disparity-focused research is framed in scientifically and population-neutral terms. They must also closely monitor NIH statements and funding guidance updates and develop contingency plans for non-renewal scenarios. 

The Consolidated Appropriations Act, 2026 (P.L 119.75) rejected the Trump administration’s proposed 40% NIH cuts, instead providing an increase of $210 million. The legislation also included a provision blocking the Office of Management and Budget’s multi-year funding proposal, which contributed to 2,000 fewer NIH grants being awarded in 2025. This represents a promising sign for medical research, but it does not fully resolve the instability surrounding NIH priorities, grant renewals, and administrative overhaul. Whether courts ultimately constrain the executive branch’s authority to deprioritize entire categories of research remains unsettled. The central question moving forward is not only whether DEI-related programs will remain legally defensible, but also whether the nation’s biomedical research can continue to address documented disparities amid shifting political priorities.

Overcompensation?: The FDA Nixes Boxed Warnings for MHT Drugs

The U.S. Food and Drug Administration (FDA) recently removed boxed warnings for six menopausal hormone therapy treatments (MHTs), drugs that reduce the uncomfortable side effects of reduced estrogen levels. These are the FDA’s highest level of warnings that appear on drug packaging in bold print and warn users of serious adverse reactions or important dosing restrictions. For MHT, the boxed warning informs consumers that MHT increases the risk of cardiovascular disease, breast cancer, and dementia.

Although this may look at first glance like another one of the current administration’s attempts to flip food and drug law on its head, a closer look at the scientific findings that prompted the boxed warning indicates it’s not so simple. Originally, the FDA mandated boxed warnings for MHT drugs after the Women’s Health Initiative (WHI) conducted a study in 2002, finding coronary heart disease and invasive breast cancer as primary adverse outcomes based on largely observational data. After the warning was implemented, usage dropped 22% for menopausal women from 1999 to 2020.

However, the safety and long-term risks of MHT have been debated by scientists, particularly because of the WHI study’s controversial design. The study had two main design flaws: it included women with an average age of 63, and the study tested synthetic hormones that are not the same as MHT drugs on the market today. The average age of participants was problematic because women generally experience menopause around age 51.5, but women around 63 years old are more likely to have preexisting cardiovascular issues. Furthermore, the use of synthetic hormones in this study means the adverse health outcomes are not necessarily attributable to the MHT treatments currently on the market. Additionally, modern MHT treatments use lower doses of estrogen and can be delivered through the skin may further reduce the likelihood of adverse events.

FDA panelists were urging the removal of boxed warnings specifically for vaginal estrogen because it poses the lowest risk of adverse effects. When this route of MHT treatment is taken, less estrogen is absorbed in the patient’s bloodstream, which lowers the risk of blood clots, stroke, and cancer. However, the FDA ultimately chose to remove boxed warnings for all estrogen-containing MHT treatments.

Under the Federal Food, Drug and Cosmetic Act, drug labeling must reflect current and accurate science-based evidence without misleading consumers. There is a risk that removing these warnings about increased risks of cardiovascular disease, breast cancer, and dementia for all estrogen-containing MHT treatments was premature, despite the shortcomings of the WHI study. If labels understate risks of MHT treatment, companies may risk facing claims of misbranding drugs under the Act, even though the FDA no longer requires the boxed warning for six current MHT drugs.

Women deserve a better solution than an outdated, poorly designed study for MHT drugs. Instead of risking liability or debating whether the WHI study is accurate enough to make the FDA require boxed warnings about serious adverse effects, the government should provide a grant for a new study on MHT drugs in menopausal women with a younger average age than the previous study.

The Future of Equal Protection for Transgender Youth in School Sports

On January 13, 2026, the Supreme Court heard oral arguments for West Virginia v. B.P.J. and Little v. Hecox. These two cases challenged state laws that banned transgender girls and women from joining girls’ and women’s sports teams at public schools and colleges. In West Virginia v. B.P.J., 15-year-old Becky Pepper-Jackson challenged West Virginia’ state’s 2021 law that prohibited her, as an 11-year-old transgender girl, from joining her middle school’s track and cross-country teams. In Little v. Hecox, college runner Lindsey Hecox sued Idaho over its 2020 “Fairness in Women’s Sports Act,” which similarly bans transgender women from women’s sports and authorizes invasive sex testing practices. Together, these cases test whether the categorical exclusion of transgender girls from girls’ sports violate Title IX and the Equal Protection Clause.

The Equal Protection Clause prohibits states from treating individuals differently on the basis of sex unless the distinction is substantially related to an important government interest. In these cases, West Virginia and Idaho argue that their laws are intended to protect fairness and safety in girls’ sports, asserting that transgender girls have an inherent advantage over cisgender girls. Yet, Idaho’s and West Virginia’s sweeping restrictions prohibit transgender girls from participating in noncompetitive and recreational teams, while allowing transgender boys to join boys’ sports teams. The result is categorical exclusion of transgender girls in sports regardless of medical transition or athletic context.

During the oral argument, Justice Sotomayor raised sharp concerns about whether these bans truly serve fairness or instead discriminate on the basis of sex, calling them a “clear sex classification” that must survive intermediate scrutiny. She acknowledged the long-settled norm of separating sports teams by sex under Title IX, a practice no one contests. Yet, she drew a key distinction: excluding a transgender girl, who lives and competes as female after medical transition, is based on her transgender status intertwined with her sex, making it “by its nature sex discrimination,” and thus subject to heightened constitutional scrutiny that states cannot sidestep by redefining who counts as female.

Justice Jackson pressed Idaho’s lawyer on this question too, asking why medically transitioned girls, who have lost male-typical muscle and strength after hormone therapy, aren’t similarly situated to cisgender girls, undermining the state’s blanket premise that girls who are transgender have an inherent advantage. Justice Kagan also flagged the overbreadth of the statute, exposing how these policies target transgender identity over any evidence-based logic. While the Court held in Bostock v. Clayton County that discrimination against transgender individuals is sex discrimination, it has not squarely decided if Title IX’s unique context allows greater leeway to address sports-specific concerns.

Since 2020, 27 states have passed similar laws as West Virginia and Idaho to prohibit transgender girls from participating in school sports. Many of these bans similarly authorize invasive forms of sex testing that put all female student-athletes at risk by allowing anyone to dispute a girl’s sex and force medical exams on her reproductive anatomy, genetics, or hormones. Such laws subject girls, especially those perceived as “too masculine,” to dangerous and humiliating surveillance, which has triggered coerced procedures, stigma, and career-ending harm worldwide.

The outcomes in these cases will impact over 380,000 transgender youth nationwide, with more than 50% living in states that restrict their participation in school sports. Although the conservative majority is expected to uphold the ban in some capacity, procedural quirks of the case may allow the Court to avoid setting broad precedent about transgender youth in sports for now. As the country awaits, transgender students, their families, and their allies continue showing up to insist that every child belongs in sports.

Artificial Intelligence Is A Threat To Public Health And Universal Programs Are The Only Solution

Under the best case scenario, AI may present novel opportunities for disease surveillance, diagnostics, and drug-development, but relatively little attention has been paid to the emerging, cataclysmic public health crisis it will cause. The costs are mounting. The noise and air pollution caused by data centers, AI psychosis, and ChatGPT encouraging a teenager to commit suicide are just the start. Aside from the high likelihood of worsening climate change and the existential risks from AI misalignment, the biggest danger no one is prepared for is AI’s potential to rupture the social contract and exacerbate existing crises. 

The public health consequences of mass layoffs will be dire. Unsurprisingly, studies consistently find that layoffs worsen health outcomes and lead to premature mortality. The white collar workers AI is already displacing will experience the same devastation neoliberalist economic policy imposed on blue collar workers in recent decades, but their misfortune will cause even more extreme ripple effects, because the US has developed into a white collar service economy where 59% of consumer spending is from the top 20% of earners. The downward spiral has already begun. Block, a financial technology parent company to Square and Cash App, just announced they will lay off 4,000 workers, 40% of their workforce. One-fourth of unemployed Americans have a bachelor’s degree and are spending more time between jobs than their peers with only a high school degree. Recently, when news broke that two CNBC reporters, without a technical background, used AI to replicate Monday.com’s workflow-management platform the company’s stock took a tumble. 

While there is a growing recognition that AI will cause a great upheaval, most of the proposed solutions are confined within the same flawed framework that conditions basic necessities on employment. Retraining and upskilling are not meaningful solutions to the massive wave of job loss that is coming to our shores. Firstly, because existing public retraining programs have mixed efficacy at best. Secondly, because it is nearly impossible to design, much less implement at scale, a program to retrain workers when the future is so uncertain.

The public health community doesn’t just need a plan, it needs an entirely new, universalist vision, to address the universal impacts of this emerging technology. Myriad public policy responses exist, but a universal school meals program and Medicare for All are great places to start because both have strong popular and scientific support. Creating universal programs lowers the barrier to entry and recognizes that in the near-term AI will create mass unemployment across the board, including in white-collar and administrative professions. Both of these proposals are tractable, evidence-based interventions that will ensure access to food during a sensitive developmental window and reduce morbidity, mortality, and healthcare costs. Childhood hunger is associated with worse health and academic outcomes. Conversely, universal free breakfast and lunch have well-demonstrated, positive impacts on behavioral, academic, and health outcomes, such as 17% reduction in obesity and a 29% reduction in morbidity overall. In an August 2025 YouGov poll, 56% supported a universal free breakfast program and 58% supported a universal free lunch program for students. Similarly, life expectancy is longer in countries with publicly funded healthcare systems. Models suggest that if the US had Medicare for All between March 2020 and March 2022, 338,594 lives and hundreds of billions of dollars could have been saved. A 2022 study found that Medicare for All would save about $438 billion dollars in a non-pandemic year. AI is forcing us to reckon with long-standing injustice and inequality embedded in our system. Whatever dangers await us tomorrow, we will be better equipped to face them if we end child hunger and guarantee universal health coverage.