with Meryl Kornfield

THE PROGNOSIS

Democrats applauded two years ago when President Trump promised in his 2018 State of the Union address to lower the high cost of prescription drugs.

But last night, it was clear any bipartisan fervor around this issue – one which deeply concerns Americans – has vanished.

Trump spent more time attacking Democrats over the issues of Medicare-for-all and coverage for undocumented immigrants than in talking about lowering prescription drug costs. 

“One hundred thirty-two lawmakers in this room have endorsed legislation to impose a socialist takeover of our health-care system, wiping out the private health insurance plans of 180 million Americans,” Trump said, referring to the Medicare-for-all bills offered by Rep. Pramila Jayapal (D-Wash.) and Sen. Bernie Sanders (I-Vt.).

“To those watching at home tonight, I want you to know: We will never let socialism destroy American health care,” the president added, to thunderous applause from the side of the room occupied by the GOP.

NBC News correspondent Kasie Hunt:

Politico reporter Sarah Ferris noted the reaction from some moderate Democrats:

From her perch on the House dais, Speaker Nancy Pelosi (D-Calif.) could be seen shaking her head as Trump declared that his administration is “taking on the big pharmaceutical companies.” 

A group of House Democrats sitting in front of the president shook their fists and chanted “HR 3” – a reference to their sweeping bill to allow the federal government to directly negotiate lower drug prices in Medicare, one which Republicans and the pharmaceutical industry vehemently oppose.

When President Trump urged lawmakers to send him a bill to lower prescription drug prices during his State of the Union speech, Democrats erupted in protest. (The Washington Post)

Meanwhile, the campaign arm for House Democrats launched Facebook ads ahead of Trump’s address accusing the president of telling “the same disappointing lies we’ve heard before.” It's part of a $1 million ad buy attacking Trump on drug prices.

Trump is merely “distracting Americans from the many ways he stood with special interests and kept Americans’ prescription drugs high,” say the Facebook ads, which are targeting eight vulnerable House Republicans including former Energy and Commerce Chairman Fred Upton (R-Mich.).

It was Trump’s third State of the Union address, and his final one before voters decide in November whether to reelect him. The president didn’t mention the impeachment vote House Democrats took against him in that very chamber, but the poisonous political atmosphere was palpable throughout the evening as the Senate is today expected to acquit him on charges of obstructing Congress and abuse of power, the Post’s David Nakamura reports.

“Several prominent Democrats, including Rep. Alexandria Ocasio-Cortez (N.Y.), chose to boycott the address, and a handful of others walked out as the president was speaking,” David writes. “As Trump basked in applause after concluding his 77-minute speech, House Speaker Nancy Pelosi (D-Calif.), standing behind him on the dais, tore up a printed copy of the remarks in four separate piles.”

In each of his previous addresses to Congress, Trump has promised to lower prescription drug prices. Here’s what he said:

2017: “We should implement legal reforms that protect patients and doctors from unnecessary costs that drive up the price of insurance – and work to bring down the artificially high price of drugs and bring them down immediately.

2018: “One of my greatest priorities is to reduce the price of prescription drugs. In many other countries, these drugs cost far less than what we pay in the United States and it's very, very unfair. That is why I have directed my administration to make fixing the injustice of high drug prices one of my top priorities for the year. And prices will come down substantially, watch.”

2019: “Already, as a result of my administration's efforts, in 2018 drug prices experienced their single largest decline in 46 years. But we must do more…I am asking the Congress to pass legislation that finally takes on the problem of global freeloading and delivers fairness and price transparency for American patients.”

But the administration’s effort has been one of fits and starts.

There was Trump’s promise a year and a half ago – delivered in a major speech at the Health and Human Services building – to lower Medicare drug prices by tying some of them to lower prices in other countries. The administration has yet to propose details on how that might work.

HHS did propose a rule in December to allow some cheaper drugs to be imported from Canada, but it’s far from final. A court has blocked its requirement for drugmakers to display list prices in television ads. And last summer, the administration walked back a plan to ban the rebates drugmakers pay to pharmacy middlemen.

It’s all been deeply frustrating for Trump. Multiple news reports have detailed how the president regularly castigates HHS Secretary Alex Azar for failing to produce a big new policy change or piece of legislation he can point to while campaigning for reelection.

As a result, Trump had little real progress on health care to tout last night.

He mentioned the record number of generic drugs being approved, something that is true. But he repeated exaggerated data on drug prices growing more slowly in 2018 (The Post’s fact-checkers explain that here) and ignored more recent data indicating little improvement in drug prices, especially for branded drugs.

And he called on Congress to pass a bipartisan bill written by the leaders of the Senate Finance Committee to cap seniors’ spending on medicines and ban some tactics drugmakers use to limit access to generic versions of their medications. Pelosi hasn’t held a vote on the bill – but neither has the Senate’s GOP leader, Mitch McConnell (Ky.).

“Get a bill to my desk, and I will sign it into law without delay,” Trump said.

Sen. Chuck Grassley (R-Iowa), one of the bill's authors:

Post reporter Erica Werner:

—Trump especially raised Democrats' ire when he talked about Obamacare's protections for patients with preexisting conditions. The president regularly talks out of both sides of his mouth on this issue, and he did it again.

"I have also made an ironclad pledge to American families:  We will always protect patients with pre-existing conditions -- that is a guarantee," Trump said.

Yet, as we have explained repeatedly in The Health 202, Trump has directed his administration to support legal arguments from GOP-led states that the entire health-care law is unconstitutional. The administration is asking federal courts to erase the entire law but hasn't detailed how it would be replaced. 

Face the Nation moderator Margaret Brennan:

Trump addressed a few other health-care topics in last night's speech:

Abortion: Trump gave a shout-out to 2-year-old Ellie Schneider sitting in the House gallery, saying she was born at 21 weeks and 6 days weighing less than a pound. He said her story "reminds us that every child is a miracle of life" and called on Congress to pass a bill banning abortions later on in pregnancy and fund neonatal research.

"Thanks to modern medical wonders, 50 percent of very premature babies delivered at the hospital where Ellie was born now survive.  Our goal should be to ensure that every baby has the best chance to thrive and grow just like Ellie," Trump said. "Whether we are Republican, Democrat, or Independent, surely we must all agree that every human life is a sacred gift from God."

Opioids: Trump alluded to recent data showing drug fatalities are dropping. 

"With unyielding commitment, we are curbing the opioid epidemic -- drug overdose deaths declined for the first time in nearly 30 years," he said. "Among the states hardest hit, Ohio is down 22 percent, Pennsylvania is down 18 percent, Wisconsin is down 10 percent -- and we will not quit until we have beaten the opioid epidemic once and for all."

Price transparency: Eleven months from now, hospitals will be required to post the prices they negotiate secretly with insurers. That's according to a new regulation from the Trump administration aimed at putting pressure on the industry to bring down costs and give consumers more information. Trump touted that work last night.

"The American patient should never be blindsided by medical bills," Trump said. "That is why I signed an Executive Order requiring price transparency. Many experts believe that transparency, which will go into full effect at the beginning of next year, will be even bigger than healthcare reform.  It will save families massive amounts of money for substantially better care.

Politico reporter Rachel Roubein:

AHH, OOF and OUCH

AHH: Sanders now has a slight popular-vote lead in the early Iowa caucus vote count, while former South Bend, Ind., mayor Pete Buttigieg has more state delegates. 

Ahead of the delayed results announcement, Barron’s called Sanders “a boogeyman” for health-care investors, saying his Medicare-for-all single-payer platform “effectively kill much of the managed-care industry, and his victories have a tendency to rock health-care stocks.” But Barron’s writes that his Iowa victory wouldn’t immediately impact stocks. 

As technical difficulties prevented Iowa election officials from announcing the Iowa results on Tuesday night, preliminaries polls revealed about 6 in 10 caucusgoers said they supported eliminating private health insurance and establishing a single-payer system.

Analysts speculated that would help the Sanders and Buttigieg camps, The Health 202 reported Tuesday.

“The American people understand that health care is a human right, not a privilege,” Sanders told supporters following the caucus. 

— Biden also spoke after the caucus, reiterating his experience made him the most equipped of the candidates to overhaul health care and push other significant legislation, our Post colleague Cleve R. Wootson Jr. reports.

OOF: Officials say 493 people have died from coronavirus, two of which were outside of China in the Philippines and Hong Kong. The Chinese government has confirmed more than 24,000 cases, which was a significant jump from the 3,235 reported Monday, our Post colleagues Anna Fifield, Derek Hawkins and Siobhán O'Grady report

Two flights evacuating 530 U.S. citizens from the Wuhan area departed for the United States Wednesday,  Anna reports

When the government began to quarantine areas where the virus originated on Jan. 23, there were about 1,000 Americans  in Wuhan and the surrounding area, Fifield writes. 

— A newly approved test for the coronavirus will be run in state labs, improving and expanding detection, the Food and Drug Administration announced, our Post colleague Derek Hawkins reports.

The test, developed by the Centers for Disease Control and Prevention, was previously only done in its Atlanta headquarters. The agency hasn’t approved a commercially available diagnostic test, Hawkins writes.

— As the CDC is quickly burning through $105 million trying to detect and treat coronavirus, House Democrats told HHS secretary Azar that the administration should ask Congress for additional emergency funding, our Post colleague Erica Werner reports.

House Appropriations Chairwoman Nita M. Lowey (D-N.Y.) and Rep. Rosa DeLauro (D-Conn.) wrote that Trump’s supplemental spending request for the 2021 budget, due out Monday, should include funding to combat coronavirus in the United States and abroad. 

HHS notified Congress it may need to transfer up to $136 million for its coronavirus response, The Post previously reported.

— Overall, Americans trust how the government is handling the epidemic, a NPR/PBS NewsHour/Marist poll found. The poll, which came out Tuesday, says 61 percent of respondents believe the U.S. government is doing enough to prevent the spread of the virus.

—  The State Department temporarily suspended the U.S. Fulbright program in China, evacuating its fellows, Miriam Berger reports. This comes after other study abroad programs run by universities have brought U.S. students back.

Wuhan businesses including fast-food chains are shutting their doors, but some McDonald’s branches have reportedly remained open, taking customers temperatures before they order, Berger reports

McDonald’s told news outlets “it was taking precautions, such as mandating constant sanitizing and providing masks and other protective gear for its workers,” Berger writes.

OUCH: Executives from five e-cigarette companies will face off with lawmakers before the House Energy and Commerce Oversight and Investigations subcommittee today.

The companies – Juul, Logic, NJOY, Fontem (blu) and Reynolds American Inc. (VUSE) – account for 97 percent of the total U.S. e-cigarette market, chairwoman Rep. Diana DeGette (D-Colo.) office’s wrote in a press release.

This is the latest in a serious of hits the industry has taken, Stat News reports. The companies have faced multiple congressional investigations into youth-targeted marketing, bans on their flavored products and lawsuits

MEDICAL MISSIVES

—  A Texas district court judge ruled to allow Cook Children's Medical Center to remove 11-month-old Tinslee Lewis from life support, our Post colleague Marisa Iati reports. While her mother begged to keep her on, her doctors said every medical procedure they could perform would only cause more suffering.

“While the battle over how long Tinslee will be kept alive plays out in the legal sphere, the case also evokes ethical questions of who should get to decide what kind of medical treatment is or is not in the best interest of a child too young to speak for herself,” Iati writes. 

Tinslee's case has been compared to that of Charlie Gard, who was also 11 months old and terminally ill. In 2017, his parents, in Britain, went to court and lost.

STATE SCAN

Bipartisanship was achieved in a bill that won unanimous support Tuesday in the Virginia Senate: The bill would both prevent surrogate mothers from being forced to abort their fetuses with abnormalities and stop any prohibitions if the mothers want to terminate, our Post colleague Laura Vozzella reports. The measure now heads to the House of Delegates.

The bill isn't antiabortion, Sen. Mark J. Peake (R-Lynchburg), said on the floor. “The choice remains with the pregnant mother," Peake said.

DAYBOOK

Coming up:

  • The House Foreign Affairs Committee holds a hearing on “Unique Challenges Women Face in Global Health” today.
  • The House Veterans Affairs subcommittee on oversight and investigations holds a hearing on how the Veterans Affairs Department supports survivors of military sexual trauma today.
  • The House Ways and Means subcommittee on health holds a hearing on “Overcoming Pharmaceutical Barriers” today.
  • The New Hampshire Democratic debate will be held Friday.

SUGAR RUSH

Triumph The Insult Comic Dog, a K-9 correspondent for The Late Show with Stephen Colbert, paraded through the halls and tunnels of the Capital to ask questions of (and dis) lawmakers.