Trump talks individual mandate repeal, drug prices, opioids in State of the Union speech

President Donald Trump touched on a number of healthcare issues in his State of the Union speech last night, but did not echo his regular refrain for a full repeal of the Affordable Care Act. 

He touted Congress' rollback of the individual mandate in the address, calling the measure, which was intended to push people to get health insurance, "an especially cruel tax" on some of the poorest Americans. 

"We repealed the core of the disastrous Obamacare. The individual mandate is now gone," Trump said. "Thank heaven." 

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The GOP-controlled Congress tried multiple avenues to cut other elements of the ACA, but those efforts came up short. Trump has characterized the individual mandate repeal, which was passed as part of a tax reform package, as "essentially" repealing the law. 

Senate Majority Leader Mitch McConnell, R-Ky., has indicated that he is ready to move on from an ACA repeal, though not all of his peers agree. 

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In addition to praising the individual mandate repeal, Trump said in the speech that reducing the rising costs of drugs is one of his administration's "greatest priorities." He said the high cost of drugs in the U.S. is "very, very unfair" compared to lower prices in other countries. 

"That is why I have directed my administration to make fixing the injustice of high drug prices one of my top priorities for this year," Trump said. "And prices will come down substantially—watch." 

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Trump also said that tackling the rising cost of drugs was a priority at the swearing-in ceremony this week for Alex Azar, the new secretary of the Department of Health and Human Services. Azar previously served as head of drugmaker Eli Lilly's U.S. operations, and opponents of his nomination expressed concern about a former pharmaceutical executive leading HHS. 

Trump said during the swearing-in ceremony that Azar would "unravel the tangled web of special interests that are driving up prices for medicine and really hurting patients," efforts that would lead drug prices to "come rocketing down." 

In the State of the Union address, Trump praised the Department of Veterans Affairs' for taking steps to improve healthcare for veterans—in particular, noting accountability changes and the Veterans Choice program—and addressed the opioid epidemic. 

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He said it's crucial to be harder on drug dealers and to increase access to access to addiction treatment. In 2016, he noted, 64,000 people died of a drug overdose—174 per day. 

"Never before has it been like it is now," Trump said. "It's terrible." 

Though Trump said his administration is "committed to fighting" the opioid epidemic, providers have been critical of the limited steps taken so far, including the fact that there is little funding behind the administration's declaration that the epidemic is a public health emergency.