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Washington, D.C., November 29, 2025 – A wave of policy shifts is reshaping the U.S. healthcare landscape, leaving patients, providers, and insurers bracing for uncertainty. The most significant development? Pricing agreements reached with Eli Lilly and Novo Nordisk in November are poised to dramatically lower the cost of popular weight loss drugs for millions, offering a rare luminous spot amid broader turmoil.
Medicaid Cuts and Drug Pricing Battles Dominate 2025
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the year’s biggest healthcare stories centered on access to coverage and affordability of medications.
- House Rule 1, enacted in July, could strip Medicaid coverage from 5.2 million adults by 2034.
- The Trump management’s Most Favored Nation (MFN) drug pricing policy continues to move forward, despite lingering questions about implementation.
- A government shutdown in November briefly threatened affordable care Act (ACA) subsidies, leaving insurance costs in limbo for many.
- Deals with eli Lilly and Novo Nordisk aim to lower the price of GLP-1 therapies, offering increased affordability for Medicare, Medicaid, and TrumpRx users.
Medicaid Coverage at Risk Following House Rule 1
A new rule enacted by the House in July, known as House Rule 1, is projected to lead to significant reductions in Medicaid coverage. Experts estimate that 5.2 million adults could lose coverage by 2034 as states begin to re-evaluate eligibility requirements. This shift is expected to have far-reaching
Evidence consistently demonstrates a link between Medicaid coverage and improved health and increased employment. Experts warn that these coverage losses could destabilize access to care for children and families, exacerbating existing health disparities.
Most Favored Nation Drug pricing Faces Implementation Hurdles
The Trump administration’s Most Favored Nation (MFN) drug pricing policy continues to advance, but significant operational and legal details remain unresolved as of November 2025. During a webinar, experts cautioned that the policy, which aims to tie U.S. drug prices to international benchmarks, is fraught with uncertainty for manufacturers, payers, and patients. Panelists discussed two proposed demonstration models – GLOBE and GUARD – and the growing trend of direct-to-consumer drug fulfillment. Concerns were raised about potential spillover effects on Medicaid and 340B pricing, as well as the limited potential for Medicaid savings under the MFN policy.
ACA Subsidies Remain in Limbo After Government Shutdown
The 2025 federal government shutdown, which concluded in November, failed to resolve the fate of enhanced Affordable Care Act (ACA) subsidies. This leaves the future of insurance costs uncertain for millions of marketplace enrollees. While Senate Republicans agreed to a vote on extending the subsidies, House Republicans remained noncommittal, raising the risk that the subsidies could expire at the end of 2025, perhaps more than doubling premiums for some low-income patients. Policy experts cautioned that failure to extend the subsidies could lead to increased uninsurance rates, particularly among older adults and individuals with chronic conditions, compounding the impact of recent Medicaid cuts.
Drug Pricing Deals Offer Hope for Affordability
In a move that could considerably impact access to weight loss medications, the White House announced pricing agreements with Eli Lilly and Novo Nordisk in November. These agreements are designed to lower the cost of GLP-1 therapies, such as semaglutide (Ozempic, Wegovy) and tirzepatide (Zepbound), for Medicare, Medicaid, and patients purchasing through the new TrumpRx direct-purchase platform. Under the deals, monthly prices for semaglutide and tirzepatide are expected to fall to roughly $245 for public programs and $350 through TrumpRx. Both companies have also committed to MFN-aligned pricing on future products and additional discounts on insulin and other chronic disease drugs.
What impact will the new drug pricing agreements have on patients? The agreements are
