WASHINGTON (Sept. 18, 2026) — The Trump administration said Friday that Medicaid programs in all 50 states, the District of Columbia, and Puerto Rico will receive most-favored-nation pricing for certain drugs under the White House’s GENEROUS model, after drugmakers agreed to offer lower Medicaid prices comparable to those in other developed countries.

According to a White House official and reporting by Reuters and Semafor, the White House Council of Economic Advisers projects the push could save state governments $27.6 billion and the federal government $36.6 billion over the next decade — more than $64 billion combined.

President Donald Trump was set to host the governors of South Dakota, Mississippi, and Arkansas in the Oval Office to tout the drug-pricing work, which Republicans hope to turn into an affordability message before the midterms. The Washington Examiner similarly reported that Medicaid programs nationwide would benefit from administration-negotiated “most favored nation” deals.

Deals with two dozen+ drugmakers

Reuters reported the administration has struck pricing agreements with more than two dozen drugmakers, including Pfizer, Eli Lilly, and Novo Nordisk. Under GENEROUS, companies agreed to offer lower Medicaid prices for many of their drugs — framed as “most-favored-nation” levels aligned with selected international prices. Last month the White House announced another round of deals with international pharmaceutical companies and some smaller biotech firms.

The biggest savings so far from the broader MFN effort have come from weight-loss drugs, Reuters noted, after Novo and Lilly agreed to price cuts tied to greater Medicare availability. Beyond that category, critics have been skeptical about how much everyday price relief Americans are actually seeing.

Medicaid already has steep discounts — skepticism on net savings

Medicaid, funded jointly by states and the federal government, already draws steep manufacturer discounts mandated by existing law, and most enrollees pay little out of pocket for prescriptions. Semafor reported that experts have questioned whether lower prices are entirely a result of Trump’s efforts and whether GENEROUS would yield significant incremental savings on top of those statutory rebates.

A White House official granted anonymity to discuss the event told Semafor: “This is a clear cut example of how you can save money in the Medicaid program in a way that strengthens the program as a whole. By getting lower drug prices, more people will have access.”

Industry lobby PhRMA remains opposed. CEO Steve Ubl criticized the policies as “importing foreign prices from socialist countries,” saying in a statement that they “would mean less treatments and cures and would jeopardize the hundreds of billions our member companies are planning to invest in America,” according to Reuters.

The episode sits at the intersection of industrial policy and midterm affordability politics: the White House is selling state and federal budget savings, while manufacturers and some analysts argue the net gain may be thinner than the CEA headline because Medicaid’s baseline discounts are already deep — and because the government’s ability to import foreign price schedules is a power play over what Americans pay for medicines.

Dated Friday, Sept. 18, 2026: all 50 states + D.C. + Puerto Rico said to participate in Medicaid MFN/GENEROUS; CEA $27.6B state / $36.6B federal over 10 years; Oval event with SD, MS, AR governors; PhRMA/Ubl skeptical.

Sources