Why do Americans pay so much for prescription drugs?** President Donald Trump’s new most-favored-nation drug pricing initiative is moving into Medicaid programs nationwide, with all 50 states, Washington, D.C., and Puerto Rico applying to participate. CMS says 40 states and Puerto Rico had already signed participation agreements as of September 18. ([CMS][1]) In this video, I break down what the **GENEROUS Medicaid drug-pricing model** actually does, why prescription drugs can cost Americans more than patients in other developed countries, and whether this approach could meaningfully reduce taxpayer costs. Under the program, participating pharmaceutical manufacturers provide supplemental rebates intended to bring Medicaid’s net prices for certain drugs closer to prices paid in selected foreign countries. ([CMS][2]) The Trump administration’s Council of Economic Advisers estimates the Medicaid portion of the policy could save federal and state taxpayers approximately **$64.3 billion over the next decade**. That is a projection, not savings already realized, which is why the real test will be what states actually pay once the program is operating. ([The White House][3]) But there’s a bigger question here: **Why has the United States—with enormous purchasing power—accepted substantially higher prices for many prescription drugs in the first place?** From the beach here in Florida, I look beyond the political headlines and talk about drug pricing, government purchasing power, Big Pharma, Medicaid, accountability, and what Americans should watch as this program moves forward. **Topics covered:** Trump drug prices, prescription drug costs, most favored nation pricing, Medicaid drug prices, GENEROUS model, Big Pharma, TrumpRx, healthcare costs, government spending, taxpayer savings, American healthcare, drug pricing reform, Donald Trump, Medicaid, prescription medicine. #Trump #DrugPrices #medicaidexpansion 00:00 The $64 Billion Question 00:42 All 50 States Apply 02