The White House said this month that Medicaid programs in all 50 states have already received one million free prescriptions of Eliquis, the blood thinner widely used by older heart patients, under an expanding set of drug-pricing agreements the administration calls most-favored-nation pricing. The September 18 fact sheet credits the discount to deals now covering 26 pharmaceutical manufacturers and 89 percent of the branded drug market. Neither number comes from an independent audit; both are figures the administration has chosen to publish about its own program. The pricing mechanism behind them, though, traces to a Medicaid drug model that CMS announced on its own timeline months earlier, with conditions on which states and drugs are actually covered.
What the White House Is Actually Claiming
According to the White House fact sheet published September 18, Medicaid programs have received one million free prescriptions of Eliquis as a direct result of the administration’s most-favored-nation pricing deals with drug manufacturers. The same fact sheet states that the Council of Economic Advisers, a White House body rather than an outside agency, estimates the deals will save $64.3 billion in Medicaid drug costs over the next decade, split roughly $36.6 billion for the federal government and $27.6 billion for states. Those are the administration’s own projections, presented as an outcome of policy the same office designed and announced.
The fact sheet says the underlying rebate model covers hundreds of individual drugs across virtually all major drug classes, including medicines for cancer, diabetes and asthma, extending beyond the single blood thinner used as the announcement’s headline example. Eliquis functions here as the illustrative case the administration chose to publicize, not necessarily the largest dollar category inside a rebate structure that, by its own description, touches a far broader set of Medicaid prescriptions.
The same fact sheet also says patients have saved more than $700 million through TrumpRx.gov, the direct-to-consumer discount site that launched in February 2026, and that roughly 600,000 seniors without GLP-1 obesity-drug coverage have saved a combined $216 million since gaining access to the drugs for about $50 a month in July. Both figures are attributed to the same White House office publishing the fact sheet itself, without a citation to a Medicaid claims database, an inspector general review or any other outside verification a reader can check independently.
The fact sheet does not explain what “free” means in operational terms — whether manufacturers absorbed the full acquisition cost of those one million prescriptions, applied a rebate large enough to net the price to zero, or covered them through some other term of the individual manufacturer agreements. That mechanical detail is left out of the administration’s own account, even as the headline number is presented as a completed fact rather than an estimate.
Free prescription checklist: When a drug’s price or coverage rule changes, the next refill is where it shows up. Get the free coverage and pharmacy checklist.
The CMS Model Behind the Deal Has Its Own Paper Trail
The pricing structure the White House credits with the Eliquis prescriptions is the GENEROUS Model, short for Generating Cost Reductions for U.S. Medicaid, which the Centers for Medicare & Medicaid Services announced separately on November 6, 2025. That announcement describes a model still built around state opt-in: CMS said it would release a formal request for applications to drug manufacturers and seek letters of intent from state Medicaid agencies, meaning participation depended on states choosing to apply rather than the pricing applying automatically nationwide the moment it was unveiled.
The same CMS announcement puts the earlier scale of the problem in perspective: total Medicaid prescription drug spending exceeded $100 billion in 2024, or about $60 billion after existing manufacturer rebates already in place, a $10 billion increase from 2022. That baseline is a CMS-published figure, not a White House estimate, and it shows the $64.3 billion in projected ten-year savings amounts to roughly one year’s worth of net Medicaid drug spending stretched across a decade — a real number, but a smaller share of the program than the announcement’s framing might suggest on its own.
The 26-manufacturer, 89-percent-of-market figure did not arrive all at once. An August 31, 2026 fact sheet shows the count reaching 26 only after nine additional manufacturers, including Alcon, Astellas Pharma and Teva Pharmaceuticals, signed on that day, following earlier waves that began with a single Pfizer agreement in September 2025. Those nine companies also committed to invest at least $19.6 billion in U.S. manufacturing and to contribute raw pharmaceutical ingredients, including more than 160 tons of an anticonvulsant from UCB, to a federal strategic reserve — commitments bundled alongside the Medicaid pricing deal rather than part of the Medicaid rebate mechanism itself.
A Number That Changed Between Two Announcements
The August 31 fact sheet and the September 18 fact sheet both describe the same GLP-1 discount program launched in July 2026 and both cite an identical $216 million in total savings, but they attribute that total to two different participant counts: over 500,000 seniors in the August version and 600,000 seniors in the September version, published just under three weeks apart. Neither fact sheet explains whether the total savings figure was recalculated, held constant as a placeholder, or simply not updated between releases, and no Medicaid or CMS claims data has been cited to reconcile the two counts.
That inconsistency does not undo the underlying claim that Medicaid programs have benefited from lower-priced prescriptions, including the one million Eliquis prescriptions the administration says are already flowing through the pricing model. It does mean the specific dollar and prescription counts in circulation are, for now, numbers the White House has chosen to publish about a program it also designed, running ahead of the state-by-state enrollment and drug-coverage data CMS would need to release before an outside observer could confirm them independently.
Drug Prices Outside the Medicaid Announcement
The pricing deals described above apply specifically to Medicaid drug rebates, a program that covers only some older Americans, mostly those with lower incomes or dual Medicare-Medicaid eligibility. Most people on Medicare pay for prescriptions through a separate Part D plan that operates under its own out-of-pocket cap and its own prior-authorization rules, neither of which is addressed anywhere in the Medicaid announcements covered above. Whether a headline about lower Medicaid drug prices changes anything at an individual pharmacy counter depends entirely on which of these two systems that person is actually enrolled in.
The Medicare Cost & Coverage Protection Kit is a 10-page kit covering the new Part D out-of-pocket cap, the prior-authorization appeal steps and a medication and cost tracker, along with 51 state Medicare cost-help packs.
See the Part D out-of-pocket cap and the prior-authorization appeal steps in The Medicare Cost & Coverage Protection Kit.
This article was researched and drafted with the assistance of AI and reviewed by The Money Overview editorial team.
