President Trump vowed on Thursday to send $200 discount cards for prescription drugs to 33 million older Americans, a $6.6 billion election-eve promise with dubious legal authority that he announced as part of a speech billed as presenting a long-awaited health care plan.
Mr. Trump made the announcement before an audience of health professionals in Charlotte, N.C., where he laid out what the White House called the America First health care plan.
Mr. Trump’s broader plan is short on specifics, and its two core provisions are largely symbolic. The first is an executive order aimed at protecting people with pre-existing conditions — a provision already in the Affordable Care Act, which Mr. Trump is trying to overturn. The second — a push to end surprise medical billing — would require congressional action.
That left the drug discount cards as the major advance in Mr. Trump’s speech. It was not clear where the money for the cards would come from or whether the White House could legally issue them. But they amounted to a gift to a key constituency, offered weeks before Election Day.
A senior administration official said the discount cards would be authorized under a waiver program that allowed Medicare to test certain new policy ideas. The money would come from savings gleaned from the president’s directive this month that required Medicare to pay no more for prescription drugs than in other developed nations, the official said.
But that program has not yet been devised or enacted.
“Is the plan to borrow from potential future savings from a program that does not yet exist?” asked Rachel Sachs, an associate professor of law at Washington University in St. Louis, who studies prescription drug policy.