Bill restores Medicaid protections, brings orphan drugs back to Medicare negotiation
S. 2447 — Repealing the Trump Sick Tax Act · Filed by Peter Welch (D-VT) · 7 cosponsors · Introduced Jul 24, 2025 · Referred to committee
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What it does
This bill repeals two provisions from a 2025 reconciliation act: one that tightened Medicaid cost-sharing rules (Section 71120) and another that excluded orphan drugs from Medicare's drug price negotiation program (Section 71203). By repealing these sections, the bill restores the prior Medicaid cost-sharing protections and brings orphan drugs back into Medicare's negotiation scope. The bill also rescinds appropriations tied to the Medicaid cost-sharing changes.
Why we flagged it
The bill's core function is to undo two 2025 cost-control measures that restricted Medicaid beneficiaries' protections and limited Medicare's drug negotiation authority. It is a straightforward restoration of prior policy, not a new regulatory regime.
What the text implies
- Restoring Medicaid cost-sharing protections may increase state Medicaid expenditures if beneficiaries use more services at lower out-of-pocket cost, potentially pressuring state budgets unless federal matching rates adjust.
- Bringing orphan drugs back into Medicare negotiation scope may reduce pharmaceutical revenue from orphan indications, potentially affecting R&D incentives for rare-disease treatments unless other incentive structures (tax credits, exclusivity periods) remain intact.
The full analysis lists 3 implications of this text.
Who stands to gain
Medicaid beneficiaries (reduced cost-sharing burden); Medicare beneficiaries (potential savings from orphan drug price negotiation)