Medicare is sunsetting a little-known program that could raise seniors’ drug costs during a hotly contested U.S. election season.

After two years in operation, CMS will end a program known as the Medicare Part D Premium Stabilization Demonstration. The voluntary demo was launched in 2024 by the Biden administration to prevent a spike in premiums under the Part D drug benefit as Medicare adjusted to changes mandated by the Inflation Reduction Act.

In a release, Medicare administrators said the program is no longer needed as plan sponsors have “sufficient experience under the redesigned Part D benefit to support their assumptions in developing the prescription drug plan bids.”

For the 2026 plan cycle, the demo gave insurance companies an estimated $3.6 billion in subsidies to offset Part D premium increases, according to federal data. Without such funds, plan sponsors may adjust for financial risks in ways that impact GLP-1 access and the 340B program.

Prominent Democrats, who have positioned affordability as a focal point of upcoming elections, labeled the move as “heartless, cruel and completely by choice.” In defense, CMS Administrator Mehmet Oz touted that premiums will increase “by less than $10 for most Medicare recipients” without compromising access to medicines — citing the pursuit of more MFN drug pricing deals with pharma companies.

– Andrew Wishon, Editor-in-Chief

The 26th International AIDS Conference convened this week in Rio de Janeiro under the theme “Rethink. Rebuild. Rise.” Instead of a traditional science conference, it became more of a real-time case study on the collapse of the global health assistance model as we know it.

Total donor funding for HIV/AIDS programmes in low- and middle-income countries is now at its lowest level in nearly two decades. According to UNAIDS, funding declined by more than US$ 1.5 billion to US$ 7.3 billion in 2025, an 18% reduction and “the lowest level in nearly two decades.”

For example, France significantly reduced its support to the Global Fund to Fight AIDS, TB and Malaria. The United States, once the leader of the global HIV/AIDS response through the U.S. President’s Emergency Plan for AIDS Relief (PEPFAR), dropped funding from $6.7 billion to $4.6 billion.

The global health architecture we knew is deglobalizing before our very own eyes. Resurging instead are country-to-country deals. U.S. Global AIDS Coordinator Jeff Graham told delegates, the new “America First” model requires recipient governments to make financial “co-investments” of their own.

Furthermore, quid pro quo conditions such as access to critical minerals are re-entering the health diplomacy conversation for the first time in a generation. African leaders haven’t forgotten the conditionality era though, and in Rio this week, HIV/AIDS activists have openly been calling out what they described as “coercive bilateral deals.”

These changes have already impacted endemic country populations. More than 1,700+ HIV service sites have closed and 30,880 fewer children are receiving HIV/AIDS treatment in South Africa alone as a direct result of PEPFAR cuts.

Yet, new localized and innovative solutions are emerging fast. Domestic financing has already risen to roughly 59% of total HIV/AIDS funding. Moreover, the new Global AIDS Strategy target is for domestic funding to cover ~67% of total resource needs by 2030. Affected individuals and countries are increasingly turning to self-care models and community volunteers stepping in where paid staff once stood.

Scientific collaboration is being reshaped too. Industry showed up in Rio with genuine scientific breakthroughs in testing, prevention and treatment — which together will provide patients with greater choice and more ways to protect themselves.

The biggest new industry commitment came from Merck, which announced it would license an experimental once-monthly PrEP pill to generic makers in 129 countries. Even though the drug is still in late-stage trials, Merck is beginning to scale up manufacturing capacity to help ensure equitable access in Africa and India.

Clearly, pharma partnerships for life-saving medications like PrEP and antiretrovirals will be essential to help fill the global health assistance financing and support gap.

Rio ultimately made one thing clear: the old model may be gone, but the resolve to build something better is not.

– Francesca Boldrini and Rachel Bridges, Real Chemistry

• August 4 – committee hearing on how “competition & transparency” lowers drug costs, Senate Judiciary
• August 4 – committee hearing on “the reality” of Medicaid, Senate Budget
• August 4 – subcommittee hearing on “building a resilient healthcare future with biotechnology,” Senate Finance

• “The bilateral MFN agreements are more than political theater. They reflect a real shift in the federal government’s prescription drug strategy…” – Matthew Vogel et al., Health Affairs Forefront
• “I have come to the conclusion that the search for a single top issue through polling questions—whether it’s health costs, or gas prices, or the cost of food—is artificial. People worry about and experience these costs together.” – Drew Altman, KFF
• “Germany has found a convenient way to cut healthcare costs: send the bill for medical innovation to the United States.” – Wolfgang Klietmann, Washington Examiner
• “A recent Council on Foreign Relations report, for instance, warns that China may ‘deliberately withhold essential pharmaceutical inputs as a tool of economic or political coercion’ — drawing from risk analyses of other supply chains like rare earth and critical minerals.” – Pooja Yerramilli, STAT

• The first wave of planned U.S. pharmaceutical tariffs is not expected to take effect today since all 17 targeted drugmakers have secured tariff exemptions through dealmaking. Endpoints News: Trump’s pharma tariffs won’t kick in Friday because there’s no one left to kick.
• A Senate committee voted to advance Dr. Erica Schwartz’s nomination to lead the CDC, moving the agency closer to securing a permanent director after months of leadership turnover. Reuters: US Senate panel advances Trump CDC pick Schwartz.
• Rising oil prices are creating new concerns about medicine affordability, with one analysis finding that manufacturing costs for certain drugs could increase significantly due to their reliance on petrochemical ingredients. STAT: Rising oil prices can boost the cost of some medicines. One expert says it’s time to lower reliance on fossil fuels.
• AstraZeneca told investors it is adapting pricing strategies for new medicines in response to the Trump administration’s most-favored-nation drug pricing policy. Reuters: AstraZeneca drug prices evolving in response to Trump policy, executive says.
• Despite Secretary Kennedy’s pledge to eliminate direct-to-consumer pharmaceutical advertising, HHS is pursuing a slower regulatory approach. NOTUS: RFK Jr.’s Big Promise to Ban Pharmaceutical Ads Is in the Slow Lane.
• The Trump administration is preparing to release $600 million in previously withheld funding for Gavi, providing a boost to immunization programs in lower-income countries. Politico: Trump administration to dispense $600M for vaccines RFK Jr. held up.
• The FDA released its FY 2027 user fee rates across all product types, reflecting revenue projections and application volume estimates that will help fund the agency’s review programs. Regulatory Focus: FDA unveils FY 2027 user fee rates.
• Secretary Kennedy launched The Real Food Show, a new cooking series featuring celebrity chefs that aims to help Americans prepare healthy, affordable meals based on new dietary guidelines. USA Today: Exclusive: RFK Jr. hosting a new cooking show with celebrity chefs.