S 2447119th CongressIn Committee

Repealing the Trump Sick Tax Act

Introduced: Jul 24, 2025

Sponsor: Sen. Welch, Peter [D-VT] (D-Vermont)

Economy & Taxes

Standard Summary

Comprehensive overview in 1-2 paragraphs

This bill, titled the Repealing the Trump Sick Tax Act, would undo two policy changes enacted earlier in Public Law 119-21 (a reconciliation package). Specifically, it repeals changes to Medicaid cost-sharing requirements and repeals changes to the exclusion for orphan drugs under the Medicare Drug Price Negotiation Program. In practical terms, the bill would restore the Medicare and Medicaid provisions to how they operated before those 119-21 changes, and would rescind funding tied to the Medicaid cost-sharing changes. The result is a return to the prior framework for how much Medicaid enrollees pay out-of-pocket and whether orphan drugs are included in the Medicare drug price negotiations.

Key Points

1Repeals Section 71120 of Public Law 119-21, undoing changes to Medicaid cost-sharing requirements and applying the Social Security Act’s Medicaid rules as if that section had never been enacted.
2Rescinds the funds allocated under section 71120(c) of Public Law 119-21.
3Repeals Section 71203 of Public Law 119-21, undoing changes to the exclusion for orphan drugs under the Medicare Drug Price Negotiation Program.
4Restores title XI of the Social Security Act as if Section 71203 had not been enacted.
5Overall effect: revert the policy changes back to the pre-119-21 status quo for both Medicaid cost sharing and orphan drug treatment in Medicare price negotiations.

Impact Areas

Primary group/area affected- Medicaid beneficiaries (including low-income individuals, families, seniors, and people with disabilities) who face out-of-pocket costs and cost-sharing under Medicaid.- Medicare beneficiaries who could be affected by how drugs, including orphan drugs, are priced under the Drug Price Negotiation Program.Secondary group/area affected- State Medicaid programs, which administer cost-sharing rules and funding; changes could affect state budgets and program administration.- Pharmaceutical manufacturers and drug pricing dynamics, particularly regarding whether orphan drugs are subject to Medicare price negotiations.Additional impacts- Potential changes in beneficiaries’ out-of-pocket costs depending on how Medicaid cost-sharing was altered by the 119-21 changes.- Possible shifts in drug pricing and market incentives related to orphan drugs if they are brought back into or kept out of Medicare price negotiations.- No new programs or funding are created; the bill focuses on reversing existing changes from the 119-21 reconciliation package.

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