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inflation reduction act
Big Pharma Army of 500 Lobbyists Is Coming for Medicare Prescription Drug Negotiations, Watchdog Warns
Lobbyists working to pass Pharma-backed legislation currently outnumber lobbyists working to oppose it by more than 20-to-1, estimates Public Citizen.
Nov 19, 2025
Government watchdog Public Citizen is warning that the pharmaceutical industry is preparing an all-out blitz aimed at sabotaging government efforts to negotiate lower prices for prescription drugs.
In a report released on Wednesday, Public Citizen said it found that the major pharmaceutical companies this year have hired more than 500 lobbyists to push for the passage of three pieces of legislation that would undermine the provisions allowing the government to negotiate lower drug prices contained in the 2022 Inflation Reduction Act.
The first piece, called the ORPHAN Cures Act, was passed by Congress in July after being stuffed into the One Big Beautiful Bill Act. According to Public Citizen, the law will "delay and exempt some of the most profitable drugs—including cancer treatments—from negotiations, representing tens of billions in annual Medicare spending."
The other two pieces of legislation—the EPIC Act and the MINI Act—have not yet been passed, and Public Citizen says that they "would lengthen the already long delay period before small molecule drugs are eligible for negotiation—effectively excluding many medicines from negotiations entirely or shortening the period patients have access to lower negotiated prices to only one or two years."
Public Citizen estimates that there are currently 501 lobbyists who are pushing to pass these laws, while just 24 lobbyists are working to block their passage. In total, notes Public Citizen, this means opponents of the legislation are outnumbered by a ratio of more than 20-to-1.
Steve Knievel, Public Citizen's access to medicines advocate, called on elected representatives to "reject the demands of pharma lobbyists and instead work to make prescription drugs more affordable" for their constituents.
"Instead of handing drug corporations billions of dollars by helping them evade price negotiations," Knievel said, "Congress should pass legislation to empower Medicare to negotiate lower drug prices on all costly medicines and allow all patients to access lower, negotiated prices, even if they don’t have Medicare."
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Trump Quietly Dishes Out More Tax Breaks to Rich Investors While Slashing Food Aid for Millions
"Why would corporations spend millions on Trump's ballroom or Bitcoin? Because they're getting billions in unlegislated tax breaks," said one Democratic lawmaker.
Nov 08, 2025
The Trump administration is quietly waging an all-out regulatory war on a Biden-era corporate tax that aimed to prevent large companies from dodging their tax liabilities while reporting huge profits.
The corporate alternative minimum tax (CAMT) was enacted as part of the Inflation Reduction Act, Democratic legislation that former President Joe Biden signed into law in 2022. The CAMT requires highly profitable US corporations to pay a tax of at least 15% on their so-called book profits, the figures reported to shareholders.
As the Institute on Taxation and Economic Policy has explained: "Many of the special breaks that corporations use to avoid taxes work by allowing companies to report profits to the IRS that are much smaller than their book profits. Corporate leaders prefer to report low profits to the IRS (to reduce taxes) and high profits to the public (to attract investors)."
But since President Donald Trump took office in January, his administration has issued guidance and regulatory proposals designed to gut the CAMT. The effort is a boon to corporate giants and rich private equity investors at a time when the Trump administration is relentlessly attacking programs for low-income Americans, including Medicaid and nutrition assistance.
The New York Times reported Saturday that "with its various tax relief provisions, the administration is now effectively adding hundreds of billions of dollars in new breaks for big businesses and investors" on top of the trillions of dollars in tax cuts included in the Trump-GOP budget law enacted over the summer.
"The Treasury is empowered to write rules to help the IRS carry out tax laws passed by Congress," the newspaper added. "But the aggressive actions of the Trump administration raise questions about whether it is exceeding its legal authority."
Why would corporations spend millions on Trump's ballroom or bitcoin?
Because they're getting billions in unlegislated tax breaks.
We've gone from a system where the rich must pay taxes for public services, to one where they must pay the president for private favors.
— Tom Malinowski (@Malinowski) November 8, 2025
The administration's assault on the CAMT has drawn scrutiny from members of Congress.
In a September 8 letter to US Treasury Secretary Scott Bessent, a group of Democratic lawmakers and Sen. Angus King (I-Maine) warned that the administration's guidance notices "create new loopholes in the corporate alternative minimum tax for the largest and wealthiest corporations."
"Most troubling, Notice 2025-27, issued this June, allows companies to avoid CAMT if their income—under a simplified accounting method—is below $800 million," the lawmakers wrote. "The Biden administration previously set the safe harbor threshold precisely at $500 million in its proposed CAMT rule after calculating that a higher safe harbor threshold would risk exempting corporations that should be subject to CAMT under statute."
"Now, less than nine months later and with zero justification, this new guidance summarily asserts that an $800 million safe harbor will not run that risk," they continued. "We are seriously concerned that this cursory loosening of CAMT enforcement will simply allow more wealthy corporations to avoid paying their legally owed share."
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Dems Say They'll Stand Firm Against Budget Deal Unless GOP Halts Attack on Healthcare
Health insurance premiums are expected to rise significantly for approximately 22 million Americans after Republicans ended a tax credit for those enrolled in programs under the Affordable Care Act.
Sep 11, 2025
Democratic leaders said Thursday that they plan to hold up negotiations on a potential government shutdown unless Republicans agree to forfeit a policy change that is expected to dramatically raise health insurance premiums for millions of Americans.
Health insurance premiums are expected to rise significantly for approximately 22 million Americans enrolled in Affordable Care Act (ACA) marketplace plans after Republicans refused to extend enhanced tax credits when passing Trump's "One Big Beautiful Bill Act" in July.
In remarks on Capitol Hill Thursday, Senate Minority Leader Chuck Schumer (D-N.Y.) said he and Democratic House Leader Hakeem Jeffries (N.Y.) were in total agreement not to negotiate unless Republicans agree to extend the tax credits.
“On this issue, we’re totally united. The Republicans have to come to meet with us in a true bipartisan negotiation to satisfy the American people’s needs on healthcare, or they won't get our votes, plain and simple,” Schumer warned at a press conference.
"We will not support a partisan spending agreement that continues to rip away healthcare from the American people. Period. Full stop,” Jeffries said.
The enhanced tax credits, which were created in 2021 under the American Rescue Plan Act and later extended through the Inflation Reduction Act in 2022, are credited with reducing the insurance premiums of millions of people who purchase health insurance through government exchanges.
The tax credits have reduced insurance premiums by 44% on average—over $700 per enrollee—and have contributed to the number of people purchasing insurance on the exchanges more than doubling to over 24 million in 2025.
According to a report released Wednesday by KFF:
Nine in 10 enrollees (92%) receive some amount of premium tax credit. If these enhanced tax credits expire at the end of 2025, out-of-pocket premiums would rise by over 75% on average for the vast majority of individuals and families buying coverage through the Affordable Care Act (ACA) Marketplaces.
The increases come as insurance companies, citing "slumping share prices," per the Financial Times, are planning the largest hike to premiums in 15 years, including an 18% increase for those buying from ACA exchanges.
These increases will come on top of those already expected as a result of a Trump administration rule passed in June, which increased the maximum percentages of income and raw dollar amounts that insurance plans could charge patients out-of-pocket for care.
According to the Center for Budget and Policy Priorities, these changes "will make coverage less affordable for millions of people." The CBPP estimates that "a family of four making $85,000 will have to pay an additional $197 in premiums for coverage in 2026" while a "family of two or more people on the same plan could face an additional $900 in medical bills if a family member is seriously ill or injured in 2026, and an individual enrolled in self-only coverage could face an additional $450 in medical bills."
In all, the Congressional Budget Office estimated in May that as a result of these mounting costs, over 5 million people will no longer be able to afford their health insurance plans.
"The death star of American healthcare, the insurance companies are preparing to blow up the lives of millions of middle-class families," warned journalist David Sirota in a podcast for The Lever.
Republicans in Congress are facing mounting pressure to extend the tax credits and stave off the premium hikes. Last week, 11 Republicans in Congress signed onto a bill that would extend the credits through 2026, allowing them to avoid the issue until after the midterm elections.
A survey conducted in July by two of Trump's most trusted pollsters, Tony Fabrizio and Bob Ward, found that for Republicans in the most competitive districts, "a 3-point deficit becomes a 15-point deficit" against the generic Democrat if they allow the healthcare premium tax credit to expire.
House Speaker Mike Johnson (R-La.) has stayed coy about whether he and the Republican caucus plan to support extending the credits.
"I'm not going to forecast that right now," Johnson told reporters earlier this week, while also saying, "There's a lot of opposition to it as well."
Democrats, meanwhile, have proposed a competing bill to make the subsidies permanent and are hoping to use this month's budget showdown to force Republicans to make concessions on the issue.
As David Dayen wrote Monday for the American Prospect, it sets up a challenging strategic and moral dilemma for Democrats:
On the one hand, Democrats fighting for healthcare benefits speaks to an issue where they have the highest level of support from the public. They would credibly be able to tell voters that they fought for lower costs during an affordability crisis and won, and that more of that will happen if they are given power in the midterms.
On the other hand, Republicans willingly drove the healthcare system toward the point of oblivion, and some may question why Democrats would offer a lifeline to bail them out. In this reading, relieving Republicans of the consequences of their health care plans would be harmful to Democratic midterm chances; Trump would take credit for keeping health care costs low.
What's clear, Dayen said, is that "unless action is taken, it will be an enormous example of Trump's failure to rein in the runaway cost of living."
Lisa Gilbert, co-president of Public Citizen, urged Democrats to stand firm as the fight over a potential government shutdown heats up.
"If Republicans refuse to negotiate and move away from their cost-increasing agenda, then it is Republicans who will be forcing a government-wide shutdown," Gilbert said. "There should be no deal without assurances that the budget will be honored and not impounded, and one that returns care to the American people.”
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