The recent State of the Union address marked the first of President Donald Trump’s second term, where among other topics, he addressed lowering prescription drug costs and healthcare affordability for American patients. It was, as these speeches tend to be, full of promises.
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For seniors on fixed incomes, those promises carry real weight — and real risk of disappointment. Healthcare cost is not an abstract policy discussion for this population. It is often the single largest line item in their monthly budget. As a nurse in Arizona, I have watched humans choose between filling a prescription and buying groceries. The data backs up what I see at the bedside: a nationally representative survey published in AARP found that roughly 38% of adults 65 and older were priced out of their own prescriptions or knew someone who was. These are not people who can afford to wait out another election cycle for relief that may never come.
Any policy that meaningfully lowers this burden deserves acknowledgment. But legislation moves slowly — and this administration’s record suggests that the people most harmed by inaction are rarely the ones whose interests shape the final bill. What gives me more immediate hope is that the private sector is already proving change is possible, right now, without waiting for a vote.
In 2022, entrepreneur Mark Cuban launched the Mark Cuban Cost Plus Drug Company, a public benefit corporation designed to address rising pharmaceutical costs by cutting out middlemen and charging a flat 15% markup plus a small pharmacy fee. A 2024 analysis published in JMIR Dermatology found that Cost Plus Drugs outperformed even GoodRx on cost savings, particularly for uninsured patients and those on high-deductible health plans. Affordable drug access does not require an act of Congress. It requires the will to dismantle the systems profiting from lack of transparency.
Which is what makes the rest of the picture so troubling. The Kaiser Family Foundation (KFF) notes that nearly two out of three nursing home residents rely on Medicaid to cover their care. At the same time Trump promises to protect Medicare and Medicaid, proposed federal legislation targets deep cuts, $911 billion per the KFF, to Medicaid spending over the next decade — cuts that would destabilize the very facilities where our most vulnerable seniors live.
Seniors deserve policymakers willing to ask the hard questions — and willing to be held to their answers. The measure of any healthcare policy is not the applause it earns in a chamber full of politicians. It is whether, six months later, an 80-year-old with diabetes and heart failure can still see a doctor who knows their name and can afford every prescription on their way home.
That is the standard every senior in this country has more than earned. Whether this administration intends to meet it is a different question entirely.
Author: Jasmine Bhatti, RN, is founder and CEO of Navi Nurses, a Phoenix-based concierge nursing collective that provides personalized in-home care for patients navigating complex medical needs. For more information, visit NaviNurses.com.
