President Trump has repeatedly promised to bring down prescription drug prices. His Republican Congress says it shares that goal. But tucked inside the recently passed 2026 Consolidated Appropriations Act is a restructuring of the drug market that makes lower prices less likely, not more.
How does a Congress that promises lower prices end up weakening the bargaining tools that restrain them? The answer lies less in ideology than in political incentives. Pharmacy benefit managers (PBMs) are opaque intermediaries—and they are unpopular with figures including Mark Cuban, who told Fortune that the current rebate system is flawed.
