“Trump: Medicaid drug pricing deals reached for all 50 states.” The paper said the White House promised nearly $65 billion in Medicaid drug savings over the next decade. Deeper in, it noted that manufacturers have not released the agreement terms.

The White House used the present tense. “Those lower prices now reach every Medicaid program in America.” “Every state Medicaid program in the nation now gets Most Favored Nation drug prices.” “All 50 states, the District of Columbia, and Puerto Rico are in, unlocking nearly $65 billion in Medicaid drug savings over the next decade.”

CMS, on the page last modified at 4:30 that afternoon, used applied. All state Medicaid programs, plus the District of Columbia and Puerto Rico, have applied to participate in GENEROUS. State Medicaid agencies have until September 30, 2026, to finalize applications.

Applied and reached do different jobs.

The model is voluntary and runs five years. States “can determine for which (if any) covered outpatient drugs they would like to obtain” the prices. Manufacturers “will participate in the GENEROUS Model after certain terms are finalized,” then sign a separate agreement with each interested state.

The Council of Economic Advisers put $64.3 billion on paper in May. Ten years of existing Medicaid drugs, at 17 manufacturer deals, for every single-source brand whose net sat above MFN. GENEROUS runs five years. The estimate runs ten. The White House fact sheet named CEA for $64.3 billion. The release rounded it to nearly $65 billion and tied it to Friday.

Officials put hundreds of drugs in the fact sheet. Larry Rhoden of South Dakota, who appeared with the president, said “South Dakota has currently identified three drugs … saving the state approximately $750,000 a year.” I read that sentence in a Pierre reprint. I do not have it from the state website.

Medicaid enrollees already pay a nominal copay, or nothing. Federal and state budgets would keep the claimed savings. Kathy Hempstead at the Robert Wood Johnson Foundation said, “No one knows what is in these deals.”

AP said the savings were unclear because the deals are not public, then cited $529 billion. That is CEA’s estimate for new launches in all markets. The $600 billion from the manufacturer announcements earlier this month is another pile.

States may finalize by September 30, and that would be a new fact. Friday’s CMS page said they had applied.