Trump's Generic Drug Tariffs & The 14% ACA Hike | Last Month in Healthcare

"Generic drugs are not the costly drugs. A 100% increase on a relatively inexpensive generic may not even be noticeable." In this episode of Last Month in Healthcare, Producer Nathaniel and I sat down with Sean McGowan of Centivo to break down the biggest healthcare news stories of July 2026. We started with the proposed tariffs on generic drugs - 100% in 2028, 200% in 2029 - and what that actually means when India supplies roughly half of U.S. generic volume and China supplies most of the active ingredients. We also dug into ACA marketplace insurers proposing a 14% median premium increase for 2027 and whether ICHRA adoption is quietly loading that risk pool, the Patients Deserve Price Act clearing Senate HELP 21-1 and whether posted prices change any real behavior, specialty drugs on track for a 32% jump by 2028 driven by utilization rather than unit price, and a misleading headline about $6.6 trillion in "tax help" for employer plans that's actually been on the books since the 1950s. To cap it off, we ran a point solution trade deadline in honor of the MLB deadline - six solutions on the roster, a $100 cap, and some tough calls on who's overpaid. Plus I answered a listener question on whether covering GLP-1s for weight loss locks an employer in for good. Tune in for a great conversation! Thank you to Walk-On Clinic for sponsoring this episode. Visit walkonclinic.com to learn more. Chapters: (00:00:00) Intro: Sean McGowan and Walk-On Clinic (00:01:39) 200% Tariffs on Generic Drugs by 2029 (00:04:41) ACA Insurers Want a 14% Premium Hike for 2027 (00:07:28) The Patients Deserve Price Act Clears Committee (00:10:44) Specialty Drug Costs to Jump 32% by 2028 (00:13:10) The $6.6 Trillion Tax Break Nobody Noticed (00:14:37) Game: The Point Solution Trade Deadline (00:19:52) Ask Spencer Anything: Can You Un-Cover GLP-1s?