All 50 states, Washington, D.C., and Puerto Rico have applied to join a program meant to give Medicaid programs lower drug prices, President Trump announced Friday - a fact he celebrated with the subtlety of a man who has just remembered there's an election in November.

"This one thing alone should win us the midterms," Trump told reporters in the Oval Office, because nothing says "healthcare policy" like a campaign slogan.

Forty states and Puerto Rico have already signed agreements, according to a separate statement from the Centers for Medicare and Medicaid Services (CMS), which helpfully noted that merely applying does not obligate states to actually participate - a bit like RSVPing to a wedding you have no intention of attending.

The administration's "generous" model lets participating states buy drugs at prices aligned with those paid in other countries. The theory, per CMS, is that state Medicaid programs will benefit from "fairer, more competitive pricing" - a phrase that has never before been uttered in the same sentence as "American healthcare."

The announcement lands as affordability dominates voters' concerns ahead of the November midterms. To address this, Trump has cut deals with pharmaceutical companies tying some U.S. drug costs to what those companies charge other wealthy countries. Critics, meanwhile, argue the administration is papering over the issue with no real plan to tackle rising health costs - particularly those stemming from Republicans letting ObamaCare's enhanced premium subsidies expire.

The White House said participating drugmakers will provide state Medicaid programs with rebates on selected brand-name drugs, ensuring the final Medicaid price doesn't exceed what other developed countries pay. More than two dozen drug companies have agreed to join - in exchange for tariff relief and exemptions from a similar pricing plan for Medicare, which is a bit like being rewarded for showing up to your own intervention.

"Medicaid programs will get the best possible price for drugs, delivering better value for taxpayers and freeing up funds to give vulnerable Americans the high-quality care they deserve," said CMS Administrator Mehmet Oz, presumably with a straight face.

The model covers hundreds of individual drugs across virtually all major classes, including oncology, diabetes care and asthma. The White House Council of Economic Advisers estimates the "most-favored nation" (MFN) deals will produce $36.6 billion in federal savings and $27.6 billion for states.

But Medicaid drugs already receive steep discounts, and many details of the agreements remain secret - so the true impact on costs and accessibility is about as clear as a fogged-up bathroom mirror. Critics say there's little evidence drugmakers are meaningfully lowering prices at all.

"Big Pharma expects little to no financial impact from these short-term Medicaid deals. Instead, pharma companies and Trump appear to have worked together to offer minor concessions to avoid taking more meaningful action to lower prices," said Peter Maybarduk, access to medicines director for Public Citizen, calling the agreements a "charade" - which is at least more honest than calling them a breakthrough.