FY2026-2035 · CBO February 2026 baseline

Expand Drug Negotiation

Negotiate 50 Medicare drugs (vs IRA's 20), remove exclusivity delays. Saves ~$500B. **Illustrative**: an unfitted reconstruction a long way from its published figure, shown for the shape of the policy rather than as an estimate of it.

Ten-year deficit effect, conventional-$41.8Breduces the deficit
With macroeconomic feedback and debt service-$47.0BFRB/US-Lite (Federal Reserve calibrated)
Checked against

Published score -$500.0B; this estimate is 93.3% away (unfitted reconstruction). Unfitted reconstruction, 93.3% from -$500B (CBO (IRA baseline) extended by model estima…) — no constant is fitted to this figure. The target itself is this model's own estimate, not a published score.

No out-of-sample band: no pre-registered row scores a drug-pricing reform. The 44 pre-registered Tier 1 rows are the only tier that measures this model's accuracy, and none of them scores a policy of this kind.

Year by year

billions, conventional
Fiscal yearRevenueDeficit, conventionalMacro feedbackDebt serviceDeficit, dynamic
2026$0.0B-$4.2B-$0.7B-$0.2B-$3.6B
2027$0.0B-$4.2B-$0.8B-$0.3B-$3.7B
2028$0.0B-$4.2B-$0.7B-$0.5B-$4.0B
2029$0.0B-$4.2B-$0.6B-$0.7B-$4.3B
2030$0.0B-$4.2B-$0.4B-$0.8B-$4.6B
2031$0.0B-$4.2B-$0.3B-$1.0B-$4.9B
2032$0.0B-$4.2B-$0.2B-$1.2B-$5.2B
2033$0.0B-$4.2B-$0.1B-$1.3B-$5.4B
2034$0.0B-$4.2B-$0.1B-$1.5B-$5.6B
2035$0.0B-$4.2B-$0.1B-$1.7B-$5.8B

Download CSV

Who pays

first year, by income group

This is a spending or sector policy, so there is no tax table by income group.

Economic effects

difference from the CBO baseline
GDP, summed over the window-0.06percent-years
Jobs at the largest effect-8K
Deficit effect of the GDP change+$4.0Bless tax collected
Deficit effect of interest on the debt-$9.2Bless debt, less interest
Fiscal yearGDP levelJobsUnemployment10-year rateGDP change, deficitInterest, deficit
2026-0.010%-7K+0.01 pt-0.00 pt+$0.7B-$0.2B
2027-0.012%-8K+0.01 pt-0.00 pt+$0.8B-$0.3B
2028-0.010%-7K+0.01 pt-0.00 pt+$0.7B-$0.5B
2029-0.008%-5K+0.00 pt-0.00 pt+$0.6B-$0.7B
2030-0.006%-4K+0.00 pt-0.00 pt+$0.4B-$0.8B
2031-0.004%-3K+0.00 pt-0.00 pt+$0.3B-$1.0B
2032-0.003%-2K+0.00 pt-0.00 pt+$0.2B-$1.2B
2033-0.002%-1K+0.00 pt-0.00 pt+$0.1B-$1.3B
2034-0.001%-1K+0.00 pt-0.00 pt+$0.1B-$1.5B
2035-0.001%-1K+0.00 pt-0.00 pt+$0.1B-$1.7B

FRB/US-Lite (Federal Reserve calibrated). Demand effects fade over five to seven years as monetary policy responds; there is no supply-side channel. The dynamic score is the conventional score, plus the deficit effects of the GDP change and of interest on the debt: -$41.8B + $4.0B - $9.2B = -$47.0B.

Other scoring models

exploratory
ModelTen-year deficit effectMethod
CBO-Style-$41.8BStatic + ETI behavioral response + optional FRB/US dynamic feedback
TPC-Microsim PilotCannot score thisExpand Drug Negotiation (DrugPricingPolicy) does not map onto current microsim pilot reforms (income-tax rates, CTC, EITC, SALT, std deduction, AMT exemption).

No pilot model returned distributional output; the comparison is aggregate-only.

CBO-Style is the model behind the headline above. The TPC-style microsimulation is a pilot: where the two disagree, the gap tells you how much the answer depends on method. It is not an official range.

Limitations

Cite asWilse-Samson, Laurence. “Expand Drug Negotiation.” Fiscal Policy Calculator, CBO February 2026 baseline, FY2026-2035. https://fiscal.lwilsesamson.com/explore/drug-negotiation-expand