Executive Order 14087: Lowering Prescription Drug Costs for Americans
President: Joseph R. Biden Jr.
Directed HHS to consider Center for Medicare and Medicaid Innovation models that could lower prescription-drug costs, complementing the Inflation Reduction Act.
Status: Revoked.
Is Executive Order 14087 still in effect? No. Executive Order 14148 revoked Executive Order 14087 on January 20, 2025. That rescission did not repeal the Inflation Reduction Act or automatically end every independently authorized CMS demonstration.
What does Executive Order 14087 do?
Biden directed HHS to consider Medicare and Medicaid payment-and-delivery models that might reduce prescription-drug costs and improve access to innovative treatments. The order built on the Inflation Reduction Act but was a separate initiative using the Center for Medicare and Medicaid Innovation. Its operative section asked the secretary to select suitable models, report to the Domestic Policy Adviser and then take appropriate testing actions. Signed text.
Potential models could lower cost sharing for commonly used drugs or use value-based payments tied to high-quality care. Selection had to meet the statutory criteria for Innovation Center testing. The order did not immediately set a universal drug price, cap all private insurance copayments or negotiate the price of every medicine. Those effects depended on the model eventually developed and on the distinct statutory provisions Congress had enacted. Signed text.
The people potentially affected included Medicare and Medicaid beneficiaries, states, prescription-drug plans, providers and participating manufacturers. Different model designs addressed different problems: affordable access to common generic medicines, payment arrangements for expensive cell and gene therapies, and incentives for timely evidence about drugs granted accelerated approval. Testing a payment model was therefore distinct from adopting a nationwide coverage mandate. Signed text.
Before and after
Before the order
Congress had already enacted the IRA’s Medicare negotiation, rebate and beneficiary-cost protections, and CMMI already possessed demonstration authority. EO 14087 did not create that center or make the statutory drug provisions possible. The concrete addition was a presidential instruction to use existing model-testing powers to find complementary cost and access improvements, with a 90-day reporting schedule. Signed text.
After the order
On February 14, 2023, HHS released a response selecting the Medicare $2 Drug List, Cell and Gene Therapy Access and Accelerating Clinical Evidence models. Development did not mean all three immediately entered operation. EO 14148 revoked the presidential instruction on January 20, 2025. CMS’s current CGT materials report a rolling start and the first state’s participation on March 1, 2025, demonstrating that an independently authorized model can continue after its initiating executive policy is rescinded. Official follow-up record 1. Official follow-up record 2. Official follow-up record 3.
Who had to do what
| Agency / office | Action | Timing / position |
|---|---|---|
| HHS Secretary | Consider and select suitable new prescription-drug payment/delivery models, report the models and testing timeline, and take appropriate testing actions after reporting. | Report within 90 days of signing; testing after submission. |
| CMS Center for Medicare and Medicaid Innovation | Test selected payment and delivery models through its existing statutory model authority as directed by the secretary. | Model-specific development and test schedules, rather than a single order-wide launch date. |
| Assistant to the President for Domestic Policy | Receive HHS’s report describing selected models and their testing plans. | Within the 90-day reporting period. |
What happened next
Biden signed EO 14087. Official source
HHS released its response identifying three selected model concepts. Official source
EO 14148 revoked the order. Official source
The first state began participating in the independently authorized CGT Access Model. Official source
Legal and source detail
How it works legally
Section 1115A of the Social Security Act, 42 USC 1315a, supplies CMMI authority, and the order expressly required consistency with its model-selection criteria. That authority concerns testing and evaluating payment/delivery approaches, with separate statutory limits on expansion and spending. The order’s description of IRA benefits did not amend the enacted law or substitute for its implementation rules. Appropriations and applicable Medicare/Medicaid requirements constrained the models. The executive instruction created no enforceable right to a $2 prescription or automatic eligibility for a gene therapy; actual coverage and participation depended on program rules. Signed text.
Sources by type
If a source is unavailable, first check the cited publisher or another official repository. The cited publisher remains the authority.
Primary and official sources
Orders, laws, court records and official implementation material.
How we checked this
Last checked against the sources above on September 9, 2026. How we research →