Many Republicans are reluctant to engage in major health policymaking before facing voters in the upcoming midterms, despite the high stakes of health care costs. While many believe it would be crazy to take a significant step towards reducing these costs, others argue it's smarter not to. This comes as the White House is preparing to sell its drug pricing deals with pharmaceutical companies as major victories for patients. The deals include commitments to manufacture drugs in the US., participate in the direct-to-consumer platform TrumpRx, offer drugs at "most favored nation" prices to state Medicaid programs and launch new drugs at prices comparable to other high-income countries. The administration has also been focusing on combating health care waste, fraud and abuse in federal health programs. However, addressing hospital and insurer business practices could be politically difficult due to their presence in nearly every congressional district.