Meanwhile, late last week, Charrow and his office directed administrative officials to seek advice from the DOJ's Public Integrity Department, which deals with election crimes, before proceeding with the drug discount plan. That further stalled the plan as the health department awaits review by the DOJ, two officials said.
"Every day that goes by is one day less," said one of the officials in order to implement the plan before the election.
Charrow didn't respond to a request for comment, and an HHS spokesman said the department "does not comment on internal considerations". The DOJ did not immediately respond to a request for comment.
Trump announced the plan in a speech on Sept. 24, pledging the "incredible" cards would be mailed to seniors in the "coming weeks," and POLITICO explained last week how administrative officials like White House Chief of Staff Mark Meadows and Centers for Seema Verma, Administrator of Medicare and Medicaid Services, rushed to realize the president's vision. Meadows and Verma had hoped to get legal and budgetary officials' approval by October 9 to send letters to 39 million seniors this week extolling the administration's new initiative, according to five officials with knowledge of the plan and of the draft documents received from POLITICO. The cards themselves would have been made and distributed during the rest of the year, and many seniors would have received them after the election.
Meadows and Verma have justified the drug cards as an authorized "test" of whether drug discount cards would ultimately help Medicare beneficiaries take their drugs more consistently.
However, the proposal has stalled since the POLITICO report, as officials tried to distance themselves from the plan and seek redress such as review by the DOJ, those aware of the recent talks said.
"This plan is going radioactive quickly," one official said of the proposal.
For example, Verma told allies she had little warning of Trump's plan, according to two people who spoke to her. A Verma spokesperson failed to respond to a request for comment.
Meanwhile, Health and Human Services Secretary Alex Azar and his team have also privately distanced themselves from the proposal for weeks, suggesting the plan was driven by Medicare officials.
An Azar spokesman said the secretary supported the Trump-backed plan. "As the architect of President Trump's drug pricing blueprint and for political reasons, Secretary Azar has always endorsed ideas to reduce the cost of out-of-pocket drugs for American seniors – including the president's copay card proposal and the plan to ship discounts direct to Seniors at the pharmacy counter, "said the spokesman. The spokesman referred questions to Medicare officials about the timing of the plan.
The White House referred questions about the plan to the health department.
Congressional Democrats this week called on a watchdog, the Government Accountability Office, to begin an immediate review of the drug discount card plan.
Ever since Trump announced the cards last month, which came as a surprise to many of his own health officials, officials and political figures have warned time and again that the plan could violate federal rules on taxpayers' money spending or adequately framing a test of Medicare Program.
In order to qualify the plan as a Medicare test, Charrow has asked officials to consider whether the plan's introduction should be random. This would ensure seniors receive information at different times and make it easier to compare their responses, said two officials, aware of Charrow's concerns. Legal and health experts have warned that the proposal is not a real test because it lacks random elements.
However, Trump is keen to give the cards to most seniors covered by Medicare's drug plan, making it harder to compare the effects of getting a card to not getting a card.
Meanwhile, Verma's team has been closely monitoring a draft letter to seniors announcing the cards' launch, despite requests from other officials to review the contents and ensure there are no additional risks such as the inappropriate celebration of Trump's role, said two officials.
But those private concerns have conflicted with the president's public promises as Trump continues to announce the initiative to prop up his low approval rating among seniors.
"[M] or more than 35 million Medicare beneficiaries will soon receive a $ 200 card in the mail that you can use to pay for prescription drugs," Trump vowed again on Friday afternoon in Florida at the "Protecting America" event. s Seniors ".
Both Azar and Verma attended Trump's speech.