People have spent a lifetime paying taxes in exchange for the promise of Medicare coverage once they reach 65. In return, seniors expect to receive the highest quality care and access to innovative, impactful treatments and therapies they need to maintain their health. The “most favored nation” drug pricing policy being considered by the Trump administration threatens to disrupt their Medicare coverage completely by importing foreign price-setting policies that could limit access to the medications millions depend on. Every Medicare beneficiary should be paying attention.The MFN policy would tie U.S. drug prices to those set in foreign countries, ignoring a fundamental difference between how the U.S. and other nations approach healthcare. The U.S. operates a market-based healthcare system that prioritizes patient choice and access, while many European countries rely on single-payer systems that prioritize cost containment over patient access, often resulting in delays for new medicines and fewer available treatment options.Those restrictions are not limited to new treatments. Many foreign healthcare systems use government-directed assessments to determine which medicines are worth covering and at what price. In some decisions, these decisions rely on metrics such as quality-adjusted life year, which attempts to measure the value of a treatment based on a patient’s expected quality and length of life. Critics have long warned that these metrics could disproportionately discriminate against seniors, placing a lesser value on their lives and sidelining their needs simply because of their age. By design, QALY could not only devastate seniors’ timely access to care but also deny it.