Drug prices are too high, and Congress lacks the political will to do anything about it. These are two of the most uncontroversial assertions in the contentious debate about U.S. health care policy — and they explain why states should be allowed to act on their own. 

The high price of medicine is a familiar lament from presidents and pharmaceutical executives alike, and there is no shortage of viable suggestions for making them cheaper: The federal government should negotiate Medicare's drug prices and end tax breaks for direct-to-consumer drug advertising. It should restrict the coupons that drug companies give out to coax patients to choose expensive brand-name drugs. It should limit Medicare patients' out-of-pocket drug costs, police pay-for-delay deals that keep generic medicines off the market, and require that all drug prices be made public. 

Yet Congress has failed to take up these proposals, and the prospects are dim for legislation anytime soon. So two states, Massachusetts and Arizona, have asked the federal government for permission to pick and choose which drugs they will cover for Medicaid beneficiaries. The idea is to save money by providing reimbursement for only the most cost-effective drugs.