Three weeks after President Trump announced the government would send tens of millions of older Americans $200 to help pay for medicine, the election-season idea is mired in uncertainty over whether such drug discount cards are legal, proper or will ever exist.

Since the last-minute inclusion of the cards in a presidential speech, Trump’s aides and Medicare officials have been hastily drafting and revising a proposal to build scaffolding under the president’s promise. This account of those efforts draws on interviews and information from five individuals familiar with the work, all of whom spoke on the condition of anonymity to disclose internal matters.

Health and Human Services Secretary Alex Azar and Seema Verma, administrator of the Centers for Medicare and Medicaid Services, are distancing themselves from the idea, each emphasizing that they were not consulted by the White House before the president’s announcement, said three officials familiar with their thinking. Still, Verma has been involved in the plan’s development, officials said.

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