The approach: Let the state contract with wholesalers in Canada, importing cheaper prescriptions from up north and distributing them to the states health care system.

According to documents circulating on Capitol Hill, the deal includes $6 billion in funding for treatment of mental health issues and opioid addiction and $2 billion in extra funding for the National Institutes of Health.

With federal officials seemingly unwilling or unable to come up with legislation to control skyrocketing drug prices, that task is increasingly moving to the states. But so is pharma muscle and money.

How do the United States and Canada neighbors with vastly different health systems compare in terms of actual results? Does one do a better job of keeping people healthy?

Even as Canadians throw shade at the American hodgepodge of public plans, private insurance, deductibles and copays, they hold in high esteem a little-known Affordable Care Act initiative: the federal Center for Medicare & Medicaid Innovation (CMMI).

Massachusetts state Medicaid program hopes to road-test an idea both radical and market-driven: it wants the power to negotiate discounts for the drugs it purchases and to exclude drugs with limited treatment value.

If enacted, the Drug Price Relief Act would prohibit state programs, such as Medicaid and state employee health plans, from paying more for a medication than does the federal Veterans Health Administration.

In states that use the federal marketplace, healthcare.gov, many navigators are hitting snags completing a mandatory certification course.