According to a report from The Hill, President Donald J. Trump has issued major proposals to lower drug prices in his budget proposal Monday, leading advocates for lowering drug costs to weigh in. The say its “a step in the right direction,” but that its “not nearly enough.”

From The Hill: The proposals in Trump’s budget include capping out-of-pocket drug costs for Medicare enrollees, allowing up to five states to join together to negotiate drug prices in Medicaid, limiting the growth rate of certain Medicare drug payments to inflation and requiring insurers to pass drug discounts on to consumers.

Notably, the proposals do not include more sweeping changes that Trump has supported in the past, such as Medicare negotiating drug prices or allowing the importation of drugs from abroad.

David Mitchell, founder of the advocacy group Patients for Affordable Drugs, said the proposals are “tinkering around the edges” of the issue but do not get at the “root cause, which is the drug companies charge too much money.”

Stephen Ubl, CEO of the Pharmaceutical Research and Manufacturers of America (PhRMA), the biggest trade group for the drug industry, issued a measured response to the proposal, praising some aspects like having insurers pass discounts on to patients.

But he said “we have concerns with other elements of the budget request which appear to limit access to innovative medicines and erode market-based systems in Medicare Part D and Part B.”

A Department of Health and Human Services (HHS) official on Monday left the door open to some of the proposals being acted on administratively, but emphasized the need for congressional action.

“HHS will continue to look for opportunities for administrative reforms in the drug pricing space,” the official said. “But congressional action is necessary to make many of the reforms outlined in the budget permanent over the long term.”

Many of the ideas in the budget change how the pie is divided up among drug companies, insurers and patients, rather than changing the overall size of the pie by reducing prices. The cap on Medicare costs for beneficiaries, for example, or having insurers pass on discounts to consumers would not lower the overall price of drugs.

Rachel Sachs, a professor at Washington University in St. Louis who does work on drug pricing issues, said the proposals would provide relief for some Medicare and Medicaid beneficiaries, but do almost nothing for the majority of Americans who get insurance through their jobs and face high drug costs.