Politics Medicare beneficiaries can't wait for lower drug prices
Biden plan omits major health care measures pushed by Democrats
President Biden's American Families Plan unveiled Wednesday leaves out two major health priorities pushed by congressional Democrats: reducing the cost of prescription drugs and lowering the eligibility age for Medicare.The major legislative package, which Biden will discuss in an address to Congress on Wednesday night, includes measures in areas like child care and paid leave, but largely steers clear of health care.It does include a measureThe major legislative package, which Biden will discuss in an address to Congress on Wednesday night, includes measures in areas like child care and paid leave, but largely steers clear of health care.
Medicare beneficiaries have been among the hardest-hit populations by the pandemic for the last 13 months - aboutwere among people 65 and older. But the pandemic is not the first or only crisis our nation's older adults have faced over the last several years. Seniors who depend on the Medicare Part D drug benefit are also the most likely to need life-saving prescriptions that they can't afford.
It has been 15 years since the Part D prescription drug benefit was created, and although the program is popular, it has not kept pace with the needs of patients with life-threatening, chronic and rare diseases. The Medicare Part D benefit requires thoughtful updates to ensure the more thanwho rely on the program can afford their prescribed medications.
Biden calls on Congress to pass drug pricing legislation this year
President Biden on Wednesday called for Congress to pass legislation this year that would lower prescription drug prices, seeking to accomplish a long-held Democratic goal."Let's do what we've always talked about for all the years I was down here in this body in Congress," Biden said in his first joint address to Congress. "Let's give Medicare the power to save hundreds of billions of dollars by negotiating lower drug prescription prices." "Let's get it done this year," he added.
Older adults can face substantial out-of-pocket health care costs in the form of insurance premiums, deductibles and coinsurance - including for physician visits, hospital stays and medical devices. They also pay out-of-pocket for non-covered but essential services such as vision, dental and hearing-related care. Piling on, out-of-pocket prescription medication spending can contribute significantly to seniors' total health care expenses. According to a study by the, the average annual out-of-pocket cost in 2019 for patients requiring a specialty medication was more than $8,000.
The sum of these health care costs can be insurmountable for those who have complex or chronic diseases - and especially for the one in two Medicare beneficiaries living on an annual income of.
Biden Says He Wants to Go Big On Health Care. But He Left Major Reforms Out of His Latest Plan
Biden Says He Wants to Go Big On Health Care. But He Left Major Reforms Out of His Latest Plan“Let’s give Medicare the power to save hundreds of billions of dollars by negotiating lower drug prescription prices. And, by the way, that won’t just help people on Medicare. It will lower prescription drug costs for everyone,” Biden said. “We’ve talked about it long enough. Democrats and Republicans, let’s get it done this year.
We regularly hear heartbreaking stories from people who decided to forgo treatment for a serious illness because they could not afford to pay and did not want to be a financial burden to their family. Research backs this up: Even afor a medication can cause many patients - especially those with lower or fixed incomes - to abandon their prescriptions. When a patient cannot stay on their medication because of the cost, it can lead to hospitalization, loss of independence and even .
With pandemic relief bills behind them, Congress has the opportunity to take action to lower out-of-pocket costs for prescription drugs to ensure seniors no longer face impossible decisions between their health and paying for basic living expenses. Any future drug pricing legislation must include the following Medicare reforms to increase patient access to treatment:
Schumer backs Sanders push on drug prices, lowering Medicare age
Senate Majority Leader Chuck Schumer (D-N.Y.) said in an interview published Friday that he supports measures to allow Medicare to negotiate drug prices, as well as lowering the Medicare eligibility age and creating a public health insurance option. The comments from Schumer give important backing to a push from progressives, who have been calling for a range of major health reforms from President Biden, including in his next major economic package, which he laid out for Congress during a joint address on Wednesday night. Schumer specifically pointed to conversations he has had with Sen. Bernie Sanders (I-Vt.). "Bernie Sanders and I agree on this," Schumer told The.
An annual cap on patient medication costs: Medicare beneficiaries are the only insured group in the U.S. without a limit, or cap, on what they owe out-of-pocket for their medications. This burden must be addressed. There isfor capping what Medicare beneficiaries spend out-of-pocket for their prescription medications. Previous legislation included different annual caps - and . Both would be a welcome reform to the Medicare Part D program, but to truly help beneficiaries, this cap should be as low as possible.
Smoothing patient medication costs throughout the benefit year: Medicare Part D prescription drug plans concentrate out-of-pocket medication costs at the beginning of the year when deductibles and benefits reset. This cycle can have a devastating impact on patients who face high cost-sharing associated with medications for diseases such as Parkinson's, cancer, diabetes and Alzheimer's disease. Instead, Part D plans should be required to offer their enrollees the option of paying out-of-pocket costs in installments throughout the remaining months of a plan year. Beneficiaries who can pay in smaller increments will stand a better chance of adhering to treatment and reducing downstream health care costs - including costly hospitalizations - due to non-adherence.
Health care: Hill Democrats aren't waiting for Biden on health care reforms
Congressional Democrats are not waiting around for President Joe Biden to propose big changes they want to see in the nation's health care system, including reducing drug prices and expanding Medicare. © Melina Mara/Pool/AFP/Getty Images US Vice President Kamala Harris (L) and Speaker of the House of Representatives Nancy Pelos (R) applaud as US President Joe Biden addresses a joint session of Congress at the US Capitol in Washington, DC, on April 28, 2021. Committee chairs in both chambers are working on aggressive steps to broaden benefits and government involvement in health care.
Moving forward, patients must be at the center of any drug pricing legislation. We must ensure lower medication costs for beneficiaries while not unintentionally harming access to care or research into future cures.
This past year has been unlike any other for our nation's seniors. They deserve a swift and collaborative legislative effort by policymakers that will help them afford treatments to protect, enhance and extend the quality of their lives.
Amy Niles is the executive vice president at the Patient Access Network Foundation. She previously served as chair, Medical Relations and Advocacy for the Together Rx Access program, and the president and CEO of the National Women's Health Resource Center, now known as Healthy Women.
Michael Ward is the vice president of Public Policy at the Alliance for Aging Research. He oversees the Alliance's public policy and advocacy efforts and has over a decade of experience advancing health care innovation through policy research, federal advocacy and partnership development.
Pelosi drug price plan threatened by centrist defections .
A group of Democratic moderates have raised concerns over a drug price negotiation bill, enough to potentially doom the effort.At least 10 caucus moderates are signaling opposition to Democrats’ drug pricing negotiation bill — more than enough to potentially force House Speaker Nancy Pelosi into dropping the reforms from infrastructure legislation Democrats hope to pass along party lines. Pelosi can only spare two Democratic defections on partisan legislation because of the party’s slim House majority.