How Medicare prescription drug coverage would change under U.S. Senate Democrats’ bill
A major spending bill from U.S. Senate Democrats would allow Medicare for the first time in its history to begin negotiating the prices of certain high-priced prescription drugs — a proposal that’s been around for years but has never come so close to the finish line.
Under the legislation, Medicare would start negotiating the prices of some drugs in Part D, the program’s prescription drug plan, beginning four years from now.
What’s more, seniors’ out-of-pocket drug costs would be capped at $2,000 a year, beginning in 2025, which would help with paying for expensive drugs like those used to treat cancer. And beneficiaries would get all their covered vaccines for free, including those for shingles.
“We will finally empower Medicare to negotiate the price of prescription drug costs,” Senate Majority Leader Chuck Schumer, a New York Democrat, said on Saturday. “After years of trying, we will finally cap out-of-pocket expenses and make vaccines free for our seniors. After years of trying.”
One disappointment for Democrats, though, came on Saturday when the chamber’s parliamentarian ruled against a section of the measure aimed at drug inflation — it would have forced drugmakers to pay rebates if the prices of prescription drugs in private insurance plans rose faster than inflation.
The inflation curb still would apply to drugs in Medicare, and that’s significant. A Kaiser Family Foundation study said that price increases ran ahead of inflation for half of all Medicare-covered drugs in 2020.
The Medicare prescription drug reforms are included in a piece of budget legislation known as reconciliation, whose main attractive feature for Democrats is that the final product can’t be filibustered by Republicans under U.S. Senate rules.
Initially, the prescription drug provisions overall were scored by the non-partisan Congressional Budget Office as reducing the deficit by $288 billion over 10 years, though a new score reflecting last-minute changes to the bill was expected.
The Senate voted on a series of amendments to the bill in what is called vote-a-rama overnight Saturday into Sunday, with a final vote appearing possible Sunday. Schumer has said he believes the legislation will be backed by all 50 Democrats, following a deal on taxes struck with Arizona Sen. Kyrsten Sinema, and it is scheduled to be taken up by the House on Friday.
Medicare is the federal health insurance program for Americans 65 and older, as well as some younger people with disabilities. About 64 million people were enrolled in Medicare as of the most recent coverage year, and close to 49 million in a prescription drug plan of some kind.
While pharmaceutical companies have argued against Medicare price negotiation, saying it would harm research and development of new drugs and innovation, polling has found strong public support.
The non-partisan Kaiser Family Foundation conducts regular tracking polls on health issues and found in October that 83 percent of those surveyed backed negotiation, even after they were told about the arguments on both sides.
The same poll found that 27 percent of those over 65 taking four or more medications said they had problems affording their medications.
This report was first published by the Arizona Mirror.