Congress mulls cap on how much Medicare enrollees pay for drugs

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Congress mulls cap on how much Medicare enrollees pay for drugs

President Donald Trump, Democrats trying to retire him in 2020, and congressional incumbents of both parties all say they want action.

"The issue has my attention," said Sen. Charles Grassley, R-Iowa, chairman of the Senate Finance Committee, which oversees Medicare. "Out-of-pocket costs are a concern of ours, particularly at the catastrophic level." His committee has summoned CEOs from seven pharmaceutical companies to a hearing Tuesday.

Before the hearing, the committee's chairman and top Republican released a joint statement unusual in polarized times: "We agree that the time is now to take meaningful action to lower the cost of prescription drugs in the U.S. health care system," said Reps. Richard Neal, D-Mass., and Kevin Brady, R-Texas.

Generally, the Medicare prescription benefit is financed with a mix of government subsidies and beneficiary premiums. But in the catastrophic portion, most of the bill is passed directly to taxpayers. That neutralizes the incentive for insurers to negotiate lower prices with drugmakers. Catastrophic is the fastest growing cost for Medicare's Part D.
 
I find it interesting that the same folks that gave us Part D now want to fix Part D.

Prior to 2006 PAP's were prevalent and most folks could qualify for assistance. When PDP plans became available it was more difficult to qualify for a PAP. Most folks are not eligible for a PAP if they have prescription drug coverage which includes Part D.

As is the case with most things covered by insurance, drug prices increased dramatically since 2006 at more than 2x the CPI.
https://www.aarp.org/content/dam/aa...d-name-prescription-drugs-year-end-update.pdf

http://www.ncsl.org/research/health/state-pharmaceutical-assistance-programs.aspx

I am from the government and I came to help you . . .
 
Prior to 2006 PAP's were prevalent and most folks could qualify for assistance. When PDP plans became available it was more difficult to qualify for a PAP. Most folks are not eligible for a PAP if they have prescription drug coverage which includes Part D.

I know someone (not a client) who gets assistance from a PAP for half the year for a serious heart drug. When I mentioned our State has a SPAP (PACE/PACENET), she replied that she was well aware of it and may qualify for PACENET, but doesn't want the "stigma" attached to it.

Tried explaining to her that it's funded by Lottery proceeds and not tax dollars, but she didn't want to hear it. And you can keep it private that you receive help, unless you tell people you're on it, how will anyone know? And some seniors just don't feel like making a phone call, or applying online, but have no issues griping about the costs.
 
Reduce drug prices or we’ll do it for you, senators tell Big Pharma execs, including Merck CEO

Sen. Ron Wyden, a Democrat from Oregon and the committee’s ranking member, doled out a list of honors no one would want to win: To Johnson & Johnson, he awarded “the record for flip-flopping” -- a reference to price hikes the company announced in January, days after J&J’s CEO said the industry needed to self-police on prices.

“Merck gets second prize for emptiest pricing gesture of 2018,” Wyden said (Pfizer got first in that category).
 
Wyden was "all in" for Obamacare.

No doubt he will fix Medicare Part D just like he did the broken health insurance system for folks under 65.
 
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