The Senate Democrats have a $3.5 trillion budget package that would improve and expand Medicare. It assumes large savings from Medicare drug price negotiation that can be spent on these improvements. The plan is to pass legislation with a 51 vote majority through the budget reconciliation process.
Republicans have become completely unwilling to agree to important health care reforms, including reforms to reduce prescription drug prices. So, Democrats have no ability to pass bi-partisan legislation.
The budget package includes a plan to bring down drug prices and add dental, vision and hearing benefits to Medicare. There is no mention of an out-of-pocket cap in traditional Medicare, although that would help make Medicare benefits more affordable to everyone and level the playing field with Medicare Advantage–coverage offered through private insurers–which has an out-of-pocket cap. Advocates, including staff at Social Security Works, Public Citizen and Just Care, are socializing the need for this reform with Senate Finance staff and others with the hope that it gets incorporated into the final legislation.
The budget package also includes benefits that would cover home and community-based care for people who would prefer to age in place over going to a nursing home.
Success at lowering prescription drug prices is key, as it could bring as much as $500 billion in savings to cover the cost of additional Medicare benefits. But, some Democratic Senators are pushing back on legislation that would ensure prices in the US were at about the same level as prices in other wealthy nations. If so, prices would come down 75 percent for some brand-name drugs.
It is not yet clear whether these Dems will defer to Pharma or put the health and lives of their constituents first through significantly lower drug prices. New data show that thousands of people with Medicare die every year because they cannot afford drug copays and so stop taking life-saving medicines.
Meanwhile, the big pharmaceutical companies are targeting moderate Democrats with money to push back on drug price regulation. Rachel Cohrs reports for Stat that CEOs at Pfizer, Merck, Eli Lilly and Bristol Meyers Squibb just sent California Dem, Scott Peters, thousands in campaign contributions. Peters has rejected House Speaker Pelosi’s drug pricing legislation, H.R. 3, which would lower prices dramatically on 250 of the most commonly used brand-name prescription drugs.
Senator Ron Wyden, Chair, Senate Finance Committee, and the Finance Committee are working through ways to lower drug prices. They have set forth a series of principles, including ensuring that everyone benefits from lower drug prices, that are heartening. The question remains as to whether their proposed legislation ends up delivering lower drug costs. Currently, wealthier Americans can benefit from lower drug costs through importing drugs from abroad–albeit technically illegally. Everyone should benefit from those lower prices.
Dental, vision and hearing benefits are critical. However, if they are less than comprehensive, it is not clear how many people with Medicare will be able to access these benefits. Right now, the data show that people in Medicare Advantage with one or more of these benefits tend not to access them because out-of-pocket costs are so high that they create a financial barrier to care.
If these Medicare improvements make it through the reconciliation process, Democrats will need to work hard to ensure they last over time. As a general rule, benefits achieved through reconciliation are of limited duration.
Here’s more from Just Care:
How can we get elected officials to actually work for their constituents? Lower drug prices should be a no brainer but it just doesn’t happen. These politicians work for contributions, citizens united needs to go.