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Would the Trump administration’s plan to address insulin costs for people with Medicare help?

Written by Diane Archer

President Trump is touting a plan that he says would bring insulin costs down to $35 a month for older adults and people with disabilities. But, Stat News reports that the Trump administration’s plan may not deliver as much it suggests. And, given the new coronavirus pandemic, who knows what will become of this plan. Here’s the gist of it.

First, older adults spend a lot more on other drugs than they do on insulin. They face particularly high drug costs when they have cancer or an autoimmune disease or hepatitis C. Insulin is not a drug that is as costly for them as many other drugs. And, the Trump administration is doing nothing to address the cost of those drugs.

Second, it is a pilot for people in enhanced drug plans. To benefit from the low copays, their prescription drug insurers have to be willing to participate. About one in three (62 percent) older adults are not in enhanced plans, which tend to have high monthly premiums but low or no deductibles.

Older adults with low incomes who qualify for Extra Help, a government program that helps cover prescription drug premiums and out-of-pocket costs, only pay $8.95 or less when they fill a prescription.

To be sure, some portion of older adults do report rationing insulin to keep their costs down. The question is whether setting their costs at $420 a year, $35 a month, will help them. Is it less than what they currently pay? It’s hard to know. It should save them some money. The Trump administration says it will save them about $446 a year, but how it came up with that number is unclear.

The biggest problem with the Trump administration’s plan is that it does nothing to bring down the price of insulin and make it affordable. Having the government negotiate prices for all drugs is what’s needed. We should not be paying more for our drugs than the Germans or the Japanese. For that, Congress would need to pass Medicare for All legislation. Right now, the House has passed Speaker Nancy Pelosi’s drug pricing proposal, which is a good start, bringing down the price of scores of drugs, but the Republican-led Senate is not likely to consider it.

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