WASHINGTON – Many health care organizations applaud the Senate passage of the Reducing Inflation Act, which would limit out-of-pocket insulin costs and allow Medicare to negotiate drug prices, but those Those with business connections were not too happy.
“David may beat Goliath,” Frederick Isasi, JD, MPH, executive director of Families USA, a U.S. health care consumer group, said in a statement after the Senate passed inflation. In a marathon polling meeting over the weekend, the party line voted 51-50 — with Vice President Harris breaking a 50-50 tie — for the reduction bill, the statement said. “Stopping Big Pharma’s price gouging and lowering the cost of prescription drugs is a huge victory for families across the country. Senators passed a strong and popular bill that would address pricing abuse in the pharma industry and make it easier for working families Need it.”
This $430 billion measure would provide $64 billion to provide an additional 3 years of premium subsidy for low-income Americans with Affordable Care Act (ACA) health insurance exchange. It also includes some provisions that affect Medicare beneficiaries:
- Limits out-of-pocket drug costs for Medicare beneficiaries to $2,000 per year
- Expanding Premium and Co-payment Assistance for Low-Income Seniors in Medicare Part D Drug Plans
- to allow Medicare to negotiate the price of certain prescription drugs starting in 2026
- to make all vaccines free for Medicare beneficiaries
Senate Democrats also added a provision into the bill that would cap the cost of insulin for Medicare beneficiaries to $35 a month. They included a similar provision for private insurance enrollees in the bill, but it was rejected by Senate lawmakers and further blocked by Senate Republicans. The bill will be considered by the House of Representatives on Friday, where it is expected to pass before heading to President Biden’s desk for signature.
The American College of Physicians (ACP) applauds the bill’s climate change-related provisions, including tax credits for clean sources of electricity and plans to reduce methane emissions from natural gas production. “This legislation will help reduce carbon pollution and advance clean energy solutions,” ACP President Ryan Mire, MD, said in a statement. “We are also encouraged that legislation will limit the cost of insulin for Medicare beneficiaries, making this life-saving drug more affordable for our elderly patients.”
Medicare Drug Prices The rules take effect gradually, Larry Levitt of the Kaiser Family Foundation noted in a tweet. They will be required to pay a rebate starting in 2023 if the drugmaker’s prices rise faster than inflation, and by 2024 it will cancel what Medicare beneficiaries currently have in the “catastrophic” phase of their Part D plan. Owned 5% copay. The $2,000 out-of-pocket cap kicks in in 2025, followed by price negotiations in 2026, starting with 10 drugs and then gradually increasing to 20 drugs. Levitt added that some of the things on the Democrats’ “wish list” failed to make it into the bill, including a permanent extension of CHIP, Medicare hearings and dental benefits, as well as paid family and sick leave.
The Endocrine Society is concerned with the regulation of insulin. “We are pleased that the Reducing Inflation Act includes provisions to lower insulin prices, as well as capping the cost of out-of-pocket insulin for the Medicare population,” the association said in a statement. “Unfortunately, the Senate missed one Important opportunity to help children and adults with type 1 diabetes. 43 Republicans voted against the inclusion of a provision that would limit out-of-pocket costs for socially supported privately insured individuals.”
Senator. Ron Wyden (D-Ore.) expressed a similar sentiment. “Republicans have just come out in support of expensive insulin,” Wyden said in an email to reporters. “After years of hard-line discussions with insulin makers, Republicans once opposed malaise in the face of the heat from Big Pharma. “
Not everyone was happy with what passed. “The Senate has passed short-sighted legislation that will adversely affect health care costs for all Americans — whether it’s Medicare or those with private or employer-sponsored coverage,” said the Affordable Health Insurance Council, a panel led by drugmakers and other groups backed by business interests that support free market solutions, said in a statement. “The Act stifles competition and innovation, leading to higher costs and a decline in new life-saving drugs, while doing little to reduce inflation.”
Pharmaceutical Research and Manufacturers of America (PhRMA) Calling the measure a “tragic loss” for patients. “This drug pricing scheme is based on a litany of false promises,” Stephen Ubl, president and CEO of PhRMA, said in a statement. “They say they’re fighting inflation, but the Biden administration’s own data shows that prescription drugs aren’t fueling inflation.”
“They say it’s ‘negotiations,’ but the bill gives out of the government’s unfettered ability to set drug prices,” Ubl continued. “They say the bill won’t hurt innovation, but many experts, biotech investors and patient advocates agree that the bill will lead to new treatments and treatments for patients battling cancer, Alzheimer’s and other diseases Ways to reduce.”
The Employers’ Affordable Drug Prescribing Coalition, an employers’ group focused on drug costs, said in a statement that it is only set for Medicare, not private insurance The cap “will actually raise prices for those with commercial insurance above the unsustainably high prices they already pay, Because the cost is shifted from Medicare to the employer plan.” The group in Health Affairs and The article was cited in the JAMA Health Forum
as evidence of its position.
The group urges Congress to “re-evaluate these provisions and refrain from measures that do not protect working families. Medicare does not have commensurate protections for the business market, and working families may foot the bill because the cost will be Rise to make up for lost Medicare drug sales.”
Joyce Frieden oversees MedPage Today’s Washington coverage, including coverage of Congress, the White House, the Supreme Court, healthcare industry associations and reports from federal agencies. She has 35 years of experience in healthcare policy. Follow