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Protecting Senior’s Medicare Benefits

Millions of seniors depend on their Medicare coverage for affordable access to prescription medicines. Yet, policymakers are considering a number of changes to the Medicare programs that would impact seniors’ access to care. While some changes would lower their out-of-pocket costs, others would restrict access to medicines. Any changes to seniors’ Medicare coverage should be for beneficiaries’ benefit – not to their detriment.  

 

Unfortunately, some proposals would put seniors’ Medicare benefits in jeopardy. These changes aim to constrain costs for the government but come at the expense of seniors’ access to the medicines and care they need. 

 

For example, the International Pricing Index (IPI) model is a concerning proposal from the Department of Health and Human Services that would set U.S. prices for Part B medicines based on the prices set by foreign governments. Research shows that every time other countries have set prices for medicines – as this proposal would – it has resulted in restrictions in access. For instance, while 96% of newly approved cancer medicines are available in the United States, on average, just half of new cancer medicines launched since 2011 are available in the 14 countries that Medicare prices would be based on under the proposal. This lack of options is not the kind of care we want for America’s seniors.
 

Other problematic proposals include imposing government arbitration on Medicare drug coverage to set the price of a medicine. Arbitration is the wrong way to change Medicare – it would be risky and could jeopardize care for seniors and people with disabilities. Rather than focusing on lowering out-of-pocket costs for beneficiaries, thereby improving their care, it would put the government between patients and their physicians in making treatment decisions.  Lastly, it could contribute to investments in innovation shifting away from serious diseases like Alzheimer’s and cancer that have a greater impact on Medicare patients. 

 

Instead of considering proposals that put patients in harm’s way, we must support proposals focused on improving seniors’ access and affordability to lifesaving medicines through Medicare. One way to do this is to ensure that the saving Medicare Part D plans currently negotiate with biopharmaceutical companies are passed through to beneficiaries at the pharmacy counter. Seniors share the cost with insurance companies, middlemen and the government, so they should also share the savings.

 

Policymakers should implement Medicare changes that benefit seniors, ensuring access to innovative treatments and improving affordability and predictability. To learn more about potential changes to Medicare and their impact on senior health care visit PrescriptionForMedicare.org.