Tag Archives: drug costs

Biden Administration, Health Care, News & Photo Features

FACT SHEET: Dozens of Pharma Companies Raised Prices Faster than Inflation, Triggering Medicare Rebates, While Republicans Work to Insure Giveaways to Big Pharma, Higher Costs for Seniors, Families

December 18, 2023 krubin

President Biden’s Inflation Reduction Act cracks down on Big Pharma price gouging, saving some seniors thousands of dollars per dose of medication. Meanwhile, Congressional Republicans push for giveaways to drug industry

President Biden visited the National Institutes of Health Clinical Center in Washington, D.C. to announce that dozens of pharmaceutical companies will be required to pay rebates to Medicare for outrageous price hikes on prescription drugs that over 750,000 seniors take per year. For the last quarter of 2023, 48 Medicare Part B drugs raised their prices faster than inflation, and some drug companies raised prices of certain medications faster than inflation for every quarter over the last year. President Biden’s Inflation Reduction Act cracks down on this exorbitant price gouging, requiring these companies to pay rebates back to Medicare, saving seniors who take these drugs between $1 and $2,786 per dose on their medication.

President Biden vowed to lower prescription drug costs for seniors and families – and he is delivering on that promise. His Inflation Reduction Act finally allows Medicare to directly negotiate lower prescription drug prices, capped the cost of insulin for Medicare beneficiaries at $35, made recommended adult vaccines free, requires drug companies to pay rebates if they raise prices faster than the rate of inflation, and locked in savings of $800 per year on health insurance for nearly 15 million Americans. While Republicans in Congress fight tooth and nail to repeal the Inflation Reduction Act and put money back in the pockets of Big Pharma, President Biden won’t back down from the fight to lower costs for hardworking Americans and make sure every family has access to affordable health care.

The Biden-Harris Administration announced:

The Department of Health and Human Services (HHS) announced a new list of 48 Medicare Part B drugs that raised their prices faster than inflation, and may be subject to inflation rebates in the first quarter of 2024 as a result of the Inflation Reduction Act. President Biden’s prescription drug law cracks down on price gouging from Big Pharma, requiring companies to pay back Medicare if they raise prices on seniors at a higher rate than inflation. Starting in January, some Medicare beneficiaries who take these 48 prescription drugs – including drugs used to treat cancer and fight infections – will have lower coinsurance than what they would have paid otherwise, and their out-of-pocket costs may decrease by $1 to as much as $2,786 per average dose.

Over the last four quarters, 64 drugs in total had prices that increased faster than inflation and may be subject to inflation rebates because of the Inflation Reduction Act. Some drugs, such as Signifor, used to treat an endocrine disorder, raised prices faster than inflation every quarter since the Inflation Reduction Act’s inflation rebate provision went into effect. Some Medicare beneficiaries who take Signifor could save $311 per monthly dose starting January because of the law.

The Administration is focused on making sure medications developed with taxpayer funds are available to Americans at reasonable prices. On average, Americans pay 2 to 3 times more than consumers in other developed countries for prescription drugs. Last week, the Administration announced a proposal to put drug companies on notice if products developed using federal funds are not made available to the public on reasonable terms, including based on price. The proposal would promote the federal government’s ability to license a patent — such as those used to create life-saving drugs — to a competitor with the goal of increasing competition and bringing costs down for families.

Building off last week’s announcement, today HHS announced that the Administration for Strategic Preparedness and Response (ASPR) is making fair pricing a standard part of contract negotiations for medical products developed or purchased as part of its commitment to obtain best value for the US taxpayer. In September 2023, ASPR finalized a Project NextGen contract agreement for a potentially life-saving COVID-19 treatment being developed by Regeneron stating if the product is commercialized, its list price in the United States will be equal to or less than its retail price in comparable global markets. Since then, ASPR has also included similar language in recent agreements with CastleVax, Codagenix and Gritstone Bio, developers of the first three vaccines selected for development within Project NextGen. These clauses will be in effect if and when a company’s candidate vaccine is selected to move into ASPR-supported Phase 2b trials to evaluate clinical safety and efficacy.These actions are the result of a successful and collaborative approach by ASPR and its industry partners and show HHS’s commitment to keep Americans from paying unfair prices for the care they need.

HHS is releasing new data on the ten drugs selected for Medicare Drug Price Negotiation. For Medicare enrollees who take these drugs, their out-of-pocket spending on the 10 drugs selected for negotiation represents, on average, over half of their total Part D out-of-pocket spending. The report shows that total Medicare spending on the 10 drugs more than doubled from 2018 to 2022 – a rate that was 3 times faster than all Part D drugs over the same period. The report also shows that 7 of the 10 drugs selected received direct at least one form of federal support towards their drug development or utilized a federal-funded invention for their development.

After decades and hundreds of billions of dollars spent by Big Pharma to block Medicare from directly negotiating lower prescription drug prices for people with Medicare, President Biden’s Inflation Reduction Act finally got it done. In total in 2022, Medicare Part D beneficiaries paid $3.4 billion in out of pocket costs for the 10 drugs selected for negotiation, and some paid over $6,000 per year for just one of the drugs on the list. Negotiated prices will go into effect for seniors in 2026.
Today’s announcements build off the actions the Administration has already taken to lower prescription drug costs for millions of seniors and families because of President Biden’s Inflation Reduction Act. In 2023 alone:

The Inflation Reduction Act saved nearly 15 million Americans an average of $800 in 2023 because of health insurance savings the law locked in.
- The Inflation Reduction Act capped the cost of insulin at $35 per covered insulin product for Medicare beneficiaries, saving an estimated 1.5 million seniors on Medicare $500 on average in 2023 on insulin costs.
- The Inflation Reduction Act made recommended vaccines – like the shingles vaccine – free for the 50.5 million seniors with Medicare Part D, and made recommended, approved adult vaccines free for all adults in the Children’s Health Insurance Program, and nearly all full-benefit adults enrolled in traditional Medicaid. Seniors on Medicare who received a Part D vaccine saved an average of $70 on vaccines in 2023.
- The Inflation Reduction Act saved many seniors on Medicare as much as $618 per average dose on 47 prescription drugs in 2023 because of the law’s provision requiring drug companies to pay rebates on certain drugs if they raise prices for those drugs faster than the rate of inflation. Starting in 2024, some seniors who take 48 prescription drugs could see savings of as much as $2,786 per average dose because those 48 drugs raised their prices faster than inflation in the last quarter of 2023.

In the coming months and years, the Inflation Reduction Act will continue to deliver cost-savings to millions of Americans, including:

In 2024, Part D enrollees will no longer pay 5% co-insurance when they reach the catastrophic phase of their benefit – meaning that some beneficiaries’ prescription drug costs will be capped at about $3,500 next year.
- When the $2,000 out-of-pocket cap on prescription drugs applies in 2025, nearly 19 million seniors and other beneficiaries are projected to save $400 per year on prescription drugs. 1.9 million enrollees with the highest drug costs will save an average of $2,500 per year because of this provision of the Inflation Reduction Act.

Millions of seniors could save money when negotiated prices of the first group of drugs selected for the Inflation Reduction Act’s Medicare Price Negotiation program are scheduled to go into effect in 2026. In 2022, seniors spent $3.4 billion in out-of-pocket costs on the first ten drugs selected for negotiation – used to treat common conditions like diabetes, Crohn’s disease, arthritis, blood clots and more. A report released last week shows that had the Medicare price negotiation program been in effect in 2021, Part D out of pocket costs would have declined 23% for people taking the ten costliest drugs at the time.

The Congressional Republican Agenda on Prescription Drugs: Giveaways to Big Pharma and Higher Costs for Seniors and Families

While President Biden has taken historic action to reduce prescription drug costs for seniors and for working-age people who get health insurance through their jobs, Congressional Republicans are actively fighting to roll back the reforms the President signed into law and to keep Big Pharma’s taxes low.

Congressional Republicans’ agenda for Big Pharma giveaways includes:

Repealing prescription drug inflation rebates. The Inflation Reduction Act (IRA) cuts costs for Medicare and seniors by requiring pharmaceutical companies to pay a rebate to Medicare if they increase prices faster than inflation. Dozens of Republicans have signed onto legislation that would revoke the rebate requirement.

By 2031, repealing this provision would:

Cost seniors $5 billion per year.

Increase federal deficits by $7 billion per year.
Give away over $10 billion per year to pharmaceutical companies.

Taking away Medicare’s ability to negotiate prescription drug prices. The IRA finally gave Medicare the authority to directly negotiate with drug companies on the high prices they charge for prescription drugs. Republican Chairs and Ranking Members of the committees with jurisdiction over Medicare have publicly committed to repealing this authority, which would allow Big Pharma to go back to charging seniors exorbitant prices for life-saving drugs.

By 2031, repealing this provision would:

Cost seniors $7 billion per year.
Increase federal deficits by $14 billion per year.
Give away over $20 billion to pharmaceutical companies per year.

Opposing caps on insulin prices. Monthly insulin costs for Medicare beneficiaries are now capped at $35—providing certainty and critical cost savings for seniors who in some cases were paying as much as $400 for a month’s supply of insulin. The Republican Study Committee budget, as well as the House Budget Committee-passed budget plan, propose to repeal this and other IRA drug price reforms.

Repealing this provision would mean the 1.5 million Medicare beneficiaries who use insulin could see their annual costs rise by an average of $500.

Protecting Big Pharma’s ability to avoid paying taxes. President Biden negotiated a historic agreement with over 130 countries that would enable the U.S. and its partners to ensure Big Pharma and other multinationals pay at least a minimum tax rate and has proposed that the U.S. implement that agreement with a 21% minimum tax rate on multinationals. Congressional Republicans are not only blocking the U.S. from implementing the global minimum tax agreement and vowing to never raise taxes on Big Pharma and other multinationals by implementing it, they also traveled to Europe this summer to try to persuade other countries to withdraw from the global agreement and keep taxes low for Big Pharma and other multinationals.

Blocking implementation of the President’s international tax reform proposals means:

Protecting a system in which Big Pharma can lower its taxes to under 12% by shifting profits offshore.

The U.S. would lose out on hundreds of billions in savings from adopting the President’s proposals to implement the international agreement. Based on a PhRMA-funded analysis, nearly $100 billion of the savings – or almost one-fifth of the total revenue – from implementing the President’s 21% minimum tax proposal would come from cracking down on pharmaceutical industry tax avoidance

Biden Administration, Health Care

FACT SHEET: Biden-Harris Administration Announces New Actions to Lower Health Care and Prescription Drug Costs by Promoting Competition

December 12, 2023 krubin

While the dictator wannabe Donald Trump promises to tear up the Constitution, weaponize the judiciary, persecute political opponents, imprison the media and repeal the Affordable Care Act (Obamacare) – and monopolizing headlines doing it as he propagandizes over his 91 indictments – President Biden is working feverishly and accomplishing landmark programs to improve lives of Americans. Here is a fact sheet on the Biden-Harris Administration’s new actions to lower healthcare and prescription drug costs by promoting competition. – Karen Rubin/news-photos-features.com

*Among the actions the Biden-Harris Administration is taking to lower healthcare and drug costs, are new regulations improving transparency of hospital charges © Karen Rubin/news-photos-features.com*

President Biden believes that health care should be a right, not a privilege. For too long, corporate special interests and trickle-down economics have allowed Big Pharma to make record profits, while millions of Americans struggle to afford health care and prescription drugs to treat common and chronic conditions. As part of the President’s Bidenomics agenda, the Biden-Harris Administration is cracking down on price gouging and taking on special interests to lower costs for consumers and ensure every American has access to high-quality, affordable health care.

The Biden-Harris Administration is announcing new actions to promote competition in health care and support lowering prescription drug costs for American families, including the release of a proposed framework for agencies on the exercise of march-in rights on taxpayer-funded drugs and other inventions, which specifies that price can be a factor in considering whether a drug is accessible to the public. The Administration believes taxpayer-funded medications should be reasonably available and affordable. These actions build on the steps the Administration has already taken to lower health care costs, including capping the cost of insulin at $35 per product per month for seniors, finally allowing Medicare to negotiate lower prescription drug prices, requiring drug companies to pay rebates to Medicare if they raise prices faster than inflation, and locking in $800 per year in health insurance savings for 15 million Americans under President Biden’s Inflation Reduction Act.

Lowering Prescription Drug Costs

Currently the 25 largest pharmaceutical companies control around 70% of industry revenues. Other parts of the health care industry also face limited competition. Over 75% of Americans live in highly concentrated hospital markets, and just three or fewer issuers of individual health insurance control 80% of the market in 44 states. In addition, five insurers control over 70% of the Medicare Advantage market. This consolidation contributes to higher costs for taxpayers, lower wages for health care workers, and worse quality of care for patients.

New research released by the Department of Health and Human Services (HHS) finds that a lack of competition in drug markets is highly correlated with higher prices. Among the highest priced drugs (i.e., those in the top 10% of price per prescription), 89% of small molecule drugs and 100% of biological products had only one manufacturer. Meanwhile, nearly three in ten individuals struggle to pay for the drugs they need.

Today, the Biden-Harris Administration announced a new action to support lowering prescription drug costs and increase Americans’ access to life-saving medications:

Promoting equitable access to lower-priced taxpayer-funded drugs. Taxpayers have spent hundreds of billions of dollars on research catalyzing the discovery and development of new prescription drugs. The Biden-Harris Administration believes taxpayer-funded drugs and other taxpayer-funded inventions should be available and affordable to the public. When an invention is made using taxpayer funds, under certain circumstances march-in authority under the Bayh-Dole Act enables the federal government to license the invention to another party. The prior Administration proposed a rule preventing the government from exercising this authority on the basis of high price alone. The Biden-Harris Administration decided not to finalize that proposal earlier this year, consistent with President Biden’s Executive Order on Promoting Competition in the American Economy. Today, the Department of Commerce (DOC) and HHS released a proposed framework for agencies on the exercise of march-in rights that specifies for the first time that price can be a factor in determining that a drug or other taxpayer-funded invention is not accessible to the public. DOC and HHS invite public input on how this framework can promote access to taxpayer-funded inventions, including treatments for patients, while promoting innovation.

Scrutinizing Anticompetitive Acquisitions and Anticompetitive Practices

Consolidation in health care markets has accelerated in recent decades, too often leading to higher costs, worse quality, and less access to care—particularly in rural areas. For example, a review of hospital merger studies finds that mergers in concentrated markets led to price increases often exceeding 20%. Consolidation has also led to a rapid decline in independent physician practices, with research finding that patients of hospital-owned practices pay nearly $300 more for similar care than at independent physician practices. At the same time, private-equity ownership in the health care industry has ballooned, with approximately $750 billion in deals between 2010 and 2020—in sectors including, but not limited to, physician practices, nursing homes, hospices, home care, autism treatment, and travel nursing. Too often, aggressive profiteering by private equity-owned practices can lead to higher patient costs and lower quality care.

Today, the Biden-Harris Administration announced new efforts to stop anticompetitive mergers and anticompetitive practices by dominant corporations in health care markets:

Launching a cross-government public inquiry into corporate greed in health care. The Biden-Harris Administration believes that the health care system should serve patients, not corporate profiteers. The Administration is concerned that our health care system is increasingly being financialized, with corporate owners like private-equity firms and others maximizing their profits at the expense of patients’ health and safety, while increasing costs for patients and taxpayers alike. The Department of Justice (DOJ), the Federal Trade Commission (FTC), and HHS will issue a joint Request for Information to seek input about how private equity and other corporations’ increasing power and control of our health care is affecting Americans. The agencies will use this joint Request for Information to identify areas for future regulation and enforcement prioritization, and they will continue to work together on case referrals, reciprocal training programs, data-sharing, and further development of additional health care competition policy initiatives. As part of this effort, HHS will appoint a Chief Competition Officer and DOJ’s Antitrust Division and FTC will name Counsels for Health Care to lead these efforts.
- Identifying anticompetitive “roll ups” that currently evade antitrust review. Businesses, including private equity firms, health insurers, and health systems sometimes use a “roll up” strategy, in which a series of relatively small acquisitions can lead to the consolidation of a market and contribute to worse patient outcomes while increasing taxpayer costs. These serial acquisitions may violate the antitrust laws. However, each individual acquisition may fall below the size thresholds for reporting the prospective deal to the antitrust enforcement agencies before consummating the acquisition—making it more challenging for the enforcement agencies to identify anticompetitive transactions at the outset. Today, HHS, DOJ, and FTC announced that they will, to the maximum extent possible, engage in data sharing to help the antitrust enforcers identify potentially anticompetitive transactions that might otherwise evade ready review by antitrust enforcers.
- Increasing ownership transparency. HHS, through the Centers for Medicare & Medicaid Services (CMS), has taken unprecedented action to shed light on ownership trends in health care. The Biden-Harris Administration is the first to make ownership data on hospitals, nursing homes, hospice providers, and home health agencies publicly available, and today, CMS is releasing, for the first time, ownership data on Federal Qualified Health Centers and Rural Health Clinics on data.cms.gov. Making ownership information transparent allows for identification of common owners with histories of poor performance, analysis of trends on how market consolidation impacts consumers, and evaluation of the relationships between ownership and changes in health care costs and outcomes.
- Increasing Medicare Advantage transparency. Currently, about 50% of Medicare enrollment is in Medicare Advantage and the government is expected to spend over $7 trillion on Medicare Advantage over the next decade. The Biden-Harris Administration is committed to ensuring Medicare Advantage insurance plans best meet the needs of people with Medicare, there is timely access to care, and the market has healthy competition. To support this work, CMS must have comprehensive and high-quality Medicare Advantage programmatic data, including understanding the effects of market shifts on consumers and care outcomes. CMS has taken steps to improve Medicare Advantage data transparency and today, it is announcing a new phase of this work, which will start with soliciting information from the public early next year to strengthen CMS’ data capabilities and Medicare Advantage transparency efforts.

Building on Past Actions to Increase Health Care Competition and Lower Prescription Drug Costs

Today’s announcements build on steps the Administration has already taken to lower health care costs, increase competition, and improve the quality and availability of care across the health care industry. These include:

Negotiating and lowering drug prices. Thanks to President Biden’s Inflation Reduction Act, the Administration has announced 10 prescription drugs for which Medicare will negotiate prices directly with participating manufacturers. These drugs cost people with Medicare $3.4 billion out of pocket in 2022. This builds on other progress to lower prescription drug costs. Individuals with Medicare can now receive certain vaccines for free under the President’s lower cost prescription drug law, which previously would have cost an average of $70 in out-of-pocket costs. The Inflation Reduction Act also capped the cost of insulin at $35 per product per month for almost four million seniors and others on Medicare with diabetes, which can lead to hundreds of dollars in savings for a month’s supply.
- Stopping Big Pharma tactics that raise prices for working families. In September, the FTC issued an enforcement policy statement explaining that Big Pharma companies may face legal action if they delay entry of generic competitors with improper patent listings in the Food and Drug Administration’s (FDA’s) publication “Approved Drug Products with Therapeutic Equivalence Evaluations,” commonly known as the “Orange Book.” When a brand pharmaceutical company improperly lists a patent in the Orange Book, it may lead to a 30-month statutory stay that blocks the approval of competing drug products, including lower-cost generic alternatives. Such improper listings may delay competition and raise prices for life-saving products like asthma inhalers. FTC and FDA are working to address such improper listings, with FTC announcing last month that it is using FDA’s regulatory Orange Book patent listing dispute process to challenge more than 100 patents listed for brand-name asthma inhalers, epinephrine autoinjectors, and other drug products.
- Cracking down on anticompetitive and anti-consumer practices in Medicare Advantage. Medicare Advantage—which serves over 30 million American seniors and people with disabilities—is increasingly dominated by just a few large national plans. Last month, HHS announced new steps to stop predatory marketing and steering of patients to Medicare Advantage plans that may not best meet their needs. HHS, through CMS, proposed a rule that would, if finalized as proposed, stop large insurance plans from offering brokers and agents lavish compensation—such as cash bonuses, volume bonuses, and perks—and working with marketing middlemen who are more likely to contract with larger insurers, leading to steerage of patients to plans based on compensation to the broker or agent, rather than based on the patients’ best interests. The agency also proposed new steps to ensure seniors and people with disabilities can actually access supplemental benefits like hearing and dental coverage that these large plans market and help drive up Medicare costs—so that they aren’t merely marketing ploys. In addition, CMS will continue to implement updates to Medicare Advantage payment that improve payment accuracy, address gaming, and recover overpayments. Addressing overpayment in Medicare Advantage will help to make the market more competitive between Medicare Advantage plans and create a more level playing field between Medicare Advantage and Traditional Medicare.
- Making hearing aids available over the counter. To lower the price of hearing aids and expand access, President Biden’s Executive Order on Promoting Competition in the American Economy called on the FDA to act promptly to make hearing aids available over the counter, without a prescription. That is now a reality. Under a final rule issued by the FDA, hearing aids are now on store shelves across the country—for thousands of dollars less than before. The rule is also spurring competition among providers, leading to new features and models.
- Cracking down on nursing homes that endanger resident safety. In recent years, there has been a disturbing trend towards private equity firms and other large corporate owners purchasing nursing homes and slashing levels of staff to maximize profits. The Biden-Harris Administration has taken numerous steps to crack down on nursing homes that put the well-being of their residents at risk, including proposing a rule that, if finalized as proposed, would establish a federal floor for safe staffing levels. In addition, last month CMS finalized a rule that will provide the public with more information about who owns a nursing home—including whether facilities are owned by a private equity company or a real estate investment trust—so that families can make more informed decisions about where to seek nursing home care for their loved ones.
- Reforming the organ transplant system. President Biden recently signed a bipartisan law, the Securing the U.S. Organ Procurement and Transplantation Network Act, to break up the monopoly that has controlled the organ transplant system for its entire nearly four decade history. HHS will harness competition with the intent to make multiple awards to different entities to benefit from best-in-class vendors and provide a more efficient system that strengthens oversight and improves patient safety.
- Addressing anticompetitive misuse of the patent system. The FDA and U.S. Patent and Trademark Office are working together on a robust set of initiatives aimed at protecting and promoting U.S. innovation while advancing marketplace competition that can lower drug prices and expand access.
- Banning non-compete agreements that trap health care workers and others. The FTC proposed a rule to ban employers from using non-compete clauses. The estimated 18% of workers covered by non-compete clauses include many across the health care industry such as doctors and nurses, who will have more employment opportunities if the rule is finalized.
- Promoting competition in eyeglasses. Bundling eye exams with the purchase of eyeglasses reduces competition in the market for eyeglasses—raising prices and reducing options for consumers. The FTC proposed an update to its Eyeglass Rule to make sure that eye doctors give patients their prescriptions immediately after their eye exam—facilitating consumers’ ability to choose where to get their eyeglass prescriptions filled.
- Developing new payment models for doctors including supporting independent doctors. Succeeding in value-based care can be challenging for small, independent physician practices. Beginning July 1, 2024, the CMS Innovation Center’s Making Care Primary Model will provide a pathway for primary care clinicians to gradually adopt prospective, population-based payments that support the delivery of advanced primary care.

Improving transparency of hospital charges. CMS hospital price transparency regulations lay the foundation for a patient-driven health care system by making hospitals’ standard charges’ data available to the public. Last month, CMS strengthened these regulations to require hospitals to make charges available in a more standardized manner to streamline enforcement capabilities. This will help the public learn how much an insurance company pays for a particular hospital service, for third parties to develop consumer-friendly materials, for hospitals to comply, and for CMS to enforce the regulations.

Biden Administration, Health Care, News & Photo Features

Biden-Harris Administration Proposes Steps to Protect People with Medicare Advantage and Prescription Drug Coverage

November 6, 2023 krubin

The Biden-Harris Administration is proposing important steps to strengthen Medicare Advantage and the Medicare Prescription Drug Benefit Program (Part D). As part of his Bidenomics agenda, President Biden has worked to increase competition in the health care industry and other sectors, lower costs for families, and make sure every American has access to affordable, high-quality health care.

The Centers for Medicare & Medicaid Services’ (CMS’) proposed rule will help people with Medicare select and enroll in coverage options that best meet their health care needs by preventing plans from engaging in anti-competitive steering of prospective enrollees based on excessive compensation to agents and brokers, rather than the enrollee’s best interests. The proposed guardrails protect people with Medicare and promote a competitive marketplace in Medicare Advantage, consistent with the goals of President Biden’s historic Executive Order on Promoting Competition in the American Economy.

The proposed rule will also improve access to behavioral health care by adding a new facility type that includes several behavioral health provider types to Medicare Advantage network adequacy requirements. CMS is also proposing policies to increase the utilization and appropriateness of supplemental benefits to ensure taxpayer dollars actually provide meaningful benefits to enrollees. Additionally, the proposed rule would improve transparency on the effects of prior authorization on underserved communities and proposes more flexibility for Part D plans to more quickly substitute lower cost biosimilar biological products for their reference products.

“The Biden-Harris Administration remains committed to making health care more affordable and accessible for all Americans. By ensuring Medicare recipients have the information they need to make critical decisions about their health care coverage, we are doing just that,” said U.S. Department of Health and Human Services Secretary Xavier Becerra. “Promoting competition in the marketplace helps to lower costs and protect access to care while making the whole process more transparent and accountable.”

“CMS continues to improve the Medicare Advantage and Part D prescription drug programs and maintain high-quality health care coverage choices for all Medicare enrollees,” said CMS Administrator Chiquita Brooks-LaSure. “People with Medicare deserve to have accurate and unbiased information when they make important decisions about their health coverage. Today’s proposals further our efforts to curb predatory marketing and inappropriate steering that distorts healthy competition among plans.”

CMS has previously taken unprecedented steps to address predatory marketing of Medicare Advantage plans, such as banning misleading TV ads. Many people on Medicare rely on agents and brokers to help navigate Medicare choices. CMS is concerned that some Medicare Advantage plans are compensating agents and brokers in a way that may circumvent existing payment rules, inappropriately steer individuals to enroll in plans that do not best meet their health care needs, and lead to further consolidation in the Medicare Advantage market. To further protect people with Medicare through stronger marketing policies and to promote a competitive marketplace in Medicare Advantage, CMS is proposing added guardrails to plan compensation for agents and brokers, including standardization. These proposals are consistent with the statutory requirement that CMS develop guidelines to ensure that the use of compensation creates incentives for agents and brokers to enroll individuals in the Medicare Advantage plan that is intended to best meet their health care needs.

CMS also proposes to strengthen and improve access to behavioral health care by adding a new facility type, which includes marriage and family therapists, mental health counselors, addiction medicine clinicians, opioid treatment providers, and others, to CMS’ Medicare Advantage network adequacy requirements. This proposed addition builds on changes finalized last year to strengthen these requirements and would ensure people with Medicare Advantage can access vital mental health and substance use disorder treatment.

“The people we serve are at the center of the Medicare program, and we work each day to make sure the program works for them. Agents and brokers play an important role in guiding people with Medicare to the option that is tuned in to their medical needs. Our proposals on how plans compensate agents and brokers seek to support a competitive marketplace that best serves people with Medicare,” said Dr. Meena Seshamani, CMS Deputy Administrator and Director of the Center for Medicare.

Currently, 99% of Medicare Advantage plans offer at least one supplemental benefit. Over time, the benefits offered have become broader in scope and variety, with more rebate dollars directed toward these benefits. CMS is committed to ensuring these offerings are effectively reaching enrollees and actually meeting their needs, and not just used for attracting enrollees. In today’s rule, CMS proposes requiring Medicare Advantage plans to send a personalized notification to their enrollees mid-year of the unused supplemental benefits available to them to encourage higher utilization. Furthermore, CMS is proposing additional requirements designed to help ensure that benefits offered as special supplemental benefits for the chronically ill (SSBCI) are backed by evidence. CMS is also proposing new marketing and transparency guardrails around these benefits. These proposals will help ensure a robust and competitive Medicare Advantage marketplace made up of plan options with meaningful benefits.

Additionally, CMS is concerned that certain prior authorization policies may disproportionately inhibit access to needed care for underserved enrollees. To provide additional safeguards, CMS is proposing to require that Medicare Advantage plans include an expert in health equity on their utilization management committees and that the committees conduct an annual health equity analysis of the plans’ prior authorization policies and procedures. This analysis would examine the impact of prior authorization on enrollees with one or more of the following social risk factors—eligibility for Part D low-income subsidies, dual eligibility for Medicare and Medicaid, or having a disability—compared to enrollees without these risk factors. These analyses would have to be posted publicly to improve transparency into the effects of prior authorization on underserved populations. To further promote health equity, CMS is also proposing to streamline enrollment options for individuals with both Medicare and Medicaid, providing more opportunities for integrated care.

To support competition in the prescription drug marketplace, CMS is also proposing to provide more flexibility to substitute biosimilar biological products other than interchangeable biological products for their reference products to give people with Medicare more timely access to lower-cost biosimilar drugs. This proposal would permit Part D plans to treat such substitutions as maintenance changes so that the substitutions apply to all enrollees, not only those who begin the therapy after the effective date of the change, following a 30-day notice.

There will be a 60-day comment period for the notice of proposed rulemaking, and comments must be submitted at one of the addresses provided in the Federal Register no later than January 5, 2024. The proposed rule can be accessed at the Federal Register at https://www.federalregister.gov/public-inspection/current.

View a fact sheet on the proposed rule at cms.gov/newsroom.

View the CMS Blog Important New Changes to Improve Access to Behavioral Health in Medicare at https://www.cms.gov/blog.

Biden Administration, Health Care, President Joe Biden

FACT SHEET: By The Numbers: Millions of Americans Would Lose Health Care Coverage, Benefits, and Protections Under Congressional Republicans’ Plans

November 1, 2022 krubin

This fact sheet on the impact on health care coverage, benefits and protections under the Congressional Republicans’ plans was provided by the White House:

While President Biden has secured a cap on insulin costs at $35/month, a cap on out-of-pocket prescription drug costs to $2000, enabled Medicare for the first time to negotiate drug prices, and lowered the cost of health care premiums, Congressional Republicans have promised to strip Medicare of the right to negotiate drug prices and remove the $2,000 cap on out-of-pocket pharmacy expenses and would put Medicare, Medicaid, and Social Security on the chopping block every five years. © Karen Rubin/news-photos-features.com

President Biden’s top priority is to lower costs for the American people. He was proud to sign the Inflation Reduction Act into law, taking on Big Pharma to allow Medicare to negotiate prescription drug costs for the first time, capping seniors’ drug costs at the pharmacy and the cost of insulin, and lowering health insurance premiums for people who get coverage through the Affordable Care Act. President Biden and Congressional Democrats are committed to protecting and strengthening Social Security and Medicare.

Congressional Republicans have a very different vision. They have promised to strip Medicare of the right to negotiate drug prices and remove the $2,000 cap on out-of-pocket pharmacy expenses. Florida’s Republican Senator and Chair of the National Republican Senatorial Committee Rick Scott has championed a plan to put Medicare, Medicaid, and Social Security on the chopping block every five years. Further, Congressional Republicans have repeatedly pledged to hold the American economy hostage by refusing to raise the debt limit unless they can cut Social Security and Medicare benefits that tens of millions of Americans have already paid into.

Here’s what Congressional Republicans’ plan would mean:

Part I: Putting Bedrock Programs like Social Security and Medicare on the Chopping Block and Threatening the Global Economy Unless Those Programs Are Cut

All Medicare, Medicaid, and Social Security beneficiaries would see their benefits threatened under Sen. Rick Scott’s plan to put those programs on the chopping block every five years. Sen. Ron Johnson’s vision of putting them up for a vote every year would make that even worse.

Congressional Republican leaders have also repeatedly said they will use the debt limit as leverage to cut these bedrock programs. Congressional Republicans have supported Medicare and Social Security cuts including:

Gradually increasing the Medicare eligibility age to 67 and the Social Security eligibility age to 70. (Republican Study Committee FY 2023 Budget)
Transforming Medicare benefits into a voucher where seniors would get a fixed amount of money to purchase a private health plan (Better Way Plan) or offering beneficiaries the option to transition to a premium support system (Republican Study Committee FY 2023 Budget) – which could lead to hundreds or thousands of dollars in additional out of pocket costs for seniors throughout the country.

Part II: Repealing the Prescription Drug and Health Care Provisions in the Inflation Reduction Act

President Biden has worked for decades to let Medicare negotiate drug prices, and that is finally happening thanks to the Inflation Reduction Act. This will save billions of dollars for both Medicare beneficiaries, who will see reduced premiums and out-of-pocket costs, and the federal government. Kaiser Family Foundation estimates suggest that some 5 to 7 million beneficiaries each year use the types of high-cost drugs that could be subject to negotiation and will directly face higher cost sharing if these provisions are repealed.

The Inflation Reduction Act also requires prescription drug companies to pay rebates if they increase drug prices faster than inflation. According to an analysis by the Department of Health and Human Services, the cost of 1,200 prescription drugs rose faster than inflation in the last year alone – some prescription drugs increasing by $1000 in just one year. If Congressional Republicans repeal the Inflation Reduction Act, drug companies will be able to continue raising prices without paying a rebate, rather than putting that money back into Americans’ pockets.

Before the Inflation Reduction Act, Medicare beneficiaries with conditions like cancer, multiple sclerosis, and lung disease could face thousands of dollars in out-of-pocket prescription drug costs per year. Thanks to President Biden and Congressional Democrats’ Inflation Reduction Act, those costs will be capped at $2,000 per year, saving over 1 million beneficiaries an average of over $1,300 per year. If Congressional Republicans get their way and repeal the law, over 1.4 million Medicare beneficiaries will pay more each year – thousands of dollars more in some cases – for drugs at the pharmacy.

Drug manufacturers have raised insulin prices so rapidly over the last few decades that some Medicare beneficiaries struggle to afford this life-saving drug that costs less than $10 a vial to manufacture. Today, Medicare beneficiaries are enrolling in plans that must cap the out-of-pocket cost of insulin at no more than $35 per month per prescription, a protection they will lose if the law is repealed.

The Inflation Reduction Act saves 13 million Americans an average of about $800 per year on their health care premiums, by continuing the improvements to Affordable Care Act (ACA) premium tax credits enacted in the American Rescue Plan. By making health care more affordable, these improvements have expanded coverage to millions of people, helping bring the uninsured rate to an all-time low. Starting today, during Open Enrollment season, Americans can choose health insurance plans that lock in the Inflation Reduction Act’s cost savings for 2023. But Congressional Republicans would repeal this assistance, drive premiums higher, and jeopardize the progress the Biden Administration has made in driving the uninsured rate to a historic low. Older Americans would see especially large premium spikes; in most states, annual premiums for a 60-year old making $60,000 would more than double to over $10,000.

Biden Administration, Health Care, News & Photo Features

FACT SHEET: Biden Takes Action to Lower Health Care and Prescription Drug Costs for Americans

October 18, 2022 krubin

President Biden Signs Executive Order Directing HHS to Explore Additional Actions to Lower Prescription Drug Costs

Starting this January, seniors and other Medicare beneficiaries will begin to see the benefits of these cost-saving measures. Because of the Inflation Reduction Act: a month’s supply of insulin will be capped at $35; Medicare beneficiaries will pay $0 out of pocket for recommended adult vaccines covered by their Part D plan, including the shingles vaccine – which costs seniors up to $200; Prescription drug companies that try to raise their prices faster than inflation will be required to pay Medicare a rebate © Karen Rubin/news-photos-features.com

This fact sheet about actions that President Biden is taking to lower health care and prescription drug costs was provided by the White House:

To mark the start of Medicare Open Enrollment season, President Biden is highlighting how seniors can take advantage of the Inflation Reduction Act’s cost-saving provisions as they shop for new health insurance plans. The President also signed an Executive Order directing the Department of Health and Human Services to explore additional actions it can take to lower prescription drug costs to build on his Administration’s work lowering costs for working and middle-class families.

Americans are squeezed by the cost of living – that’s been true for years and is a key reason the President ran. Health care costs in particular are driving inflation. Too many Americans face challenges paying for prescription drugs. On average, Americans pay two to three times as much as people in other countries for prescription drugs, and one in four Americans who take prescription drugs struggle to afford their medications. Nearly three in ten American adults who take prescription drugs say that they have skipped doses, cut pills in half, or not filled prescriptions due to cost.

The Inflation Reduction Act – which President Biden and Congressional Democrats delivered – tackles that problem and locks in on average $800 per year lower health care premiums for 13 million families, lowers seniors’ prescription drug prices, and caps their out of pocket expenses for prescription drugs at $2,000 per year. The Inflation Reduction Act protects Medicare beneficiaries from catastrophic drug costs by phasing in a cap for out-of-pocket costs at the pharmacy, establishing a $35 monthly cap per prescription of insulin, requiring companies who raise prices faster than inflation to pay Medicare a rebate, and allowing Medicare to negotiate prices for high-cost prescription drugs for the first time ever. Republicans in Congress, meanwhile, have said their top priority is to repeal the Inflation Reduction Act, ending these cost-saving provisions and raising prices for tens of millions of Americans.

To further lower health care costs, earlier this week, the Treasury Department took action to fix the so-called “family glitch” rule that was making it harder for families to afford health care coverage for their spouse or child. About 1 million Americans will either gain coverage or see their insurance become more affordable as a result of the new rule.

Lowering Medicare Costs This Open Enrollment Season

Starting this January, seniors and other Medicare beneficiaries will begin to see the benefits of these cost-saving measures. Because of the Inflation Reduction Act:

A month’s supply of insulin will be capped at $35 starting on January 1, 2023.

Medicare beneficiaries will pay $0 out of pocket for recommended adult vaccines covered by their Part D plan, including the shingles vaccine – which costs seniors up to $200.

Prescription drug companies that try to raise their prices faster than inflation will be required to pay Medicare a rebate.

Earlier this year, HHS released a report showing that the price of 1,200 prescription drugs rose faster than inflation in just the last year. For example, one manufacturer of a drug used to treat high blood pressure and heart failure, used by millions of Medicare beneficiaries, increased the drug’s price by nearly 540 percent in 2022. Another drug used to treat autoimmune conditions increased by $1000 just this year.

During Medicare Open Enrollment – running from October 15 to December 7 – seniors and other beneficiaries will be able to choose drug coverage that reflects these new cost-savings, putting money back into their pockets.

Medicare beneficiaries should visit Medicare.gov or call 1-800-MEDICARE to review their options for the coming year, and make sure their health and prescription drug coverage is right for them.

Using HHS’ Innovation Center to Further Bring Down Costs

As the Biden-Harris Administration works to implement the Inflation Reduction Act, President Biden signed an Executive Order directing the Department of Health and Human Services to consider additional actions to further drive down prescription drug costs. That includes leveraging the “Innovation Center” at HHS, created by the Affordable Care Act, which has authority to test new ways of paying for Medicare services thatimprove the quality of care while lowering costs.

Under Executive Order XX, HHS will have 90 days to submit a formal report outlining any plans to use the Innovation Center’s authorities to lower drug costs and promote access to innovative drug therapies for Medicare beneficiaries. This action would build on the Inflation Reduction Act’s landmark drug pricing reforms and help provide additional breathing room for American families.

Democratic Party, Democrats, Democrats 2020, Election 2020, Social Safety Net, Social Security

Democratic Candidates for 2020: Klobuchar Policy Plan for Seniors Tackles Alzheimers, Healthcare, Drug Costs, Retirement Security

August 7, 2019 krubin

*Senator Amy Klobuchar’s plan for Seniors tackles Alzheimer’s, enhances health care and retirement security and reduces prescription drug costs.* © *Karen Rubin/news-photos-features.com*

The vigorous contest of Democrats seeking the 2020 presidential nomination has produced excellent policy proposals to address major issues. Senator Amy Klobuchar’s plan for Seniors tackles Alzheimer’s, enhances health care and retirement security and reduces prescription drug costs. This is a summary from the Klobuchar campaign:

MINNEAPOLIS, MN – Senator Amy Klobuchar released her policy priorities for seniors. Building on her leadership in the Senate when it comes to lowering the cost of prescription drugs and addressing the challenges our seniors face, Senator Klobuchar is proposing a bold plan to tackle Alzheimer’s disease and other forms of dementia, enhance health care and retirement security, reduce skyrocketing prescription drug costs and combat senior fraud and abuse. As President, Senator Klobuchar will continue to stand up for our seniors and the 10,000 Americans who turn 65 each day.

“Everywhere I go, I meet seniors who tell me about their struggles to afford everyday costs like prescription drugs or health care,” said Senator Amy Klobuchar. “I meet family members who face challenges caring for loved ones with Alzheimer’s and urgent action is needed to take on these problems. I believe we owe it to our seniors to make sure they have the care and support they need as they get older, and as President I will prioritize tackling Alzheimer’s, strengthening health care and retirement security, and reducing prescription drug costs.”

Highlights of Senator Klobuchar’s Plan:

Tackling Alzheimer’s and Other Chronic Conditions

Support caregivers for those living with Alzheimer’s and other chronic conditions. Senator Klobuchar has been a leader when it comes to supporting people affected by Alzheimer’s and their families. As President, she will support expanding resources for health care providers to expand training and support services for families and caregivers of people living with Alzheimer’s disease or other forms of dementia as well as other chronic conditions, improving caregiver well-being and health, as well as allowing patients to stay in their homes longer.

Make it easier for people with Alzheimer’s and their families to get the medical care they need. Medicare is an essential resource for people affected by Alzheimer’s, but many patients and their families are unaware of the resources and coverage available when it comes to Alzheimer’s. Senator Klobuchar will take action to expand Medicare covered services for Alzheimer’s and she will expand efforts to make patients and their families aware of the care-planning and services that are covered. She will also support an ongoing investment in public health infrastructure for Alzheimer’s that reduces risk, improves early detection and diagnosis, and focuses on tribal, rural, minority, and other underserved populations.

Strengthen the National Institutes of Health and invest in research for chronic conditions. While the current administration has proposed draconian cuts to lifesaving research, Senator Klobuchar will bolster research at the National Institutes of Health and increase investments in research into cancer, including breast cancer, which the Senator has long supported, and other chronic conditions. And Senator Klobuchar will also invest in research into health disparities. Significant and persistent disparities exist in health outcomes for minority populations in the United States. When it comes to healthy aging, research has shown divides based on race, wealth, and education. Senator Klobuchar will invest in research across the federal government into the causes of these disparities and how they can be reduced.

Invest in Alzheimer’s research. Senator Klobuchar will commit to preventing, treating and facilitating a cure for Alzheimer’s disease, with the goal of putting us on a path toward developing a cure and treatment by 2025. To support researchers, she will make sure that funding is reliable and consistent. Since African Americans and the Latino community will represent nearly 40 percent of the 8.4 million American families affected by Alzheimer’s disease by 2030, Senator Klobuchar will increase federal research into disparities in the incidents and outcomes of Alzheimer’s and other forms of dementia.

Improve mental health care for seniors. Senator Klobuchar is committed to making mental health a priority, including for our seniors. As part of her recently released mental health plan, she will expand access to mental health treatment for seniors and expand depression treatment and suicide prevention efforts that focus on seniors.

Implement and extend Kevin and Avonte’s law and expand dementia training. Senator Klobuchar introduced bipartisan legislation signed into law last year that helps families locate missing people with forms of dementia, such as Alzheimer’s, or developmental disabilities, such as autism. As President, Senator Klobuchar will make sure the program is fully implemented and she will also establish federal partnerships with state and local governments to provide dementia training for public sector workers who interact with seniors.

Ensure a Secure Retirement

Protect Social Security and make sure it is fair. Social Security has served as a stable and secure retirement guarantee for generations of Americans. Senator Klobuchar believes that this program must remain solvent for generations to come and she will fight against risky schemes to privatize it. As President, Senator Klobuchar will work to lift the Social Security payroll cap. Currently the payroll tax only applies to wages up to $133,000. Senator Klobuchar supports subjecting income above $250,000 to the payroll tax and extending the solvency of Social Security. And Senator Klobuchar will make sure people are treated fairly by the current Social Security system. As President, she will work to strengthen and improve Social Security benefits for widows and people who took significant time out of the paid workforce to care for their children, aging parents, or sick family members.

Expand retirement savings. Senator Klobuchar believes all Americans deserve a secure retirement. As she has previously announced, Senator Klobuchar will work to create innovative, portable personal savings accounts called Up Accounts that can be used for retirement and emergencies by establishing a minimum employer contribution to a savings plan. [ This proposal is modeled after the Saving for the Future Act, which was introduced by Senators Coons and Klobuchar.] Under her plan, employers will set aside at least 50 cents per hour worked, helping a worker build more than $600,000 in wealth over the course of a career. And Senator Klobuchar will work to reduce disparities when it comes to retirement savings. According to a recent study, the median wealth for white families was more than $134,000, but for African American families it was just $11,000.

Defend pensions. Senator Klobuchar has been a leader in the Senate when it comes to keeping our pension promises. As President, she will support legislation to ensure retirees can keep the pensions they have earned and, in her first 100 days, she will recommend that Treasury heighten the scrutiny of any applications to reduce retiree benefits under the Kline-Miller Multiemployer Pension Reform Act of 2014.

Improve Health Care for Seniors and Lower Prescription Drug Costs

Unleash the power of 43 million seniors in Medicare Part D to negotiate better drug prices. Seniors should have access to their medicines at the lowest possible prices. As President, Senator Klobuchar will push to allow the government to directly negotiate lower drug prices for Medicare Part D, building on legislation she has led in the Senate.

Take immediate and aggressive action to lower prescription drug prices, including allowing personal importation from countries like Canada and crack down on “Pay-for-Delay” agreements. Senator Klobuchar has been a leading advocate for reducing the price of prescription drugs for seniors, including by helping close the Medicare Part D donut hole and introducing legislation to increase competition and require Medicare to negotiate lower drug prices. As President, during her first 100 days she will allow for the personal importation of prescription drugs from safe countries like Canada and crack down on “Pay-for-Delay” agreements that increase the cost of prescription drugs.

Strengthen Medicare and provide incentives for getting the best quality health care at the best price. Senator Klobuchar opposes cuts and risky schemes to privatize Medicare and will take action to strengthen Medicare and find solutions so it remains solvent. She will improve Medicare for current beneficiaries by reforming payment policies through measures like site neutral payments and providing incentives for getting the best quality health care at the best price, including bundled payments and telehealth.

Expand coverage for dental, vision and hearing under Medicare. Dental, vision, and hearing care should be covered as part of Medicare. Senator Klobuchar will support new Medicare coverage for these services that makes them affordable for all seniors.

Expand telehealth and rural health services and maintain rural hospitals. In the Senate, Senator Klobuchar has championed policies that ensure seniors who want to stay in their homes and communities can do so. As President, she will promote remote monitoring technology and telehealth services in Medicare and other programs that improve the quality of life and expand access to quality home care and emergency hospital services in rural areas. As President, she would work to create a new Rural Emergency Hospital classification under Medicare to help rural hospitals stay open and provide expanded support to our critical access hospitals.

Invest in Long-Term Care

Create a refundable tax credit to offset long-term care costs. Senator Klobuchar will work with Congress to establish a new refundable tax credit to help offset the costs of long-term care. The credit will be available for qualifying long-term care costs including both nursing facility care and home- and community-based services, and additional expenses like assistive technologies, respite care, and necessary home modifications. The credit will be targeted towards those who are most in need of support. Senator Klobuchar will also stand up to efforts to cap Medicaid spending, which would put services like mental health care, transportation costs, and long-term care at risk for millions of Americans.

Reduce the costs of long-term care insurance and increase access. Senator Klobuchar believes seniors and their adult children must have the resources they need to prepare for long-term care, including education about the types of services available. To reduce the costs of long-term care, Senator Klobuchar will propose a new targeted tax credit equal to 20 percent of the premium costs of qualified long-term care insurance. Senator Klobuchar will also establish incentives and make it easier for employers to offer their employees long-term care insurance on an opt-out basis. In addition, she will explore updating federal policies to combine long-term care policies with life insurance.

Provide financial relief to caregivers and ensure paid family leave for all Americans, including those who care for elderly or disabled relatives. Senator Klobuchar is proposing a tax credit of up to $6,000 a year to provide financial relief to those caring for an aging relative or a relative with a disability to help offset expenses, including the cost of medical care, counseling and training, lodging away from home, adult day care, assistive technologies, and necessary home modifications. As President, Senator Klobuchar will also support legislation to provide paid family leave to all Americans so no one has to sacrifice a paycheck to care for someone they love, including an elderly parent.

Support a world class long-term care workforce, increase long-term care options, and tackle disparities in long-term care. Senator Klobuchar believes we must invest in and address shortages in our long-term care workforce. She is committed to increasing wages, improving job conditions and promoting other recruitment and retention policies, especially in rural communities facing workforce challenges. She will also support training for long-term care workers and new loan forgiveness programs for in-demand occupations that includes our long-term care workers. In addition, she will expand long-term care facilities and beds as well as home care and telehealth services. Research also suggests that there are significant racial and ethnic disparities in the quality of long-term care as well as disparities in coverage for long-term care. Senator Klobuchar is committed to tackling disparities in care through expanding access to long-term care with a focus on reducing inequities as well as addressing the costs of long-term care services for people in the greatest need of assistance.

Reduce Costs and Prevent Fraud

Fight senior fraud and elder abuse. As a prosecutor, Senator Klobuchar created a senior protection unit at the Hennepin County Attorney’s Office. And she has always believed that we need strong safeguards to prevent and address fraud, abuse and exploitation of our seniors, and has led and passed multiple bills in the Senate that would strengthen these safeguards. Within her first 100 days as President, she will establish a new senior fraud prevention office to educate consumers, expedite the handling of complaints, and coordinate prevention efforts across the federal government. Senator Klobuchar will stregthen enforcement of age discrimination laws, and she will also take action to tackle elder abuse, strengthen oversight and accountability for court-appointed guardians, support training for employees at long-term care facilities, and increase tracking of incidents and investigations to help prevent and better respond to elder abuse.

Improve access to affordable housing, transit, and nutrition for seniors and expand workforce opportunities. In the first 100 days of her Administration, Senator Klobuchar will reverse the Trump Administration’s proposed changes to federal housing subsidies that could triple rent for some households and would be particularly harmful for seniors. In addition, she will update regulations for reverse mortgages to make sure seniors have access to safe products that make it easier to stay in their homes, as well as expand support for affordable senior housing. Senator Klobuchar is also committed to expanding transportation programs and services for older adults, particularly in rural and underserved populations. She also supports expanding resources for Meals on Wheels, helping the food bank system serve seniors in need, and launching a national effort to increase enrollment among seniors in the Supplemental Nutrition Assistance Program. Senator Klobuchar will also work to expand workforce and training opportunities for older Americans who are looking to remain in and return to the workforce.

Help seniors afford their energy costs: Senator Klobuchar strongly opposes efforts by the Trump Administration to eliminate funding for programs like the Low Income Home Energy Assistance Program (LIHEAP), which helps seniors afford heating and cooling. As President, Senator Klobuchar’s budget will preserve and expand resources for LIHEAP and the Weatherization Assistance Program, which helps households in need reduce energy spending, and she will support new efforts to help seniors with their energy costs.

To pay for these policies, Senator Klobuchar will close the trust fund loopholes that allow the wealthy to avoid paying taxes on inherited wealth.

Election 2016, Health Care, Presidential Politics

Hillary Clinton Announces Aggressive New Plan to Address Unjustified Price Hikes in Life-Saving Drugs

September 2, 2016 krubin

Hillary Clinton announced a new plan to protect Americans from unjustified price hikes of long-available prescription drugs with limited competition, like EpiPens and pyrimethamine, the drug for a disease related to AIDS that Turing Pharmaceuticals raised the price of by more than 5,000% © 2016 Karen Rubin/news-photos-features.com

Hillary Clinton has announced a new plan to protect Americans from unjustified price hikes of long-available prescription drugs with limited competition, like EpiPens and pyrimethamine, the drug for a disease related to AIDS that Turing Pharmaceuticals raised the price of by more than 5,000%. After speaking out against excessive prices for prescription drugs throughout the campaign and, last week, calling for Mylan to lower its EpiPen price, Clinton believes that Mylan’s recent actions have not gone far enough to remedy their outrageous price increase. So today, Clinton is proposing a new set of strong tools – including a consumer protection group – that will let the government take effective action in such cases where public health is put at risk by an unjustified, outlier price increase for a treatment long available on the market with limited competition.

“Over the past year, we’ve seen far too many examples of drug companies raising prices excessively for long-standing, life-saving treatments with little or no new innovation or R&D,” Clinton said. “It’s time to move beyond talking about these price hikes and start acting to address them. All Americans deserve full access to the medications they need — without being burdened by excessive, unjustified costs. Our pharmaceutical and biotech industries are an incredible source of American innovation and revolutionary treatments for debilitating diseases. But I’m ready to hold drug companies accountable when they try to put profits ahead of patients, instead of back into research and innovation.”

Today, building off the comprehensive plan she offered earlier in the campaign last year, Clinton is calling for action to protect consumers from unjustified prescription drug price increases by companies that are marketing long-standing, life-saving treatments and face little or no competition. She’ll start by convening representatives of Federal agencies charged with ensuring health and safety, as well as fair competition, to create a dedicated group charged with protecting consumers from outlier price increases. They will determine an unjustified, outlier price increase based on specific criteria including: 1) the trajectory of the price increase; 2) the cost of production; and 3) the relative value to patients,among other factors that give rise to threatening public health.

Should an excessive, outlier price increase be determined for a long-standing treatment, Clinton’s plan would make new enforcement tools available including:

Making alternatives available and increasing competition: Directly intervening to make treatments available, and supporting alternative manufacturers that enter the market and increase competition, to bring down prices and spur innovation in new treatments.

Emergency importation of safe treatments: Broadening access to safe, high-quality alternatives through emergency importation from developed countries with strong safety standards.

Penalties for unjustified price increase to hold drug companies accountable and fund expanded access: Holding drug makers accountable for unjustified price increases with new penalties, such as fines – and using the funds or savings to expand access and competition.

Her plan will establish dedicated consumer oversight at our public health and competition agencies. They will determine an unjustified, outlier price increase based on specific criteria including: 1) the trajectory of the price increase; 2) the cost of production; and 3) the relative value to patients, among other factors that give rise to threatening public health.

In combination with her broader plan – which addresses the costs facing consumers from both long-standing and patented drugs – these new tools to address price spikes for treatments available for many years will lower the burden of prescription drug costs for all Americans.

This plan would impact the many examples we’ve seen over the past year of drug companies raising prices excessively for drugs that have been available for years – from Turing raising the price of pyrimethamine for AIDS patients by over 5,500 percent, to Mylan raising the price of the EpiPen by more than 400 percent. This is not an isolated problem: Between 2008 and 2015, drug makers increased the prices of almost 400 generic drugs by over 1,000 percent. Many of these companies are an example of a troubling trend—manufacturers that do not even develop the drug themselves, but acquire it and raise the price.

The immediate protections she is offering today build on her broader plan to lower prescription drug costs for all Americans that she released last year.

The full fact sheet is available here.