This fact sheet on the impact on health care coverage, benefits and protections under the Congressional Republicans’ plans was provided by the White House:
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:
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.
President Biden Signs Executive Order Directing HHS to Explore Additional Actions to Lower Prescription Drug Costs
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.
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.”
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
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.
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.
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.
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.