Medicare Drug Savings Eclipsed by Part B Premiums, COLA Challenges and ACA’s Rising Costs

Published in RINewsToday on January 5, 2026

The official arrival of the New Year was marked by millions of viewers channel surfing between ABC, CBS, NBC, and CNN, eager to watch the ball drop in Times Square and ring in 2026. The iconic New York City ball—12,000 pounds and adorned with 5,280 Waterford Crystal discs and LED lights—descended a 139-foot flagpole atop One Times Square. In just 60 seconds, it reached the bottom at midnight on New Year’s Eve, signaling the beginning of 2026.

Just two days before January 1—when Medicare-negotiated prices for 10 prescription drugs take effect—AARP Executive Vice President and Chief Advocacy & Engagement Officer, Nancy LeaMond, shared good news. As the clock struck midnight, she announced that older Americans would see lower prices for the first 10 Medicare-negotiated drugs, which would take effect on January 1, 2026. AARP quickly issued a statement, celebrating the first-ever Medicare-negotiated drug prices and estimating a whopping 50% reduction in out-of-pocket costs for beneficiaries.

“For millions of older Americans managing chronic conditions, prescription drugs are not optional—they are a lifeline. But medicine doesn’t work if people can’t afford it,” said LeaMond in a Dec. 29 statement. She emphasized that AARP has been at the forefront of advocating for drug pricing reforms since 2022. The nation’s largest aging advocacy group, representing nearly 38 million members, shared their stories, conducted national research on drug costs, and urged lawmakers on both sides of the aisle to support legislative efforts to lower drug costs.

According to LeaMond, this advocacy has delivered significant progress. On January 1, negotiated prices will take effect for the first time, marking a major milestone for both patients and taxpayers. “Older Americans will see real results and billions in savings as the first Medicare-negotiated prices take effect,” she stated, pledging that “AARP won’t stop fighting to lower drug prices until every American can get the medications they need at a price they can afford.”

“These drugs are used by nearly 9 million Medicare beneficiaries and treat conditions such as diabetes, heart disease, autoimmune disorders, and cancer,” she noted.

While Medicare beneficiaries are set to see substantial savings, the Centers for Medicare and Medicaid Services (CMS) anticipates that the Medicare drug price negotiation program will save billions. CMS, a federal agency providing health coverage to over 160 million people through Medicare, Medicaid, the Children’s Health Insurance Program, and the Marketplace, expects the program to save enrollees roughly $1.5 billion in out-of-pocket costs in 2026 while saving the Medicare program $6 billion per year.  The negotiated prices are a minimum of 38% off the 2023 list price.

On the Other Hand

Though Medicare beneficiaries will benefit from lower out-of-pocket costs on 10 Medicare-negotiated drugs in the new year, the 2026 Social Security COLAs will barely cover Medicare Part B premiums and rising inflation.  Meanwhile, older Americans who are not eligible for Medicare coverage will face soaring health insurance premiums due to the Senate’s failure to extend the Affordable Care Act (ACA) Tax Credits.

Max Richtman, President and CEO of the National Committee to Preserve Social Security & Medicare, stressed the importance of ACA marketplace coverage for older adults, who often struggle to find affordable health insurance. “It’s not only cruel to let their premiums skyrocket; it costs everyone in the long run,” observes Richtman. “Older patients without insurance will be forced to use emergency rooms for care, which drives up costs for all healthcare consumers,” he says in a statement released on Dec. 11, 2026.

“They’ll also arrive at Medicare sicker or more disabled, which not only costs taxpayers more but raises premiums for all older Americans on Medicare,” warns Richtman.

Richtman pointed out that 40% of ACA enrollees are between the ages of 45 and 64. Without the extended tax credits, many of these individuals—including farmers, ranchers, entrepreneurs, and small business owners—will face unaffordable premium increases and may be forced to drop or downgrade their health care coverage. “Extending these tax credits to prevent premium hikes would have made simple common sense,” Richtman argued. “Why would Senators vote to push people off health insurance instead of widening the safety net when the ACA is so clearly beneficial, especially for older, vulnerable enrollees?,” he asked.

Additionally, this year’s premium increase for the standard Medicare Part B program, while not as high as originally projected, will still affect beneficiaries, too. They will face an increase of nearly $18 per month, marking roughly a 10% hike in 2026. In a statement on Nov. 17, 2025, Richtman said that this rise basically cancels out one-third of the average beneficiary’s cost-of-living adjustment (COLA) for 2026.

The standard Part B premium for 2026 will be $ 202.90 a month, which is $17.90 more than last year’s $ 186.  The average COLA will be $ 56 a month in 2026. After accounting for the $18 Part B premium increase, the average Social Security beneficiary will be left with an effective monthly increase of only $36 next year, notes Richtman.

Richtman pointed out that the 2.8% COLA for 2026, announced in October, was already modest before the Medicare premium hike. “In this economy, an extra $36 per month will provide only marginal relief for Social Security beneficiaries,” he said, stressing that seniors with below-average benefits will see even less of a benefit increase once Medicare Part B premiums are deducted.

“Some in lower-income brackets may experience an effective COLA of zero,” predicts Richtman.

A Final Note…

Yes, Medicare beneficiaries will see a decrease in Medicare-negotiated prices for 10 prescription drugs that took effect last week.  But, with inflation rising and older adults struggling to afford basic needs such as food, rent, utilities, and healthcare costs, aging advocates urge Congress to  take action to mitigate the negative impacts of HR 1, the 2025 budget reconciliation bill, on the Medicare drug price negotiation program.  It’s also crucial that Social Security COLAs accurately reflect the out-of-pocket expenses faced by beneficiaries, they say.

“Unfortunately, the 2025 budget reconciliation bill—HR 1—further limits the drugs that can be negotiated under the IRA’s negotiation program, reducing its effectiveness,” warns Julie Carter of the Medicare Rights Center in an October 9, 2025, blog post for Medicare Watch. “KFF, an independent health policy and research organization, estimates that this change will increase Medicare spending by at least $5 billion. As always, increases in Medicare spending lead to higher out-of-pocket costs for beneficiaries,” she says.

“At Medicare Rights, we strongly oppose efforts to scale back the IRA’s negotiation framework. We believe more drugs should be subject to negotiation, not fewer. We also advocate for expanding other cost-saving aspects of the law to reduce expenses for those covered by other forms of insurance,” Carter adds.

“Social Security COLAs are meant to offset the impact of inflation on beneficiaries. However, they are clearly insufficient for many seniors living on fixed incomes,” argues NCPSSM’s Richtman. He explains that this is why his organization has been pushing for an improved COLA formula—the CPI-E (Consumer Price Index for the Elderly). The CPI-E would more accurately reflect the inflationary effects on the goods and services seniors rely on, he says.

“We support legislation that would adopt the CPI-E for determining COLAs, but Congress has yet to take action. Adopting this formula would be a reasonable step toward expanding benefits and truly meeting the needs of 21st-century seniors,” Richtman concludes.

2025: A Year on the “Age Beat” in Rhode Island

Published in RINewsToday on December 29, 2025

Throughout 2025, this “Age Beat” columnist published a weekly commentary covering an extensive list of aging, healthcare, and medical issues. During this year, this columnist followed Congressional debates inside the Beltway involving Medicare, Medicaid, reauthorization of the Older Americans Act, and Social Security, reporting on how these federal policy proposals would affect older Rhode Islanders.  During the latest legislative session of the Rhode Island General Assembly, policy debates on Smith Hill were also covered in my weekly commentaries, examining how the proposed bills or enacted laws would impact state programs and services serving Rhode Island’s growing older population.

After reviewing the latest U.S. Census Data, it becomes very clear that the state’s aging population continues to grow.  For more than twenty-five years, I have tracked and continue to follow the graying of Rhode Island’s population.  Through more than 50 articles published in 2025 in Blackstone Valley Call & times and its sister publications, RINewstoday, Senior Digest and other statewide outlets, these stories have decoded complicated public policy debates, and demographic trends to shed light as to how they affect the daily lives of older adults, their caregivers, and nonprofit organizations that serve them.   

Some might interpret my weekly reporting as a way that specifically looks at older adults as one group of people.  However, others might see them on how aging impacts our own family members and our neighbors, and how we all deal with real-life challenges as we get older.

 Themes from Past Year’s Coverage

 Over the past year, several themes have become clear:  the economics of growing older and financially surviving retirement; staying safe from increasing sophisticated scams, public health issues surrounding loneliness and food insecurity; limited public transportation, finding a primary care physician, and managing multiple chronic illnesses.  Many of these commentaries also looked closely at state and federal policies that led to cuts in Medicare and Medicaid; the pressure points placed on Rhode Island’s safety net; and the ongoing policy questions the Rhode Island General Assembly is asking about how to help older adults stay independent at home—not just to live  longer, but live better.

You learn very quickly that national policy debates don’t go the same way here,, if you’ve lived in the Ocean State for a while.  A change in federal requirements of the Supplemental Nutrition Assistance Program (SNAP) or changing eligibility requirements and cuts to Medicaid funding are not distant Washington stories reported by the Washington Post or New York Times especially if they affect food, meal deliveries and health care provided in Providence, Pawtucket, Woonsocket, or Westerly. A change in Medicare drug pricing is not an abstract concept if it determines whether your older neighbor can fill a lifesaving prescription—or whether your spouse’s non-drug compliance stretches pills just to make them last.

 Many of these articles were tied to timely triggers—AARP reports detailing findings of national surveys and polls, a Senate Aging Committee or Congressional hearing putting a spotlight on an aging issue, a proposed legislative proposal being considered by Congress or the Rhode Island General Assembly. But the reporting doesn’t just give a concise summary of a policy issue. The point of these commentaries is to shed light on the issues by asking: “So what does this mean for older Rhode Islanders?” Where are the funding gaps?”  “Who is being left out?  “What can be done now while larger reforms slowly grind their way forward, only to be enacted years later?”

 Many of the commentaries published this year focused on out-of- pocket costs that increase with one’s aging —especially skyrocketing medical expenses. Even when Medicare covers a significant portion of one’s care, many older adults still face overwhelming costs, from premiums and co-pays to dental and vision needs, to uncovered services and especially costly prescription drugs and nursing home care.  The reporting also examined pending questions about Medicare’s financial future, including whether the program will be able to pay beneficiaries full benefits beyond 2033, or face potential benefit cuts.  Even the Washington, DC-based National Committee to Preserve Social Security and Medicare’s call for expanding the retirement program, along with raising the cap to enable Social Security to pay its bills made it into these commentaries.

 Another common theme in this year’s published commentaries is the recognition that aging affects not only our bodies and wallets, but also our emotions and relationships as well. The past year’s reporting on the role of loneliness and isolation serves as a reminder of how harmful they can be, especially when they lead to worse health outcomes.  In these writings, the goal is not to romanticize “community” but to show how social connection and networks in a “community” can be a good way to improve one’s health.

 The commentaries on loneliness do not regard the negative emotional response as a personal deficiency but rather as a significant policy concern influenced by the persistent scarcity of affordable housing, inadequate public transportation, mobility limitations, the loss of spouses and friends, and communities designed around the use of cars rather than their pedestrian walkability or accessibility.  How we view this matters because it is the framing that shifts the discussion away from “Why don’t older adults get out more?” to “What community barriers make connections harder to make—and what public supports are needed to make community connections possible?”

 Taking a New Look at Being Age-Friendly

The commentary on “age-friendly” thinking shows how Rhode Island’s 39 cities and towns can change their programs, services, and public spaces to keep older adults engaged in their community instead of primarily isolated. The announcement that the City of Pawtucket had joined Newport, Cranston, Providence, Westerly, and Bristol to become one of Rhode Island’s Age-Friendly Network Communities is an example.  We hope to report on more communities doing the same.

Over the past year, coverage of food insecurity, and a profile on the Meals on Wheels of Rhode Island, have helped to answer bigger policy questions:  What happens when demand goes up but and payments don’t? How do people get on waiting lists?  “What does “service disruption” mean for someone living at home? And how much does it cost—both in money and in people, when these programs have to be cut back?

One of the most important things we’ve reported on this year is consumer protection, especially when it comes to scams that target older people, because they are often the ones that more easily fall for scams because they have savings and are concerned about them, aren’t as familiar with digital manipulation, or have cognitive impairment.  There are many reasons why this topic is important right now, especially with new technology being used to spread scams.  And the Rhode Island General Assembly has been quick to act.  One commentary informed readers that Rhode Island has passed a new law to crack down on Crypto ATM fraud, making it the 12th state to do so.

 The best reporting on scams doesn’t just explain the tricks and why people fall for them – it also keeps the reader updated as to how scams keep changing.  Plus, it gives you practical tips as to how to avoid them, like pausing before you respond, double-checking what you’re told, and turning to someone you trust if something feels off, verifying, and seeking trusted help before acting. I wrote about these tips in great detail.

These consumer protection commentaries didn’t blame the victims, rather by framing scams as a systemic program caused by new technology and weak verification standards. And it makes this point clear.  Scams are not just seen as financial crimes; they can also cause shame, isolation, and stress that can harm your health.

 Caregiving is also another common topic in this year’s published commentaries. Aging advocates will tell you that caregivers are the hidden backbone of providing care to those in need.  They will tell you that family members, friends, and neighbors help out in ways that would otherwise need paid services or institutional care.  An AARP report says that about 121,000 in Rhode Islanders provided unpaid care to others in 2021 – estimated to be valued monetarily at over $2.1 billion.

 These commentaries on caregiving don’t talk about it in terms of sentiment, but in terms of policy, taking a look at time costs, impact on jobs, burnout, and the lack of enough respite support. The reporting also helps to shed light on common caregiver stress, and that needing help is not a personal failure but a normal result of  demographics and underfunded state programs and services.

When National Policy Hits Close to Home

In Rhode Island, where community-based services are important  to “aging in place,” the weekly coverage has helped readers to understand the whole long-term care continuum—from home care to day care to senior centers to assisted living to nursing home care, if needed.

 At best, access to health care is uneven; transportation is a barrier to many; affordable, accessible housing is limited; and the Medicaid-funded workforce that helps people stay at home is overworked and underpaid.  Older adults are dealing with rising costs for food, utilities, and rent or home upkeep, as well as the effects of inflation.

 Although many of this year’s commentaries put the spotlight on policy issues that need to be fixed, they also provide state policy makers ideas to solve these issues.  These are advocacy groups age-friendly planning; stronger protections for consumers; smarter use of technology; and increased state funding that treats community-based supports as cost-effective interventions rather than optional add-ons.