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.

Speaker Pelosi: Bring Larson’s Social Security proposal to a floor vote 

Published in RINewsToday on September 12, 2022

On the 87th Anniversary of Social Security, the Washington, DC based Social Security Works (SSW) hosted a “Social Security Town Hall Meeting” to get the word out about the importance of passing the Social Security 2100: A Sacred Trust. 

The virtual town hall meeting brought together House lawmakers, aging advocates and beneficiaries to send a strong message to House Democratic leadership to support the markup of Congressman John Larson’s (D-CT) social security proposal to expand and strengthen Social Security and send it to the House floor for a vote.

The town hall participants, including host Nancy Altman, President of Social Security Works, Larson, chair of the Social Security Subcommittee of the House Ways and Means, Congresswoman Pramila Jayapal, Chair of the Congressional Progressive Caucus, Peter Morley, Patient Advocate and co-founder of Health Care Awareness month, and John Blair, who chairs the Community Advisory Board, SPACE in Action, strongly supported quick action and passage of the legislative proposal. Additionally, several members of Congress also pre-recorded videos which were played at the end of the town hall meeting.

Town hall participants used the Aug. 15th virtual town meeting to highlight polls that show Democratic and Republican voters strongly support Democratic proposals to expand Social Security, and to call on House leader Nancy Pelosi to schedule a vote on Larson’s legislative proposal prior to the upcoming mid-term elections.  

Throughout the hour-long internet discussion, they also condemned the recent attacks on Social Security from Senate Republicans. Specifically, Sen Ron Johnson has called for Social Security spending to be considered “discretionary spending” and subject to routine budget negotiations, even though the program is self-funded by workers. Sen. Rick Scott (R-FL), chairing the GOP’s committee to re-take the Senate, also has proposed a plan where Social Security would have to be renewed by Congress every five years. And finally, Sen. Mitt Romney (R-Utah) is pushing for passage of the TRUST Act, which could fast-track legislation to cut Social Security benefits. 

“Social Security has provided our nation with the most comprehensive retirement, disability, and survivors benefits for 87 years,” said Larson. “Democrats are fighting to expand and protect it, yet my Republican colleagues have plans to cut benefits and even end the program as a whole,” he noted.

Larson noted that Congress had not acted in 50 years to enhance benefits. “The American people have made clear they want to protect the program they pay into with each and every paycheck so they can retire with dignity,” he said. “With the COVID-19 pandemic still impacting our country and Republicans revealing their plans to end benefits, there is a fierce urgency to protect and enhance Social Security now. Alongside commemorating 87 years of this program, Congress must pass Social Security 2100: A Sacred Trust to make much needed benefit improvements and ensure this program can serve our nation for years to come. Congress must vote!” he said. 

Congresswomen Rep. Pramila Jayapal (D-WA), chair of the Congressional Caucus Progressive, representing 100 lawmakers made an urgent call for the protection and expansion of Social Security. “It’s not an entitlement program,” she said, stressing that it is an earned benefit.

“The work we have to do to make sure that this earned benefit pays out the dividends that keep up with the requirement and needs of our Social Security benefit is what H. R. 2100 is all about,” she said, pushing Larson’s Social Security legislative proposal.  

Like Larson, Jayapal calls Social Security the most successful antipoverty program in this country.  “It has lifted more than 20 million Americans out of poverty, including one million children and more 16 million older Americans.  It provides a lifeline to over 16 disabled persons.,” she says.

Julian Blair, Chair of the Advisory Board, SPACEs in Action, called for Congress to get behind expanding and protecting Social Security. “Expanding Social Security …will allow us seniors, and many other people who depend on Social Security, to live with a little dignity—a right all of us have earned and should expect to receive from our country,” she said.

 Peter Morley, Patient Advocate & co-founder of Health Care Awareness Month, who is permanently disabled,” urged that Congress overhaul the and expedite the process for patients applying to SSDI and SSI. “They should not have to wait for years. It’s a tragedy and a shame on our country,” he said.

Urgency to Act Now

Four days before SSW’s virtual town meeting, Max Richtman, President and CEO of the National Committee to Preserve Social Security and Medicare (NCPSSM) gave his thoughts as to the need to expand and strengthen Social Security in an opinion piece, “Let’s Honor Social Security’s 87th Anniversary by Strengthening and Expanding it,” published on the digital site, The Hill.

When President Franklin D. Roosevelt signed the Social Security Act of 1935 into law 87 years ago, he didn’t “intend for it to remain frozen in place” but would need to be expanded with the nation’s changing demographics,” says NCPSSM’s Richtman.

“In fact, during the first 40 years of Social Security, Congress expanded the program no less than 15 times – mostly to broaden coverage and increase benefits.  In 1950, Social Security was expanded to cover domestic and agricultural workers.

In 1956, Congress added monthly disability benefits, which is why millions of workers with disabilities collect Social Security today. The 1972 amendments provided annual cost-of-living adjustments  (COLAs) to help beneficiaries keep up with inflation,” states Richtman. 

“Sadly, benefits have not been significantly improved since then. Instead, lawmakers have prioritized keeping the program’s trust fund solvent amidst waves of retiring baby boomers. In 1983, Congress increased the payroll tax and raised the retirement age gradually from 65 to 67, which was, in effect, a benefit cut. It was ‘hard medicine’ that affects retirees four decades later. At the time, Congress had little choice because it waited so long to act that Social Security was just months away from being unable to pay full benefits,” added Richtman in his opinion piece.

Like Larson and Jayapal, Richtman also called for strengthening Social Security and in his opinion, piece, urging passage of the Social Security 2100 Act, that expands Social Security benefits and extends the life of the trust fund. At press time, this legislative proposal has 208 cosponsors in the House. The legislative proposal has not one Republican supporting it and some moderate Democrats still haven’t endorsed it.

Richtman also expressed strong concern about the Republican proposals to cut and privatize Social Security if they take over leadership of the House and Senate Chambers. “When Congress returns from summer recess, Democrats have a limited window to enact the Social Security 2100 Act before the midterm elections and subsequent lame duck session, observes Richtman.

According to Richtman, under Larson’s legislative proposal, all beneficiaries would receive a 2 percent increase in boost in benefits — with special increases for widows and widowers, lower-income workers, and retirees over 85 years of age. Future COLAs would be based on a new inflation formula – the Consumer Price Index for the Elderly –  that more accurately reflects seniors’ spending patterns. 

Richtman says that Larson’s Social Security proposal would increase the flow of tax revenues into Social Security. Currently, he noted that high earners do not contribute to Social Security on wages exceeding $147,000. Under this proposal, wages above $400,000 also would be subject to payroll taxes. 

Overwhelming support for the Social Security’s proposal for passage

With the midterm elections just 57 days away, Congress must move quickly to bring Larson’s Social Security 2200 Act to the House floor for a vote.  Even with President Biden and 208 Democratic House lawmakers calling for a House vote on Social Security 2100 Act, it has been reported that Wendell Primus, House Leader Nancy Pelosi’s senior staffer on domestic policy issues, has advised his boss to pull the Social Security proposal from markup, reportedly over cost concerns, effectively derailing Larson’s efforts to get a House vote on his legislative proposal.

Almost 40 aging groups have joined 208 House lawmakers in advocating for expanding and protecting Social Security benefits received by over 70 million Americans.  Primus must rethink his position opposing House consideration.  If the GOP retains control of the House and Senate chambers, Democrats will not be able for years to improve the financial health and expand Social Security benefits. The GOP will control the House and Senate’s legislative agenda. Congressional Democrats and aging advocacy groups would be put in the defensive position to keep the program that we know so well in existence.

For details about the Social Security 2100 Act, go to https://larson.house.gov/sites/evo-subsites/larson.house.gov/files/Social%20Security%202100%20-%20Fact%20Sheet%20117th.pdf

To watch the livestream event, “Social Security Town Hall Meeting,” go to https://www.youtube.com/watch?v=xycabwQSurI

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