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.

Social Security 2025 COLA expected to be small increase 

Published in RINewsToday on September 16, 2024

Stay tuned… Next year’s cost-of-living adjustment (COLA) will be announced by the Social Security Administration (SSA) in mid-October, upon the release of September’s annual inflation adjustment data.  SSA’s COLA for 2025 will be reflected in beneficiary checks starting in January of that year. Like clockwork, this happens annually, although beneficiaries may see their payments occasionally arrive a few days early due to holidays or weekends. 

The Senior Citizen’s League (TSCL) releases its COLA projections each month. The official COLA is determined by the Labor Bureau’s revised CPI-W data from July, August and September.

Some say SSA’s 2025 COLA is “Chump Change”

With one month left, TSCL’s latest COLA model results, released on Sept. 11, 2024, predicts that next year’s COLA will be 2.5 % based on a decline from 2.9% to 2.5% in consumer price data. While 2.5% is lower than the 3.2% received in 2024, that wouldn’t be far from the historical norm. The COLA has averaged about 2.6% over the past 20 years. It went as low as 0.0% in 2010, 2011, and 2016 and as high as 8.7% in 2023.

According to TSCL, by law, the annual inflation adjustment is based on the average inflation during July, August, and September as measured by the Consumer Price Index for Urban Wage Earners and Clerical Workers (CPI-W). The Bureau of Labor Statistics averages the CPI-W for these three months and then compares it with the same timeframe from the previous year, says the Alexandria-based nonprofit advocacy group whose mission is to protect Social Security, Medicare, and veteran or military retiree benefits.  

TSCL’s COLA latest analysis findings indicates that next year’s COLA of 2.5% would raise the average monthly benefit for retired workers of $1,920 by $48 or about $564 annually. The modest increase will not enable seniors to cover increasing cost of living expenses (including food, clothing, transportation, energy, and shelter costs).  “Rising grocery prices is creating food insecurity for many retireesFeeding America estimated that 5.5 million Americans age 60 and above suffered from food insecurity in 2021, in the most recent study available on the subject, and that number is likely higher today,” note the researchers.

“Due to a higher cost of living, older Americans are using more and more of their income each month just to get by compared to a year ago. “Sixty-five percent of seniors reported monthly expenses of at least $2,000, up from 55% in 2023,” says TSCL’s COLA analysis, noting that statistical testing shows that there’s almost no chance that this gap is due to noisy survey variation. (The 2024 survey had 2,129 respondents; 2023 had 2,258 respondents.)

But low-income seniors aren’t the only ones who have seen their expenses rise, either, say the researchers, noting that more seniors are spending at least $4,000 or $6,000 per month compared to 2023, too, while fewer are able to get by on $1,000 or less. TSCL says that a rise in monthly expenses wouldn’t be much of an issue if seniors’ higher expenses were going to fun activities things, like activities with their grandchildren, or discretionary costs, like bucket-list vacations. However, this is not the case, says the Social Security advocacy group.  “Nearly 80% of senior households in the 2024 survey reported that their monthly budget for essential items like food, housing, and prescription drugs had increased over the last 12 months, with 63% saying they’re worried that their income won’t be enough to cover these basic costs in the coming months,” says the analysis findings.

Over the years, TSCL, along with other aging advocacy groups including the National Committee to Protect Social Security (NCPSSM) and Social Security Works, have called for higher COLAs.

Calls for Congress to change current COLA formula.

Last March, in correspondence to Sen. Bob Casey, Jr. (D-PA), chairman of the U.S. Senate Special Committee on Aging, NCPSSM, the Washington DC based Social Security advocacy group endorsed Casey’s legislative proposal, S. 3974, entitled the “Boosting Benefits and COLAs for Seniors Act.”  The proposal has been referred to the Senate Finance Committee.

Specifically, Casey’s legislative proposal, introduced March 19, 2024, would direct SSA to adjust benefits based on CPI-E rather than CPI-W, if CPI-E would result in a larger increase in benefits. The Bureau of Labor Statistics  (BLS) would calculate and publish the CPI-E on a monthly basis. The Senator believes it would be the most accurate measure of the real effect of inflation on the goods and services that are purchased by America’s seniors.

In NCPSSM’s correspondence, CEO and President Max Richtman strongly supported Casey’s call for requiring BLS to change the way it calculates SSA’s annual COLAs, using a CPI-E formula.

According to Richtman, SSA’s current formula for calculating COLAs is based upon the Consumer Price Index for Urban Wage Earners and Clerical Workers (CPI-W), which is a measurement by the BLS of the changes in the prices paid for a market basket of goods and services purchased by urban wage earners and clerical workers.

“The current CPI-W has fallen far short of providing needed inflation protection because it fails to adequately measure the spending patterns of seniors,” says Richtman in his endorsement of Seniors typically spend more on out-of-pocket health care costs than other Americans, and in most years, the cost of health care rises more quickly than general inflation,” he says. “We believe adoption of your bill would go a long way toward protecting those on fixed incomes from the ravages of inflation,” says Richtman.

The following organizations have endorsed S. 3974: Arc of the United States; Alliance for Retired Americans; American Federation of Government Employees; American Federation of State, County and Municipal Employees; California Alliance for Retired Americans; Justice in Aging; National Committee to Preserve Social Security and Medicare; National Education Association; National Organization of Social Security Claimants Representatives; Social Security Works; Strengthen Social Security Coalition.

While former President Donald Trump and Vice-President Kamala Harris have both pledged to protect Social Security, nether have put out a specific plan to keep America’s retirement program solvent.

According to the last Social Security Trustees report, the Social Security Old-Age and Survivors Insurance  trust fund is projected to be depleted by 2033 at which point SSA will be forced to make a 21 percent across the board reduction.  The nonpartisan Committee for a Responsible Federal Budget estimates that this would be a $16, 500 cut in annual benefits for a typical dual-income couple retiring at the time of trust fund depletion. 

When the dust settles after the upcoming presidential election, the new president must make it a priority to hammer out a bipartisan fix along with pushing for requiring BLS to use the CPI-E Formula to accurately predict the impact of inflation on America’s retirees.