Tag Archives for House Ways and Means Committee

Medicare Enrolled will see Lower Costs on Select Drugs in 2026

Published in Blackstone Valley Call & Times on December 2, 2025

With Medicare Open Enrollment ending next week, the Centers for Medicare & Medicaid Services (CMS) has announced that last year’s Medicare negotiations produced a net savings of 44%—about $12 billion—on 15 widely used prescription drugs that treat cancer and other serious chronic conditions.

The new Maximum Fair Prices (MFPs) for these 15 drugs will take effect on January 1, 2027. Combined with the 10 drugs already negotiated—whose MFPs take effect January 1, 2026—a total of 25 drugs will have negotiated lower prices. These medications, used to treat conditions such as cancer, diabetes, asthma, and cardiovascular and neurological disorders, represent some of the highest Medicare Part D spending.

The Beginning of Drug Price Negotiations

Three years ago, after President Biden signed the Inflation Reduction Act (IRA) in August 2022, CMS began developing the process for Medicare’s first-ever drug price negotiations. On March 15, 2023, the federal agency issued its initial program guidance and received more than 7,500 public comments from consumer groups, patient advocates, drug manufacturers, and pharmacies. Revised guidance followed on June 30, 2023.

On August 29, 2023, CMS released the first list of 10 high-cost drugs selected for negotiation—marking the first time in Medicare’s history that it could negotiate directly with pharmaceutical companies.

Pharmaceutical industry groups and several companies attempted to block the law in court. In response, 70 organizations and 150,000 petition signers urged Merck, Bristol Myers Squibb, Janssen Pharmaceuticals, Astellas Pharma US, the Pharmaceutical Research and Manufacturers of America (PhRMA), and the U.S. Chamber of Commerce to drop their lawsuits. Multiple organizations also filed amicus briefs supporting the law.

Three years in process, and with courts ultimately allowing the program to proceed, that first round of 10 drugs with negotiated prices will take effect in 2026.

CMS Drug Negotiations Added 15 Drugs

On January 17th, CMS announced it had selected 15 additional drugs for the second cycle of negotiations under Medicare Part D and on November 25th, it was announced that agreements had been reached on all of them. These medications are among the most costly and most commonly used by Medicare beneficiaries, treating conditions such as cancer, diabetes, and asthma. The new round of negotiations is expected to save Medicare billions and strengthen the program’s long-term sustainability.

“This year’s results stand in stark contrast to last year’s,” said CMS Administrator Mehmet Oz, MD, in announcing the second cycle of negotiations.  “Using the same process with a bolder direction, we have achieved substantially better outcomes for taxpayers and seniors in the Medicare Part D program — not the modest or even counterproductive ‘deals’ we saw before.”

“Whether through the Inflation Reduction Act or President Trump’s Most Favored Nation policy, this is what serious, fair, and disciplined negotiation looks like,” adds CMS Deputy Administrator and Medicare Director Chris Klomp. “I’m deeply proud of our team, who execute exceptionally well to bring affordability to the country in everything we do.”

Between January 1 and December 31, 2024, approximately 5.3 million Medicare Part D enrollees used one or more of these 15 drugs. Total gross Part D spending for them was $42.5 billion, representing about 15% of all Part D drug costs.

Anthony Wright, executive director of Families USA, praised the newly released negotiated prices, stating that they show what is possible when “policymakers put patients before corporate profits.” Wright emphasized that these reductions build on the work of establishing the Drug Price Negotiation Program, which aims to provide financial relief to older adults and people with disabilities.

Wright noted that the first and second rounds of negotiated drugs together account for about one-third of Medicare Part D spending, with price reductions ranging from 38% to 85%. In 2027, beneficiaries using these drugs are projected to save $685 million in out-of-pocket costs. He added that the savings support both individual beneficiaries and the long-term sustainability of the Medicare program.

Despite pharmaceutical companies’ continued attempts to limit the program—through lawsuits and legislative provisions such as those in H.R. 1—Wright said the negotiation program remains “the most effective tool currently available to lower drug prices.”

“The Medicare Negotiation Program changed the trajectory of drug pricing in the United States, helping to reduce Big Pharma’s monopoly pricing power, which dictated prices to Americans on Medicare for two decades,” said Merith Basey, executive director of Patients for Affordable Drugs in a statement. “This second round of negotiations — now under President Trump — marks another major milestone, delivering continued savings for patients and taxpayers,” he said.

“The lower negotiated prices are more than numbers on a page. For patients who’ve been forced to work multiple jobs, cut pills in half, or choose between filling a prescription and buying groceries, these lower prices will bring long-overdue relief, flexibility, and stability,” added Basey.

“The requirement that Medicare negotiate lower prices for prescription drugs continues to pay dividends for older Americans and taxpayers,” adds Richard Fiesta, executive director of the Alliance for Retired Americans. “The announcement of lower drug prices for 15 high-priced drugs is a win for more than 5 million seniors who take these drugs to treat asthma, diabetes, lung disease and other serious conditions, and will soon pay less for their medications,” he says.

“The 4.4 million members of the Alliance are pleased that the Trump Administration has followed the law, negotiated these prices, and defended this law in court,” Fiesta says, calling on Congress to increase the number of drugs subject to price negotiations.

While the White House along with aging groups praise the impact of IRA’s Medicare drug negotiation provisions, the Pharmaceutical Research and Manufacturers of America (PhRMA) issued a statement calling it “flawed.”

“Whether it is the IRA or MFN, government price setting for medicines is the wrong policy for America. Price setting does nothing to rein in PBMs who decide which medicines are covered and what patients pay. In fact, many patients are facing additional coverage barriers and paying more out-of-pocket for medicines because of the IRA, warns Alex Schriver, Senior Vice President of Public Affairs.

“These flawed policies also threaten future medical innovation by siphoning $300 billion from biopharmaceutical research, undermining the American economy and our ability to compete globally,” states Schriver, noting that PhRMA members are stepping up to make medicines more affordable by enabling direct purchase at lower prices and investing in U.S. manufacturing and infrastructure.

Lower Drug Cost Legislation Introduced

Congressman John B. Larson (D-CT), a senior member of the House Ways and Means Committee, praised the latest CMS announcement, estimating that both negotiation rounds will save older Americans more than $2 billion per year in out-of-pocket costs. Larson noted that families and seniors continue to struggle with rising prices, especially for prescription drugs.  The lawmaker pushed to enable Medicare to negotiate drug prices to lower drug costs by the enactment of IRA.

Last week, House Democrats introduced the Lower Drug Costs for American Families Act, aimed at closing loopholes in H.R. 1 and further reducing prescription drug prices. The bill (H.R. 6166), introduced November 20 by Ranking Members Frank Pallone Jr. (Energy and Commerce), Richard Neal (Ways and Means), and Bobby Scott (Education and Workforce), has been referred to all three committees.

Key provisions of the bill would:

  • Extend Medicare’s price negotiation authority to all Americans with private insurance—covering more than 164 million people with employer-sponsored plans and over 24 million enrolled in Affordable Care Act plans
  • Apply inflation-based rebate protections to private insurance markets, potentially saving $40 billion over 10 years
  • Increase the number of negotiated drugs from 20 to 50 per year
  • Extend the $2,000 annual out-of-pocket prescription drug cap to privately insured patients
  • Cap insulin costs at $35 per month for those with private insurance
  • Close the orphan-drug loophole that allows companies to avoid negotiation
  • Require consideration of international drug prices to ensure Americans do not pay three to five times more than patients in other countries

Continue the Momentum

According to CMS, the agency will announce the specifics on 15 drugs for the third round of Medicare price negotiations by February 1, 2026. This new round will include drugs paid under Medicare Part B for the first time and will begin with negotiated prices effective January 1, 2028. CMS has already released final guidance for the program and will also use this process to select drugs for renegotiation in previous cycles. IRA also establishes an ongoing process where more drugs will be selected for negotiation in subsequent years.

A Dec. 2024 AARP survey found that almost 3 in 5 adults age 50 and older expressed concern about their ability to afford prescriptions over the near future.  Respondents included both Medicare beneficiaries and younger persons. About 96 percent of the respondents call on the government to do more to lower pharmaceutical prices.

AARP noted that this survey was taken right before a new $2,000 cap on out-of-pocket drug expenses took effect in 2025.

With the announcement of lower drug costs that result from Medicare’s round 2 drug negotiations, there is an  opportunity to build on this momentum for real change. Lawmakers can legislate to put the public’s health above profit by giving consumers more power to negotiate, making competition stronger, and keeping patients from having to pay too much out of pocket.

It is now time for Congress to act.

Will Social Security survive the midterms?

Published in RINewsToday on October 31, 2022

With the midterm elections just a week away, the sputtering economy and inflation top the public’s agenda. If voters hold President Joe Biden and Democratic lawmakers accountable for these concerns, voting for Republican candidates might just give control of Congress to the GOP.  By controlling the legislative agenda of both chambers, the GOP could drastically impact the future of Social Security and Medicare, warns the Washington, DC-based Center for American Progress (CAP), a public policy research and advocacy organization.   

House Minority leader Kevin McCarthy (R-CA) signaled on Oct. 18 during a Punchbowl News interview that the GOP would use next year’s debt limit threat as a bargaining chip to force spending cuts to entitlement programs including Social Security and Medicare, warns CAP, sounding the alarm in an Oct. 21st website article.

CAP’s article reported that McCarthy’s statement reveals how he might use the upcoming debt-limit debates next Congress to make cuts in entitlement programs if he takes control of the House’s legislative agenda next Congress. “You can’t just continue down the path to keep spending and adding to the debt.  And if people want to make a debt ceiling {for a longer period of time}, just like anything else, there comes a point in time where, okay, we’ll provide you more money, but you got to change your current behavior.” When pressed on whether the GOP would seek cuts to entitlement programs in a debt ceiling fight, the House Minority Leader refused to take Social Security and Medicare cuts off the table, saying “he wouldn’t predetermine anything,” he said.

Over the past ten months some Republican lawmakers have transparently outlined their plans to change the entitlement programs, noted CAP, detailing these examples:  

Nearly 75% called for slashing and privatizing Social Security, raising the retirement age to 70, and ending Medicare as we know it as part of the Republican Study Committee FY 2023 budget, says CAP.  

According to CAP, statements made by two Republican Senators might gain traction in a GOP controlled Congress.  Specifically, Rick Scott (R-FL), Chair of the National Republican Senatorial Campaign Committee, might gain support for his “Rescue America” plan, that would sunset Social Security and Medicare after five years, and recreate it every five years.

Over four months ago, Senator Lindsey Graham (R-SC), a key Republican on the Senate Budget Committee, promised “entitlement reform is a must for us to not become Greece” if the Republicans control the upper chamber,” noted CAP. 

CAP also noted that Republican Senate and House candidates in hotly contested races also called for changes to Social Security and Medicare and prescription drug reforms that lower drug costs for seniors. 

Added CAP, “Forty seven percent of Republican candidates for U.S. House running in toss-up districts, according to the Cook Political Report, actively support ending Social Security or Medicare as we know it.”

House and Senate Republicans are calling for the repeal of the recently enacted Medicare drug reforms. “In a Sept. 2022 story in Axios, several House Republicans called for repealing the prescription drug reforms included in the [recently enacted] Inflation Reduction Act.  Rep. Kevin Brady (R-TX), the ranking member of the powerful House Ways and Means Committee, saying, “I would image that will be a top priority for Republicans in the new [Congress],” says CAP.

Even before the dust settles after the upcoming midterm elections, Republican Senators have sponsored legislation to eliminate Medicare prescription reforms, says CAP.  “Senate Republicans Marco Rubio (R-FL), Mike Lee (R-UT), Cynthia Lummis (R-WY), and James Lankford (R_OK) have sponsored legislation to repeal the Inflation Reduction Act’s prescription drug provisions, including the creation of a $2,000 out-of-pock cap on prescription drug spending for Medicare Beneficiaries; a crackdown on drug companies that increase drug prices in the Medicare program faster than inflation; and empowering Medicare to negotiate for lower prescription drug prices,” notes the web article.  

Can Rhode Island’s new congressman stand up to House GOP leadership?

Throughout the CD2 campaign, RI General Treasurer Seth Magaziner has tried to tie former Mayor Allan Fung to the GOP agenda to cut Social Security and Medicare.  Fung has called his Democratic opponent “a liar,” stating that his own mother relies on her Social Security check. During his debates, the GOP candidate says,  “Do you think I would ever do anything to hurt my own mother?” he says.

Fung calls for bipartisan support to strengthen Social Security – like “Scrapping the Cap” that will tax persons at higher incomes, and for the expansion of coverage for dental work, vision care, and hearing aids.  

Fung also distances himself from the far-right Republicans by consistently saying he has a long history of being a political moderate and taking a balanced approach and working across the aisle to get things done. He pledges to co-sponsor bipartisan legislation.

While Fung stays razor focused on tying Magaziner, President Biden and Congressional Democrats to causing high inflation rates and a sputtering economy, Magaziner says don’t forget about Social Security and Medicare.

In an interview with Politico Fung said, “I’ve always been that middle-of-the-road, common sense-type person. They’re talking like, ‘Oh, there’s this radical Republican.’ That’s not me.”

Politico continues, “Fung is among a small cadre of centrists looking to revive the mantle of New England Republican in the House. They’re largely running away from Trump and social conservatism, hitting their Democratic opponents on record-high prices and betting that inflation worries over everything from home heating oil to fertilizer will resonate in the region’s mix of tiny blue-collar cities, wealthy suburbs and family farms.”

Fung talks frequently about his intent, if elected to be involved in the “Problem Solvers Caucus”,  an independent member-driven group in Congress, comprised of representatives from across the country – equally divided between Democrats and Republicans – committed to finding common ground on many of the key issues facing the nation. He hopes to have a leadership role in this group, bringing a more moderate Republican influence to Congress.

As a moderate freshman congressman, can Fung be a strong voice to the GOP leadership against any proposal that would make cuts to Social Security and Medicare?  As a moderate freshman congressman, can Magaziner be a strong voice to the Democratic leadership?

It’s clear that after a Congressman (Langevin) with considerable years of clout in congress, both candidates will have a path in front of them to create their own influence and strength.

A Sacred Trust – moves to strengthen Social Security

Published on November 8, 2021 in RINewsToday

Almost two weeks ago, House Ways and Means Social Security Subcommittee Chairperson John B. Larson (D-Conn.) threw H.R. 5723, the Social Security 2100: A Sacred Trust, into the legislative hopper. During its unveiling in the historic committee room of the House Ways and Means Social Security subcommittee, the same room where Social Security and Medicare legislation was crafted in the 1930s and 1960, the Connecticut Congressman’s proposal comes on the heels of the Social Security Administration’s 2021 estimate that the trust funds that support the program will be depleted in just 13 years, averting an estimated 20 percent cut in benefits by 2034.

The Sacred Trust Act is the successor to Larson’s original Social Security 2100 Act, which he first introduced in 2014.The House Ways and Means Committee is planning to hold a hearing on the bill in Nov. followed by a markup.

At press time, 194 House Democratic Members are cosponsoring the 100-page House Democratic proposal with no Republican lawmakers crossing the aisle. Almost 40 advocacy groups are endorsing the House Democratic proposal.

At the Oct. 26 news conference unveiling Larson’s legislative proposal, the Connecticut congressman noted that Congress expanded Social Security during the past 50 years and it has been 38 years since lawmakers have taken any comprehensive action to strengthen the program.“ With 10,000 Baby Boomers a day becoming eligible, and with millennials needing Social Security more than any generation, the time for Congress to act is now,” he said.

Taking a Close look at H.R. 5723

According to the legislative fact sheet released at the news conference, H.R. 5723 gives a benefit bump for current and new Social Security beneficiaries. It provides an increase for all beneficiaries (receiving retirement, disability or dependent benefits) equivalent to an average of 2% of benefits to make up for inadequate Cost-of-Living Adjustments (COLA) since 1983.

Larson’s Social Security proposal also protects Social Security beneficiaries against inflation. It improves the annual COLA formula by adopting a Consumer Price Index for the Elderly (CPI-E), to better reflect the costs incurred by seniors who spend a greater portion of their income on health care and other necessities. Although the 2022 COLA 5.9%, the largest in years, the average for the past 10 years is roughly 1.5% and in 3 of the past 12 years, beneficiaries received no COLA at all.

It protects low-income works that provides a new minimum benefit stet at 25% above the poverty line and would be tied to wage levels to ensure that minimum benefits doe not fall behind. Currently, 5 million seniors live in poverty.

The Sacred Trust Act also contains other provisions that seniors and their advocates have sought for years, including:

  • Improving Social Security benefits for widows and widowers in two income households so they are  not penalized for having two incomes.
  • Ending five-month waiting period to receive disability benefits so those with ALS or other severe disabilities no longer have to wait.
  • Providing caregiver credits for Social Security wages to ensure that caregivers are not penalized in retirement for taking timeout of the workforce to care for children and other dependents.
  • Extending Social Security benefits for students to age 26 and for part-time students.
  • Increasing access to Social Security dependents for children who live with grandparents or other relatives.
  • Requiring Social Security Administration (SSA) to mail annual statements to all workers detailing the FICA contributions they make and projects of their benefits in the future. 
  • Preventing unwarranted closures of SSA offices to improve customer serve
  • Improving access to legal representation for people seeking long-term disability benefits.

H.R. 5723 would pay for strengthening the Social Security Trust Fund by having millionaires and billionaires pay the same rate as everyone else.Currently, payroll taxes are not collected on an individual wages over $142,800.The legislative proposal would apply payroll taxes to wages above $400,00.This provision would only impact the top 0.04% of wage earners.

Larson’s proposal would also extend the solvency of Social Security by making a significant contribution to the programs solvency, making up more than half of the shortfall in the Social Security Trust Funds.

Finally, H.R. 5723 would combine the Old-Age and Survivors Insurance with Disability Insurance into one Social Security Trust Fund, to ensure all benefits will be paid.

It’s Now Time to Fix Social Security 

Larson’s Social Security proposal would “take historic steps to expand Social Security — delivering for retirees, people with disabilities, and their families the first real boost in benefits in 50 years.  The Sacred Trust Act also would bring new revenue into Social Security amid projections that the trust fund will run dry in 2034 if Congress doesn’t take action,” says Max Richtman, President and CEO of the Washington, DC-based National Committee to Preserve Social Security and Medicare.

“To those who claim that no one in Washington has the courage to address Social Security’s challenges, or that the only solution is to cut benefits for future generations, Congressman Larson’s bill is a stunning refutation,” states Richtman, noting that he understands that beneficiaries need an increase in monthly checks to meet skyrocketing living expenses. “He knows that the fairest way to strengthen Social Security’s finances is for the wealthy to begin paying their fair share of payroll contributions.  For years, seniors and their advocates have demanded these improvements,” adds Richtman.   

“There is good news for everyone in this bill, which is only fitting, since Social Security touches almost every American’s life.  Beneficiaries have waited long enough for these vital improvements.  Congressman Larson now has nearly 200 cosponsorsin the House.  After seven long years, seniors and their advocates can finally see the finish line, says Richtman.  

With the Democrats controlling the White House, seniors have a good chance of seeing the expansion and strengthening of Social Security.  The proposal has many of President Biden’s promises made during his campaign.  But, like Larson’s previous Social Security Bill, the latest version has no Republican cosigners.

Over the years, poll after poll has shown that the American public strongly supports Social Security, across party and demographic lines.  Larson’s legislative proposal has the support in the House, but will it pass in the upper chamber with Senate Democrats holding a slim majority?  Will voter support influence Republican lawmakers to work across the aisle with Democrats to hammer out an acceptable bipartisan  proposal, as the 2022 mid-term elections get closer?  We’ll just have to wait and see.