Tag Archives for John B. Larson

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.

A call to Congress to strengthen, expand Social Security & Medicare 

Published in Rhode Island News Today on September 6, 2021

The 2021 Annual Report of the Board of Trustees of the Federal Old-Age and Survivors Insurance (OASI)) and the Social Security Disability trust fund (SSDI), released last week, gives Congress this stark warning: the Social Security Trust fund is heading toward insolvency in 13 years while SSDI will see its reserve funds depleted in 2057, eight years sooner than last year’s estimate. As a whole, combined, the two Social Security trust fund reserves will be depleted in 2034, a year earlier than estimated made in last year’s Trustee report.

However, there is good news. This year’s report notes that there is more than enough time for lawmakers to make up shortfalls by immediately shoring up the ailing Social Security Old-Age and Survivors Insurance (OASI) trust fund and the Social Security Disability trust fund (SSDI) by Congress increasing revenues or cutting costs to these programs.

“The theoretical combined trust funds will exhaust their reserves by 2034, when today’s 54-year-olds reach the full retirement age and today’s youngest retirees turn 75. Upon insolvency, all beneficiaries will face a 22% across-the-board benefit cut,” says a detailed analysis released by the Washington, DC-based Committee for a Responsible Federal Budget (CRFB), a non-partisan, nonprofit organization committee that addresses federal budget and fiscal issues.

According to this year’s Medicare Trustee’s report, there was no change from last year’s projections that noted Medicare Hospital Insurance trust funds would be deleted in 2026. If this occurs, physicians, acute care facilities and nursing homes would not receive their full compensation of the program (only 91% of scheduled payments), pushing the uncompensated costs on the patients to pay.

Total Medicare expenditures are projected to increase in the future at a faster pace than both total workers’ earnings and the overall economy, says the newly released Medicare Trustee report.

In light of the projected insolvency of Social Security, this year’s Trustee’s report notes that beneficiaries may receive an estimated 3.1% cost-of-living adjustment (COLA) for benefits in 2021, the highest COLA in a decade. This large increase was triggered by higher inflation rates caused by the ongoing pandemic.

Beltway Insiders Respond

“The Trustees’ projections in this year’s report include the best estimates of the effects of the COVID-19 pandemic on the Social Security program,” said Kilolo Kijakazi, Acting Commissioner of Social Security. “The pandemic and its economic impact have had an effect on Social Security’s Trust Funds, and the future course of the pandemic is still uncertain. Yet, Social Security will continue to play a critical role in the lives of 65 million beneficiaries and 176 million workers and their families during 2021.”

“The Trustees Report confirms that Social Security’s financing is strong in the near-term yet underscores why it is so important that Congress take action now to prevent 22% in cuts across the board on all benefits in 2034,” says House Ways and Means Social Security Subcommittee Chairman John B. Larson (D-CT) in a released statement. “With the loss of traditional pensions, rising health care costs, and many people unable to save enough for retirement, there is a growing retirement crisis. 65 million Americans currently rely on Social Security benefits, yet millions are suffering and can’t make ends meet, adds Larson.

Furthermore, the Trustees Report shows that this year the cost of paying out benefits will exceed the income from the Federal Insurance Contribution Act (FICA) payments,” states Larson.

The released 2021Trustee reports on the financial solvency of Medicare and Social Security trust funds once again identify unsustainable benefit promises in Medicare and Social Security programs, stated senator Mike Crapo (R-Idaho) said in a released statement.

 “The Hospital Insurance trust fund [Medicare] is projected to be exhausted around 2026; there are $60 trillion of unfunded liabilities in Social Security programs; and unfunded liabilities increased by trillions of dollars over the last year alone,” adds Crapo.

Crapo urges Congress and the White House to “work closely together with a sense of urgency to address the challenges detailed in the Social Security and Medicare Trustees Reports. However, “most Democrats want only to expand benefit promises further without generating sustainable trust fund solvency,” he said.

Seniors Depend on Social Security on Most of Their Income

“There is no need to sound the alarm, but now is the time to address Social Security’s long-term solvency – and provide an overdue boost in benefits. Phone calls and emails to Congress are definitely warranted at this critical juncture,” says Max Richtman, President and CEO of the Washington, DC-based National Committee to Preserve Social Security and Medicare, responding to the Social Security Trustee Report released August 31.

According to Richtman, Social Security has never missed a benefit payment in its 86-year history, but remains strong. Even if no Congressional action is taken and the Trust fund becomes deleted, Social Security could still pay 79% of the benefits with revenue coming from regular worker’s payroll contributions. “But that poses a huge financial risk for the millions of retirees who depend on Social Security for most if not all of their income.  It also raises a serious political risk for members of Congress who fail to boost the program’s finances so that the trust fund remains solvent beyond 2034,” he says. 

Living on an average monthly benefit of $1,540 is tough to do, says Richtman, as retirement savings dwindle, pensions disappear and the soaring cost of senior housing and medical care.  

Nancy Altman, President of Social Security Works (SSW) and chair of the Strengthen Social Security Coalition, agrees with Richtman’s assessment of Social Security’s fiscal solvency and impact on the retiree’s income. “Today’s report shows that Social Security remains strong and continues to work well, despite the once-in-a-century pandemic. That this year’s projections are so similar to last year’s proves once again that our Social Security system is built to withstand times of crisis, providing a source of certainty in uncertain times,” she says.

“We don’t have a Social Security crisis, but we do have a retirement income crisis — made worse by the pandemic, which, among other economic impacts, forced millions of workers to retire earlier than planned. The solution is to expand Social Security, as President Joe Biden has promised to do,” suggests Altman.

According to SSW, “about one out of two married senior beneficiaries and seven out of 10 unmarried senior beneficiaries and almost one out of tow unmarried beneficiaries rely on Social Security for virtually all their income.”

Mustering the Political Will 

Richtman calls for Congress to closely look at Congressman John Larson (D-CT) legislation to fix and expand the nation’s ailing Social Security program. “For over six years, Congressman John Larson has been driving efforts to strengthen Social Security by adjusting the payroll wage cap so that high income earners begin paying their fair share,” he notes.

Larson has also proposed an across-the-board boost for all retirees, enhanced benefits for the most vulnerable seniors, and a more accurate formula for calculating annual cost-of-living adjustments (COLAs) so that benefits truly keep pace with inflation, says Richtman, noting that the Connecticut Congressman’s  proposals also align with President Biden’s initiatives to strengthen and expand Social Security. 

“Of course, the default response from conservatives will be to suggest, indirectly or otherwise that Social Security benefits must be cut to address the program’s funding shortfall,” states Richtman said. “Some will insist that Social Security be privatized, which would gamble workers’ hard-earned retirement benefits on Wall Street. Meanwhile, conservatives likely will oppose common sense revenue-side measures that would actually boost benefits, including Rep. Larson’s proposed adjustment of the payroll wage cap.”  For Congress to act to advance legislation to strengthen and expand Social Security, voters must put political pressure on their elected officials “to muster the political will to get it done,” says Richtman.

A Final Note…

It’s better to make changes to ensure Social Security’s solvency now, rather than waiting, suggests CRFB, a delay only adds more costs to fixing trust fund shortfalls in a timely fashion.“ Acting now allows more policy options, lets policymakers phase in changes more gradually, and provides more time for workers to adjust their work and savings, if necessary,” the fiscal advocacy group says.

The clock is ticking. There are almost 4,500 days until the project insolvency of the Social Security trust fund. It is now time for Congress to find viable, bipartisan solutions to fixing Social Security and Medicare, once and for all. 

The 276-page 2021 Social Security Trust Fund report is available by going to https://www.ssa.gov/oact/TR/2021/tr2021.pdf.

Let Rhode Island’s Social Security Debate Begin

Published in Woonsocket Call on August 21, 2016

It’s less than 80 days before the upcoming 2016 presidential election. At press time, Social Security has been placed on the backburner as the GOP standard bearer Donald Trump and his Democratic opponent, Hillary Clinton, turn their attention to crime, national security, health care and the economy.

On the sideline, nearly 218,000 Rhode Islanders who collect Social Security benefits, including 155,710 seniors, 37,476 disabled workers, and 17,802 survivors of a deceased spouse or parent, are closely watching one of the nation’s nastiest political campaign unfold. Political insiders and aging groups know that whoever takes over the White House and controls Congress will control in the year’s to come how retiree’s receive their retirement checks.

Putting a Spotlight on Social Security

Earlier this week David N. Cicilline (D-RI) and John B. Larson (D-CT) came to the Rumford Towers in East Providence to put the spotlight on Social Security, both stressing how important it is to keep Social Security solvent through the end of this century. The two Democratic lawmakers called on GOP House Speaker Paul Ryan to move their introduced legislation, “Social Security 2100 Act,” from House Committee to floor vote.

“Social Security is a promise that after a lifetime of hard work, you should be able to retire with dignity, economic security, and peace of mind. It’s critical that Congress act expeditiously to preserve and strengthen this promise for years to come,” said Cicilline to over 80 attendees at the 90 minute event.

Larson noted that Social Security is not an entitlement but benefits that have been earned by hard-working Americans who have paid into the retirement system their whole lives. “Two-thirds of retirees rely on Social Security for the majority of their income, and it is a lifeline for the disabled and those who have lost a loved one,” he said, calling those pushing for Social Security cuts as “fundamentally misguided.”

The Nuts & Bolts

The “Social Security 2100 Act,” introduced by Cicilline and Larson in 2015, expands Social Security benefits, cuts taxes for 11 million seniors, provides stronger cost of living adjustments, and requires millionaires and billionaires to pay their fair share. The legislative proposal also provides an immediate increase equivalent to 2% of the average benefit for all Social Security recipients. This change is projected to yield an annual increase for the typical retiree of $300.

The Democratic lawmakers Social Security fix also improves the annual cost-of-living-adjustment (COLA) formula to reflect the prices of goods and services seniors actually buy – especially housing, health care, and transportation – to ensure that seniors aren’t asked to go without a COLA to protect against inflation. In three of the past seven years, Rhode Island seniors did not receive a COLA as a result of the inadequate formula that is used today.

Finally, the Cicilline-Larson Plan also lifts the cap on payroll taxes for individuals making more than $400,000 each year, requiring the wealthiest 0.4% of Americans to pay the same rate as all other workers. The increased revenue generated as a result will provide a tax cut for 11 million seniors and establish a new minimum benefit so that no one who has worked hard and played by the rules is asked to retire into poverty. Tax relief for Social Security beneficiaries due to an increase in the threshold for taxation of Social Security benefits to $50,000 for individuals and $100,000 for joint filers, up from $25,000 and $32,000 respectively.

While current projections indicate that the Social Security Trust Fund will begin generating annual deficits in 2019 and stop paying out full benefits in 2033, the Cicilline-Larson Plan expands the lifeline of Social Security through the end of this century by gradually phasing in an increase in the contribution rate equivalent to 50 cents per week for the average worker.

NCPSSM Gives Thumbs Up

In an endorsement letter, Max Richtman, President and CEO of the Washington, DC-based National Committee to Preserve Social Security and Medicare (NCPSSM), calls the Cicilline-Larson Plan “a bold step on behalf of seniors and all Americans by strengthening and safeguarding Social Security for future beneficiaries while at the same time making important improvements in the adequacy of the benefits the program provides.”

According to Richtman, the “Social Security 2100 Act” strengthens the retirement programs “financial foundations.” He says: “First, it extends the payroll tax to all wages paid to workers that are in excess of $400,000. Over time, the bill would completely eliminate the cap on Social Security payroll taxes. Second, the “Social Security 2100 Act” implements a small,
gradual increase in workers’ and employers’ contributions to Social Security. Because the increase is phased in over a long period of time, the average worker would see his or her annual contributions to the Social Security program increase by about 50 cents per week.”

In this presidential election cycle, Darrell M. West, Ph.D., Vice President and Director of Governance Studies at the Brookings Institution, sees Democrats making a “big push” to strengthen and expand the Social Security program. “This will not likely happen as long as there is a Republican Congress as many members of the GOP want to cut the future rate of growth of Social Security and increase the retirement age,” he says, predicting that there is a good chance Democrats will get the Senate back.

West adds, “whether the GOP regain control of the House will depend on how big the presidential victory is. If Clinton wins big, she may sweep in enough Democrats to have control of that chamber. In that situation, this legislation has much better prospects. A President Clinton could very well be interested in this proposal and be willing to sign it into law.”

Where’s the Beef?

Political newcomer and GOP challenger H. Russell Taub, calls on Cicilline, his Democratic opponent in the 1st Congressional District race, to not attach new benefits to Social Security, a self-funded program. Taub wonders how new federal expenditures to pay for added Social Security benefits will impact the heavily burdened retirement program.

Taub sees a need to have a “serious public discourse” on the nation’s budget. “When we’ve come to a conclusion lets craft meaningful legislation to get the law to reflect that decision. Let’s not drop flash-in-the-pan, headline grabbing false initiatives just because it’s an election year. Our Constituents in the First District deserve much better than that shabby treatment,” he says.

“AARP Take a Stand volunteers and members of our staff were on hand to listen to what the Congressmen had to say,” said AARP State Director Kathleen Connell. “Having candidates for office outlining their specific plan for making the necessary changes to preserve Social Security is what Take a Stand is all about. We are not at this time endorsing specific proposals, but we are engaging our members to keep asking for substantive answers. We’ve been saying ‘sound bites aren’t good enough.’ The Congressmen, indeed, go beyond a sound bite by presenting this plan in a public venue open to the media. People deserve to know how the plans will affect our families, what it will cost, and how they’ll get it done.

“Doing nothing is not an option.” Connell continued. “Every time the candidates dodge the question, our families pay the price.

If our nation’s leaders don’t act, future retirees stand to lose up to $10,000 a year. And every year our leaders wait and do nothing, finding a solution grows more and more difficult.”

Rhode Island voters are now able to see Cicilline’s fix for strengthening Social Security and expanding its benefits, detailed in his introduced legislative proposal, “Social Security 2100 Act.” GOP challenger Taub must throw in his two cents for strengthening the nation’s retirement program, but give us the details. Do you favor the GOP approach for privatizing Social Security? What is your position on raising the cap on Social Security payroll contributions to address the retirement program’s projected shortfall? Do you support raising the retirement age? What are your thoughts about slowly increasing the payroll contribution rate by 1/20th of one percent over 20 years to strengthen the program’s financial condition? Or even changing the current COLA formula.

While the presidential candidates put the economy, crime, and national security in the spotlight at their rallies, town meetings and speeches, Social Security receives little coverage. Let the serious debate begin in the Ocean State. Hopefully, this act will spread like wild fire across the country.