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 is in Crisis: We Must Resist Efforts to Change It

Published in Blackstone Valley Call & Times on August 19, 2025

Security will mark its 90th anniversary. On that date in 1935, President Franklin D. Roosevelt signed the landmark program into law as a safeguard against the “hazards and vicissitudes” of life.

“For a federal program to endure for 90 years and maintain an extremely high level of popularity among the American people is truly extraordinary,” says the National Committee to Preserve Social Security and Medicare (NCPSSM). “It is an achievement that should be celebrated far and wide.”

Yet this milestone comes amid growing political controversy that could shape the program’s future.

Privatization Concerns Emerge

Just 15 days before the anniversary, U.S. Treasury Secretary Scott Bessent made remarks that sent shockwaves through the aging advocacy community. Speaking at a Breitbart News–sponsored event, Bessent described President Trump’s newly enacted “Trump accounts” (also referred to as “Child Savings Accounts” or “Child IRAs”) as potentially serving as a “backdoor for privatizing Social Security.” His comments, made during a Breitbart policy panel on the evening of July 30, were quickly picked up by national media outlets.

Bessent elaborated: “If these accounts grow and you have in the hundreds of thousands of dollars for your retirement, that’s a game-changer too.” He suggested that the success and expansion of these individual retirement accounts—created under President Trump’s One Big Beautiful Bill Act—could eventually reduce Americans’ reliance on traditional Social Security benefits.

The law, signed by Trump on July 4, creates a new tax-deferred investment account for children under the age of 18, born in the U.S. between January 1, 2025, and December 31, 2028. These accounts are seeded with $1,000 in federal funds and allow additional contributions of up to $5,000 annually from parents, family members, or employers. Structured similarly to IRAs, the funds must be invested in low-cost mutual funds or exchange-traded funds (ETFs) that track a U.S. stock index.

Max Richtman, NCPSSM President and CEO, quickly issued a public response, calling on Trump to denounce Bessent’s suggestion of a “backdoor” to privatization. “President George W. Bush tried it after his re-election in 2004—and failed miserably. The American people didn’t buy it then, and they won’t buy it now,” Richtman said.

He urged the former president to issue a clear and unequivocal statement: “Make a clear, unequivocal statement (as only you can) that your administration will not try to privatize Social Security.”

John Hishta, Senior Vice President of Campaigns at AARP, also issued a statement and condemned Bessent’s comments. “We have fought any and all efforts to privatize Social Security, and we will continue to,” he said. “President Trump has emphasized many times that Social Security ‘won’t be touched,’ and that he is ‘not going to touch Social Security.’ This must include any and all forms of privatization.”

“Privatization is a terrible idea”, says Nancy Altman, President of Social Security Works in a statement, noting that unlike private savings, Social Security is a guaranteed earned benefit that you can’t outlive. “It has stood strong through wars, recessions, and pandemics. The American people have a message for Trump and Bessent: Keep Wall Street’s hands off our Social Security!,” she says.

Following the backlash, Bessent attempted to clarify his remarks in a post on X (formerly Twitter) the next day: “Trump Baby Accounts are an additive benefit for future generations, which will supplement the sanctity of Social Security’s guaranteed payments. This is not an either-or question. Our administration is committed to protecting Social Security and making sure seniors have more money.”

During her Thursday press briefing, White House Press Secretary Karoline Leavitt emphasized that President Trump remains “wholeheartedly committed” to protecting Social Security—even as Bessent’s earlier comments appeared to contradict that position. “What the Secretary of the Treasury was saying—and what this administration believes—is that these Trump newborn accounts, which are an incredibly creative and positive provision in the One Big Beautiful Bill, are meant to help supplement, not substitute, Social Security,” Leavitt told reporters.

Democrats and Advocacy Groups Push Back

Last Thursday, amid hundreds of events scheduled this month throughout the nation to celebrate SSA’s 90th anniversary, the Washington, D.C.–based Social Security Works hosted a press conference to warn against what they called Trump administration efforts to undermine and dismantle Social Security.

Moderator Nancy Altman, President of SSW, opened the Town Hall by emphasizing the importance of celebrating Social Security’s milestone anniversary and the need to protect and defend the program. Throughout the event, Altman introduced each speaker, describing them as champions dedicated to safeguarding Social Security.

Speakers cited administrative actions such as firing 7,000 employees, closing field offices, and creating a customer service crisis. During the 37-minute press event, prominent Democrats and leaders of progressive advocacy groups argued these steps were part of a deliberate strategy to erode public confidence and justify future benefit cuts or privatization.

They contrasted these actions with proposals to expand benefits and extend the program’s solvency by lifting the cap on taxable income. Sen. Bernie Sanders (D-Vermont), described as a leading champion of earned benefits and author of the Social Security Expansion Act, called Social Security “the most successful federal government program of all time.” This was said to counter claims by critics, like Elon Musk, who have called it a “Ponzi scheme.” Sanders added: “This is a huge fight. We have the American people behind us. Let’s win it.”

Sen. Ron Wyden (D-Oregon), Ranking Member of the Senate Finance Committee and a key figure in the Senate’s “Social Security War Room,” said: “Trump’s so-called promise to protect Social Security, in my view, is about as real as his promise to protect Medicaid—no substance.”

Rep. John Larson (D-Connecticut), Ranking Member of the Social Security Subcommittee of the Ways and Means Committee, urged Congress to expand benefits. He noted that the last major expansion was under President Nixon and that millions of seniors still live in or near poverty.

Former Social Security Commissioner under President Biden, Martin O’Malley, charged, “They’re trying to wreck its customer service so they can turn enough Americans against it—and ultimately get away with robbing it.” He described this as the strategic motivation behind what he called the Trump administration’s dismantling of the SSA’s operational capacity.

Rep. Debbie Dingell (D-Michigan), who helped organize the Expand Social Security Caucus and has deep family ties to the creation of both Social Security and Medicare, declared: “I’ll be damned if anybody’s going to take us back to those days,” recalling the poverty and desperation seniors faced before the program’s enactment.

Judith Brown, a Social Security beneficiary, gave personal testimony underscoring the critical role her monthly check plays in her financial survival.

Keisha Bras, Director of Opportunity, Race, and Justice for the NAACP; Molly Weston Williamson, a Senior Fellow with the Center for American Progress Action Fund and an expert on paid leave; and Sarah Francis of Unrig Our Economy rounded out the panel.

A Legacy Under Threat

NCPSSM President Max Richtman warns that while the anniversary is cause for celebration, “we must always defend the program from those who would privatize or outright eliminate it. These forces have been at work ever since Social Security was enacted.”

To educate the public and counter misinformation, NCPSSM has produced a new documentary, Social Security: 90 Years Strong, with funding from AARP. The film tells the story of the program’s creation during the Great Depression and its enduring role for seniors, people with disabilities, and their families.

The documentary features interviews with Senators Tom Harkin and Chuck Grassley, Nancy Altman (Social Security Works), Bill Arnone (formerly of the National Academy of Social Insurance), FDR’s grandson Jim Roosevelt, Tracey Gronniger (Justice in Aging), Kathryn Edwards (Labor Economist), and Giovanna Gray Lockhart (former Director, Frances Perkins Center).

Social Security is often called the “third rail” of American politics—a metaphor drawn from the high-voltage rail powering some trains, where contact can be fatal. In politics, “stepping on the third rail” can mean political death.

“More than 69 million Americans rely on Social Security today and as America ages, we expect at least 13 million more people to rely on it by 2035.” said Myechia Minter-Jordan, Chief Executive Officer at AARP in s July 21 statement announcing the results of a new SSA survey. “For 90 years, Social Security has never missed a payment, and Americans should have confidence that it never will,” she said. 

The survey findings indicate that nearly two in three (65%) retired Americans say they rely substantially on Social Security, while another 21 percent say they rely on it somewhat. In 2020, 63% of retired Americans said they relied substantially on Social Security, jumping from 58% in both 2015 and 2010.

Social Security has strong bipartisan support, too.  The survey found that that more than two-thirds of Americans (67%) believe Social Security is more important to retirees today than it was five years ago. Overall, 96% consider the program important, with broad bipartisan agreement: 98% of Democrats, 95% of Republicans, and 93% of Independents.

The Social Security Trustees’ 2025 annual report, released in June, projects the program’s trust funds will run short of money by 2034. Without action, beneficiaries could face an estimated 19% cut in monthly payments.

Whether lawmakers who support privatization —while keeping their voter base—if they “step on the third rail” by raising the full retirement age or refusing to raise taxes remains to be seen.

We’ll see.