Tag Archives for Medicare

Ahead of Midterms, Trump Unveils His Proposal to Slash Prescription Drug Costs

Published in Woonsocket Call on October 28, 2018

With mid-term elections looming, President Trump moves to block Democrats tying the high cost of prescription drugs to an unresponsive Republican-controlled Congress and to GOP efforts to undo health care protections for people with preexisting medical conditions, one of the most popular provisions of the Affordable Care Act, referred to as Obamacare.

According to recent Roll Call poll, health care is a top issue for Democratic and Independent voters in key battle ground states while the GOP tout’s immigration and the economy and jobs as its priority.

Last Thursday, afternoon, at the Department of Health and Human Services (HHS) with Secretary Alex Aza, FDA Commissioner Scott Gottlieb and CMS Administrator Seem Verman standing by President Trump, he announced major changes as to how Medicare pays for prescription drug to bring down costs by making prescribed medications more affordable to seniors, making pricing of U.S. drugs fairer relative to costs paid by other countries.

Bringing Down Medicare’s Skyrocketing Drug Costs

“We’re taking aim at the global freeloading that forces American consumers to subsidize lower prices in foreign countries through higher prices in our country,” said Trump at the Oct. 25 press conference in his 14-minute speech. He noted that the costs for the same pharmaceutical drug in some countries are 20 percent less than those purchased in the United States even though it was made by the same manufacturing company.

“At long last, the drug companies and foreign countries will be held accountable for how they rigged the system against American consumers,” says Trump.

Trump rattled off specific examples of how Medicare pays higher prices for the same pharmaceutical drugs that are cheaper in other developed countries. For instance, one eye medication that prevents blindness would annually cost about $187 million rather than $1 billion dollars if Medicare paid the same prices other countries pay, he said.

Another example, a highly used and very effective cancer drug is nearly seven times as expensive for Medicare as it is for other countries, said Trump, noting that “this happens because the government pays whatever price the drug companies set without any negotiation whatsoever.”

Under Trump’s unveiled proposal, a new Medicare model, the International Pricing Index (IPI), is created to bring down Medicare drug costs to ensure seniors get a “more fair deal on the discounts drug companies voluntarily give to other countries.”

Currently, Medicare sets payments for physician-administered drugs at the average sales price in the U.S. market—plus a price-based add-on fee. Trump’s proposal would allow Medicare to set the payment of these drugs at a Target Price, based on the discounts drug companies give other countries. With the model fully implemented, it is estimated that total payment for these drugs would drop by 30 percent.

Under the IPI model, described in an Advance Notice of Proposed Rulemaking, Medicare’s payments for select physician-administered drugs would shift to a level more closely aligned with prices in other countries. Overall savings for American taxpayers and patients is projected to total $17.2 billion, with out-of-pocket savings potentially totaling $3.4 billion over five years.

Medicare beneficiaries not covered by the IPI model could also see their drug costs lowered, because the average price used to calculate traditional Medicare reimbursement will drop.

Trump’s drug pricing proposal still needs to be refined and put though a federal rule-making process and its impact may not be seen for years.

Is Trump’s Efforts to Lower Drug Costs Just Election Year Posturing?

“It’s hard to take the Trump administration and Republicans seriously about reducing health care costs for seniors two weeks before the election when they have repeatedly advocated for and implemented policies that strip away protections for people with pre-existing conditions and lead to increased health care costs for millions of Americans,” says U.S. Senate Minority Leader Chuck E. Schumer in a statement.

“Once again, the President’s plan doesn’t go far enough to bring down the costs of prescription drugs. Democrats have proposed letting the HHS Secretary negotiate the prices of all drugs covered under Medicare, as well as new tools to ensure transparency and accountability when companies try to raise their prices. Without these critical steps, the President’s plan is just more words with little substance,” says Rhode Island Congressman David N. Cicilline.

Pharmaceutical Research and Manufacturers of America (PhRMA) president and CEO Stephen J. Ubl, opposes Trump’s proposal to lower Medicare’s drug costs, warning that it would “jeopardize access to medicines for seniors and patients with disabilities living with devastating conditions such as cancer, rheumatoid arthritis and other autoimmune diseases.” Trump’s proposal severely alters the Medicare Part B program by reducing physician reimbursement and inserting middlemen between patients and their physicians,” charges Ubl.

Adds, Frederick Isasi, executive director of Families USA, in his statement: “The data is clear. The way we currently pay providers and pharmaceutical companies for drugs administered in doctors’ offices and hospitals creates perverse financial incentives for providers to select extraordinarily expensive drugs that may not be best for their patients. “

“Medicare Part B is the perfect example of misaligned incentives, and the proposed rule, if implemented, could pilot significant new ways to pay for drugs that align incentives so that patients get the highest value care, they have the best outcomes possible, and costs come down, says Isasi.

Like many, Isasi hopes that Trump’s proposal of using the power of the federal government to reduce Medicare drug costs is “not just election year posturing” but truly reflects a policy shift to using federal negotiating power to get unstainable prescription drug prices under control.

Next year, after the dust settles after the mid-term elections, Congress must work together to hammer out a comprehensive legislative strategy to lower pharmaceutical drug costs and to provide health care to all Americans. Listen to the polls.

Democrats target high drug costs

Published in Pawtucket Times on Oct. 1, 2018

On Aug. 21, at an afternoon Democratic Senate hearing titled “America Speaks Out: The Urgent Need to Tackle Health Care Costs and Prescription Drug Prices,” senators Debbie Stabenow (D-MI), Ron Wyden (D-WA), Chris Van Hollen (D-MD), Tina Smith (D-MN), Richard Durbin (D-IL) and Joe Manchin (DWV), gathered to hear the personal stories of witnesses who have struggled with paying for the high cost of prescription drugs and also to listen to an expert who tracks price trends for prescription drugs widely used by older Americans.

In the last 18 years prescription drug prices have risen three times faster than physician and clinical services,” says DPCC’s chairwoman Stabenow in her opening statement. “We pay the highest prices in the world. The outrages prices force people to skip doses, split pills in half and even go without the medication they need,” she says, calling this problem a “matter of life and death,” says Stabenow.

Democrats believe health care to be a basic human right, while the GOP considers it to be a commodity to go to the highest bidder, adds Stabenow, denoting the philosophical differences of the two political parties.

Wyden, ranking member on the Senate Finance Committee who sits on the DPCC, recalled that two years ago when then presidential candidate Donald Trump was on the campaign trail pledged to make sure Medicare would negotiate like crazy to hold down costs for seniors and taxpayers. While Trump is well into one year and a half into his term, Americans year ad half into his term Americans believe it is crazy that we are still not negotiating to hold down the cost of medicine.

Wyden and his fellow DPCC committee members call for Medicare to allow Medicare to negotiate prescription drug prices with pharmaceutical companies.

Senate DPCCs puts spotlight on rising drug costs

At the Senate’s DPCC’s hearing, witness Nicole Smith-Holt, a Minnesota state employee and mother of four children, shared a tragic story about her 26-year old diabetic son, Alec, who had died because he could not afford his copay of $1,300 for diabetic supplies and insulin. The Richfield, Minnesota resident recounted how her son tried to ration the insulin to make it last until his next paycheck, but he died as a result of diabetic ketoacidosis.

Stahis Panagides, an 80-year old Bethesda, Maryland retiree, testified that he could not afford to pay $400 per month for prescribed Parkinson’s medication. He could not pay for the new course of treatment, recommended by his neurologist, even with a supplemental Medicare plan, he says, so he just refused to take it.

Retired social worker John Glaser, a longtime grassroots organizer for the Washington, D.C.-based National Committee to Preserve Social Security and Medicare, came before the Democratic committee, saying “Medicare drug benefits and the Affordable Care Act’s closing of the coverage ‘donut hole’ have made a huge difference in my life and are invaluable for the quality of my life. Without these improvements he would have spent about $5,000 out-of-pocket on prescription drugs last year,” he notes.

Glaser also shared that his brother, who is afflicted with diabetes, heart problems and kidney disease, takes over 50 pills every day. “If my brother had to pay the full price for all of those drugs, he’d be living on the street,” he says.

Marques Jones, who has Multiple Sclerosis (MS), told the senators that his MS medication costs about $75,000 annually. Despite having robust insurance coverage, Jones’ annual out-of-pocket spending on drug co-pays and insurance premiums for his family of five is very high. This has caused the resident of Richmond, Virginia to become a vocal advocate for those who suffer from MS. Finally, Leigh Purvis, director, Health Services Research, AARP Public Policy Institute, a co-author of the AARP Public Policy Institute’s annual RX Price Watch Reports, warned that today’s prescription drug price trends are not sustainable.

“The current system is simply shifting costs onto patients and taxpayers while drug companies remain free to set incredibly high prices and increase them any time that they want,” says Purvis, noting that Congressional efforts to reduce prescription drug prices could save billions of dollars.

AARP report tracks skyrocketing drug costs

One month after Senate’s DPCC’s hearing, a new AARP report, released on Sept.

27, 2018, says that retail prices for many of the most commonly-used brand name drugs prescribed to older adults by older adults increased by an average of 8.4 percent in 2017, greater than the general inflation rate of 2.1 percent. The annual average cost of therapy for just one brand name drug increased to almost $6,800 in 2017, says the AARP researchers.

According to the new “Rx Price Watch Report: Trends in Retail Prices of Prescription Drugs Widely Used by Older Americans: 2017 Year-End Update,” released just days ago, revealed that for over a decade, brand name drug prices have “exceeded the general inflation rate of other consumer goods by a factor of twofold to more than 100-fold.” If retail drug price charges had reflected the general inflation rate between 2006 and 2017, the average annual cost for one brand name drug in 2017 would have been $2,178 instead of $6,798, said the AARP Public Policy report.

Taking multiple medications can be costly, says the AARP report. “For the average senior taking 4.5 medications each month, this would translate into an annual cost of therapy that is almost $21,000 less than the actual average cost of therapy in 2017 ($9,801 vs. $30,591), notes the findings of the AARP report.

“Despite years of relentless public criticism, brand name drug companies continue increasing the prices of their products at rates that far exceed general inflation,” said AARP Chief Public Policy Officer Debra Whitman, in a Sept. 26 statement with the release of the AARP report. “It’s clear that we need long-term, meaningful policies that go beyond just hoping that the drug industry will voluntarily change its excessive pricing behavior,” adds Whitman.

“The average older American taking 4.5 prescription medications each month would have faced more than $30,000 in brand name costs last year,” adds Purvis. “That amount surpasses the median annual income of $26,200 for someone on Medicare by more than 20 percent. No American should have to choose between paying for their drugs and paying for food or rent,” says Purvis.

Some highlights of AARP’s new drug cost report

AARP report’s findings noted that brand name drug prices increased four times faster than the 2017 general inflation rate and that drug retail prices that year increased for 87 percent of the 267 brand name drugs studied.

Finally, research findings indicated that “retail prices for 113 chronic-use brand name drugs on the market since at least 2006 increased cumulatively over 12 years by an average of 214 percent compared with the cumulative general inflation rate of 25 percent between 2006 to 2017.”

In recent correspondence to the Secretary of the Health and Human Services, AARP calls for regulatory and legislative reforms that will allow the Secretary to be able to negotiate drug prices for Medicare, allowing the safe importation of lower cost drugs into the United States and ensuring that generic drugs can more easily enter the market. Now, AARP waits for a response.

Putting the brakes on the skyrocketing pharmaceutical costs might just be the bipartisan issue that the new Congress can tackle once the dust settles from the upcoming mid-term elections.

To watch DPCC’s Aug. 21 Senate hearing, go to http://www.democrats.senate.gov/dpcc/hearings/senate-democrats-to-hold-hearing- with-Americans-hurt-by-high-cost-of prescription-drugs.

For a copy of AARP’s drug cost report, to aarp.org/rxpricewatch.

Midterm Elections Can Impact Social Security’s Long-Term Survival

Published in the Woonsocket Call on August 19, 2018

After just weeks celebrating the 53rd Anniversary of Medicare to score political points, Democrats, aging groups and Social Security Advocates put 83 candles on a cake to celebrate President Franklin D. Roosevelt’s signing of Social Security Act into law on August 14, 1935. The new Act created a social insurance program designed to pay retired workers age 65 or older a continuing income after retirement.

With the midterm elections looming, less than three months away, the Democrats are gearing up their efforts to recapture the House and Senate. Polls tell us that Social Security is being positioned as a key issue to energize voters, especially in competitive races, to control both legislative chambers.

According to the Washington, DC-based AARP, recent polling suggests Social Security and Medicare will be key issues for 50-plus voters. Recent
AARP/Politico polls found a significant majority of age 50 and over Arizona voters report Social Security (78 percent), health care (76 percent) and Medicare (75 percent) are “very important” issues to them as they head to the polls in November. Also, significant majorities of older Florida voters age 50 and older say Social Security (82 percent) and health care (78 percent) will be very important to their vote for Congress this fall. In this swing state, nearly three-quarters of Florida voters cite the future of Medicare as an important election issue.

Social Security Checks Prime States and National Economic Engine

AARP, the National Committee to Preserve Social Security and Medicare (NCPSSM) and Social Security advocates say it’s a great time to remind political candidates for House and Senate races of the popularity of Social Security and Medicare and both programs impact on the nation’s fiscal health. The Washington, DC-based NCPSSM calls Social Security and Medicare an economic generator, annually paying out more than $ 800 billion in benefits to over 57 million beneficiaries who put this money back into their local, state and federal coffers.
In the Ocean State, there are 222,851 Social Security beneficiaries, including 152,898 Retired Workers, 37,133 Disabled Workers, 11,680 Widow(er)s, 5,810 Spouses and 15,330 Children Social Security benefits that pump $3 Billion each year to state’s economy, says NCPSSM, its figures taken from the nonprofits state-by-state analysis of how much revenue Social Security contributes to the economy of every Congressional District in each state.

“Social Security has a very big footprint in Congressional districts across the country, which is a tremendous benefit not only for beneficiaries, but for entire communities,” says Max Richtman, NCPSSM’s president, and CEO. “Yet, in the face of clear evidence of Social Security’s effectiveness, conservatives want to cut and privatize the program. Candidates in this year’s mid-term elections must ask themselves whether their communities can afford to lose billions of dollars in economic stimulus – not to mention the baseline financial security that these earned benefits provide retirees and their families. The answer for anyone who seeks to represent the people should be a resounding ‘No,’” he says.

Yet, throughout the years, GOP lawmakers sought to ensure the solvency for the Social Security program by cutting benefits, raising the retirement age and
to privatize the program. Democrats call for the raising or eliminating the payroll cap on taxable wages, now $ 118,500 a year, to bring more revenues into Social Security from the nation’s wealthy. They say Social Security must be considered an earned benefit rather than an entitlement because working Americans pay into the system each paycheck, and receive benefits when they retire or become disabled.

Key Congressional Races to Watch

And there are a lot of Congressional races to watch during the upcoming mid-term elections. According to fivethirtyeight.com, a website that focuses on
opinion poll analysis and politics, “… 39 Republicans and 18 Democrats are not running for re-election. That includes 13 Republicans and 10 Democrats who are leaving to seek another office, such as governor. Excluding them, 26 Republicans and eight Democrats are walking away from their political careers at the end of the 115th Congress. That’s the most “pure” retirements by Republicans — and the fewest by Democrats — since the 2008 election.”

NCPSSM is closely monitoring both House and Senate races, calling for voters to support candidates who commit to strengthening and expanding Social Security. “These Social Security champions can be found across the country, in both red and blue states,” says the Social Security advocacy group.
Here are just a few campaigns to watch.

NCPSSM says one of these Social Security campaigns is Kathleen Williams, a water conservation expert, who is running for the House seat in Montana currently occupied by Republican Greg Gianforte. The Republican Congressman, elected in 2017, voted for the sweeping GOP tax plan, the Tax Cuts, and Jobs Act, increasing the national debt by $ 1.9 trillion between 2018 and 2028, according to the Congressional Budget Office. The skyrocketing deficit puts Social Security, Medicare and Medicaid on the GOP radar screen for cuts to the nation’s debt and deficits. Gianforte’s opponent pledges to “make sure that our seniors can retire with dignity by protecting Medicare and Social Security no matter what.”

Another, in Arizona, three-term Democratic Congresswoman Kyrsten Sinema, formerly serving in both chambers of the State Legislature, is running for retiring Republican Senator Jeff Flake’s seat, a race that could determine which political party takes control of the Senate. “Sinema says, “We can’t allow… Washington to threaten the Medicare and Social Security benefits Arizonans have earned through a lifetime of hard work.” Her likely opponent, Republican Congresswoman Martha McSally, like Congressman Gianforte, voted for the GOP tax plan and Sinema has accused her of wanting to privatize Social Security while her Congressional voting record does not reflect this charge.

Finally, in Illinois’ 12th Congressional district, where challenger Brendan Kell, serving as the state’s attorney for St. Clair County and earned a commission as an officer in the U.S. Navy opposes incumbent Mike Bost. The Republican voted for the GOP’s failed Balanced Budget Amendment – Democrats and NCPSSM considering this a backdoor strategy to slash Social Security. The Democratic challenger Kelly that “instead of cutting Social Security, Medicare and Medicaid, as those in Congress currently want to do… we have to fight against that and expand the access and coverage overall.”

You Can Make a Difference

With the outcome of the midterm elections, especially in battleground state, AARP’s voter engagement multifaceted campaign “Be The Difference. Vote” is mobilizing older voters to get them to vote in primaries and in the November general election. The “get out the vote” initiative will put issues of particular importance to aging baby boomers and seniors front and center— issues like Medicare, Social Security, financial security, prescription drug costs, and family caregiving.

AARP is tracking key races, sponsoring debates, and hosting candidate forums and tele-townhall events. Election information is provided through a full-scale digital effort, including aarp.org/vote, the AARP Now app, social media outreach, graphics, and news alerts. AARP is also using direct mail, phone banks and transportation assistance to help people get to the polls.

Social Security celebrates its 83 Anniversary this month. Older voters can send a message to Capitol Hill by casting votes for candidates to strengthen and expand the program instead of voting for those who call to privatize Social to replace the federal government-administered system.

A Final Note…

Congressman David Cicilline (D-RI) will release a new report from the U.S. House Democrats’ Seniors Task Force during an event at Rumford Towers in East Providence this Monday. The report outlines the history of Washington Republican efforts to attack Social Security and Medicare.

Cicilline, who serves in the House Democratic Leadership, also plans to outline the policies that Democrats will advance if they take control of the House this November. Democrats have outlined a series of proposals to lower the costs of prescription drugs and health care premiums.

“Republicans are on the side of powerful special interests. Democrats are for the people,” Cicilline told me. “When Democrats take the majority, we’re going to pass legislation giving Medicare the ability to negotiate the cost of prescription drugs. We’re going to make Social Security and Medicare a priority by requiring the wealthy to pay into the system as much as everyone else and improving cost-of-living adjustments.”