AARP Rhode Island calls on Congress to act on lowering high drug costs

Published on March 14, 2022 in Rhode Island News Today

On the day before the Washington, DC-based AARP’s March 8th launch of its new ad campaign showing the impact of Congress’s failure to act on prescription drug prices, AARP Rhode Island State Director Catherine Taylor, Volunteer State President Marcus Mitchell and Volunteer Lead Federal Liaison Dr. Phil Zarlengo joined Rhode Island US Senators Jack Reed and Sheldon Whitehouse for a virtual news conference highlighting the need for Congress to act now to slash rising prescription drug costs. 

During the 26 minute and 45 second event, AARP Rhode Island, representing 132,000 members, delivered a petition signed by more than 16,114 Rhode Islanders, calling for Congress to act now and stop unfair drug prices. AARP has called for fair drug prices for years and supports legislation that passed the House in November, which would allow Medicare to negotiate drug prices, put a cap on out-of-pocket costs that older adults pay for their prescription drugs and impose penalties on drug companies that raise prices faster than the rate of inflation.

“Americans are fed up with paying three times what people in other countries pay for the same drugs. More than four million people across the country, including more than 16,000 here in the Ocean State, are joining AARP to demand lower prices for prescription drugs,” said Taylor in a statement announcing the petition being delivered to Reed and Whitehouse. “There will never be a better time to lower drug prices than the historic opportunity in front of Congress. Now is the time to get it done!” Taylor says.

Big Pharma makes billions from high drug costs

“Big Pharma is making billions while seniors and taxpayers are suffering,” says AARP State President Mitchell, noting that just last month Big Pharma raised the prices of 800 prescription medications.” People are sick and tired of paying three times for prescription drugs what people in other countries are paying for these drugs, “It’s outrageous and unacceptable,” Mitchell said.

According to Mitchell, “if consumer prices had risen as fast as drug prices during the last 15 years, gas would cost $12.20 a gallon and milk would cost $13 a gallon.” This gives perspective to this issue, he said.

“Big Pharma is trying again to scare lawmakers and members of AARP and everyone else with misleading claims to stop Medicare to negotiate prices, charged Zarlengo. “We, at least, know the truth. The truth is by allowing Medicare negotiation [of prices], that process will help seniors during these times of inflation by lowing their prices of drugs and putting more money in their pocket,” he said.

Zarlengo gave the two Rhode Island Senators a message from Rhode Island seniors: “Don’t let Pharma win this time, lets lower drug prices now.”

“We hear you loud and clear,” said Senator Reed, responding to the over 16,000 signees of AARP’s petition. “Congress must address this issue of drug pricing. The system continues to force families into untenable choices between their health and other basic needs. One of the simplest things to do is to allow the federal government to negotiate drug prices for Medicare beneficiaries. I have been urging administrations, both Republican and Democratic for more than a decade to do this,” he noted.

“The VA already does this,” said Senator Whitehouse told his fellow panelists and those tuning in to the March 7 news conference. “And there is a big discrepancy in what the Veterans Administration (VA) pays for drugs and what Medicare pays for drugs. We have a reconciliation bill still in the Senate; it’s something Democrats can pass with only 50 votes. The bad news is that we need all 50 members to agree on the reconciliation measure and that has proven difficult. I hope we can agree on a package that all 50 of us can sign off on… and finally, finally, finally give Americans the drug pricing relief that they need. AARP is incredibly important in this fight. All your members make a difference. Thank you for stepping up yet again,” he said.

AARP fights Big Pharma on television and with digital advertising

In AARP’s new ad campaign, Larry Zarzecki, a retired law enforcement officer with Parkinson’s Disease who was forced to sell his home in order to afford his medications, returns to the airways as a spokesperson for AARP, illustrating the impact of the high cost of prescription drugs on seniors.  The retiree first shared his story in an AARP ad three years ago, but Congress’ failure to act means he has had no relief from the high cost of his treatments. As he says in the new ad, “I shouldn’t have to decide between my home or my medicine because Congress refuses to act. I’m tired of waiting for Congress.”

AARP’s seven-figure ad buy includes television and digital advertising in the DC area, and television in Arizona, Colorado, Georgia, New Hampshire, New York, Nevada, and Pennsylvania.

Responding to AARP’s new ad campaign, AARP Rhode Island’s Taylor said: “Larry Zarzecki was forced to sell his home in order to afford his medications.  He is but one example of Congress’ failure to act. No one should have to give up a home in order to pay for over-priced prescription medicines.  She called on Congress to put a stop to “spiraling price increases” by giving Medicare the authority to negotiate with pharmaceutical companies for lower prices.

“If the Veterans Administration can do so – paying roughly half as much for brand name prescription drugs as does Medicare Part D – then why can’t Medicare?” says Taylor.  “For a decade, Big Pharma has spent more on stock buybacks and dividends than on research and development; it’s outrageous that drug makers are charging Americans three times what people in other countries pay for the same drugs and justifying it with lies and scare tactics that simply don’t hold up,” she  added.

AARP has called for lower drug prices for years and is urging the Senate to pass legislation that would allow Medicare to negotiate drug prices, put a cap on out-of-pocket costs that older adults pay for their prescription drugs and impose penalties on drug companies that raise prices faster than the rate of inflation.

“Americans are sick and tired of Congress’ broken promises to bring down the price of prescription drugs,” said Nancy LeaMond, AARP Executive Vice President and Chief Advocacy & Engagement Officer announcing the launching of this ad campaign. “As Americans pay more and more for many consumer goods, Congress has an historic opportunity to lower drug prices and help seniors like Larry to afford their medications and other essentials,” she said.

It’s time to act NOW

According to AARP, without congressional action, pharmaceutical companies will continue to set high prices for prescription drugs and raise them without any warning or justification. The Washington, DC based advocacy group representing 38 million members recently released a report showing that 75 of the 100 brand name drugs with the highest total Medicare Part D spending have already increased their  list prices in the first month of 2022.

During the State of the Union, President Biden called for Congress to bring down the price of prescription drugs as a way to help consumers manage rising prices. The House of Representatives passed several prescription drug measures as part of the Build Back Better Act in November, but the Senate has yet to pass similar legislation.

It’s time for the Senate to put the welfare of the nation’s seniors first by passing legislation to put the brakes to spiraling prescription drug costs. This will be a hot campaign issue in the upcoming mid-term elections, just 230 days from now.

Medicare slow to fix equity issue for seniors’ access to at-home COVID test kits

Published on Feb. 7 in Rhode Island News Today

Today home test kits were made available in a variety of ways – but, for Medicare recipients, it was a different story, being forced to go thru a different purchasing and payment process than those having private insurance, or no insurance. That process required the oldest and most at-risk population to take more than several steps, put up their own money, do a lot of paperwork, to seek reimbursement.

The White House made changes in testing so that at-home tests are now fully covered by health insurances. Those insured can pick up their test kits in a store and have them paid for at the time of purchase by their insurance, at no cost to the person. They aren’t required to visit their physician or get a prescription to obtain the free test. They have a limit of 8 test kits per month.

But, when the program began, this was not the plan for those insured through the government’s Medicare and Medicare Advantage plans.

Red Tape… Upfront Charges for COVID-1

Jane, a 65-year old Medicare beneficiary from Warwick went through the steps to get a kit after a relative she had seen found out she was exposed to COVID.  Before Medicare announced easing up on the purchasing process of COVID-19 test kits, she expressed frustrations to this writer about the regulatory hoops she faced because she was on Medicare – purchasing the test kits and getting reimbursed for the upfront charges. “First, I had to request a prescription from my physician and say that I had either been exposed to someone who had COVID, or I was having symptoms, myself,” recalls the frustrated Medicare beneficiary.  “Once my physician sent the prescription over to CVS, I was notified that it would take a couple of days before I could pick up the kits and that I would only be given two kits per prescription”, she fumed, knowing that sometimes it takes 4 or 5 days of testing to test positive, but was only eligible to receive two, and she might have to go through the whole process again in a few days.

“Three days later CVS finally left me a message saying these kits were in. I used the drive-up window for pickup and the cashier asked me for $46,” Jane remembered.  “When questioning this charge, a pharmacist came to the window to assist and told me that I had to pay for the kits upfront and then seek reimbursement,” she added.

Paying for the kits, Jane went home, and called Blue Cross, her Medicare supplement company and was told she needed to request a copy of the prescription which took hours to finally request with the back and forth phone calls to her busy doctor’s office. It was almost two weeks later she finally got a copy of the receipt detailing her $46 payment for the kits. She was then able to upload the copy of the prescription and a copy of her receipt to a BCBS reimbursement screen on her computer (or she could have printed the form out and mailed the whole package in). At press time, Jane is still waiting for her reimbursement, being told it will take from 4 to 6 weeks to receive a check.

It’s better late than never, says Jane, when she heard that Medicare would now cover free over-the-counter COVID-19 tests. “Not everyone can put out $46 and wait two months to get it back, home health tests were made available in a variety of ways – but, for Medicare recipients, there was a different process. More concerning was all the steps I had to take to complete the process they had originally intended for us to do. How many people would really complete all those steps?” she says. “We talk a lot about equity, but seniors need equitable healthcare processes, too.”

Just days ago, the Centers for Medicare & Medicaid Services (CMS) announced that beneficiaries in either Original Medicare or Medicare Advantage will be able to get over-the-counter COVID-19 tests at no cost starting in early spring, estimated to be in April. Under the new CMS initiative, Medicare beneficiaries will be able to access up to eight over-the-counter COVID-19 tests per month for free. Tests will be available through eligible pharmacies and other participating entities. This policy will apply to COVID-19 over-the-counter tests approved or authorized by the U.S. Food and Drug Administration (FDA). A prescription will not be required.

CMS Unveils New Medicare Benefit

According to CMS, this new initiative will enable payment from Medicare directly to participating pharmacies and other participating entities to allow Medicare beneficiaries to pick up tests at no cost. This is the first time that Medicare has covered an over-the-counter test at no cost to beneficiaries.

CMS’s announcement follows last month’s announcement that the Biden-Harris Administration would be requiring commercial health insurance companies to cover at-home COVID tests for free.

Until the new benefit kicks in, Medicare beneficiaries can access free tests through a number of channels established by CMS, too. Now, they can request four free over-the-counter tests for home delivery at covidtests.gov. Or beneficiaries can access COVID-19 tests through health care providers at over 20,000 free testing sites nationwide. Many cities and towns are also giving out free test kits at drive-up handout programs as the state receives supplies.

CMS’s Feb. 3 statement noted that Medicare beneficiaries can also access lab-based PCR tests and antigen tests performed by a laboratory when the test is ordered by a physician, non-physician practitioner, pharmacist, or other authorized health care professional at no cost. In addition to accessing a COVID-19 lab test ordered by a health care professional, people with Medicare can also already access one lab-performed test without an order, also without cost sharing, during the public health emergency, says CMS.

In addition, CMS says that Medicare Advantage plans may offer coverage and payment for over-the-counter COVID-19 tests as a supplemental benefit in addition to covering Medicare Part A and Part B benefits. Medicare beneficiaries covered by Medicare Advantage should check with their plan to see if it includes such a benefit.

Finally, all Medicare beneficiaries with Part B are eligible for the new benefit, whether enrolled in a Medicare Advantage plan or not.

“AARP applauds today’s announcement that will guarantee access to at-home over-the-counter COVID-19 tests at no cost for Medicare’s 64 million beneficiaries and we thank [Health and Human Resources]Secretary Becerra and CMS Administrator Brooks-LaSure for their diligence in addressing this issue. Expanded access to no-cost testing will help protect seniors who have been hit hardest by the pandemic and ensure they can remain connected with their loved ones and community.,” says AARP Executive vice president and Chief Advocacy and Engagement Officer Nancy LeaMond in a statement issued with CMS’s Feb. 3rd announcement of the new Medicare benefit.

“Every American should have an easy way to get at-home COVID tests. We know that people 65 and older are at much greater risk of serious illness and death from this disease – they need equal access to tools that can help keep them safe. The cost of paying for tests and the time needed to find free testing options are barriers that could discourage Medicare beneficiaries from getting tested, leading to greater social isolation and continued spread of the virus, adds LeaMond.

Successfully Advocating the Seniors

Last month, Senators Sherrod Brown (D-OH) and Debbie Stabenow (D-MI) along with 17 of their  Senate colleagues including Rhode Island Democratic Senators Reed and Sheldon Whitehouse wrote to HHS Secretary Becerra and  CMS Administrator Brooks-LaSure urging them to expand Medicare coverage of free at-home rapid COVID-19 testing.

Aging groups also joined the Senators in pushing Medicare to offer the new testing kick benefit.  “It is clear that regular testing is a crucial part of managing the spread of COVID-19. That’s why AARP has been calling for coverage of at-home tests, says AARP’s LeaMond, noting that the nation’s largest aging advocacy group “will continue to watch for details about when and how at-home COVID tests are made available to those in Medicare.”

Thankfully CMS quickly heeded their calls.

For more information, please see these Frequently Asked Questions, https://www.cms.gov/files/document/covid-19-over-counter-otc-tests-medicare-frequently-asked-questions.pdf (PDF)

Stay tuned for free N95 masks to be made available to all coming up soon.

Cicilline Pushes for House Aging Committee

Published in Pawtucket Times on January 4, 2021

Yesterday, the 116th Congress came to an end, with the new Congressional session convening that day with the swearing in of lawmakers elected on Nov. 3, 2020.   Some political observers say that legislative gridlock during this Congress made it the least productive in the last fifty years.  GovTrack.us, reported that of 16,587 bills thrown into the legislative hopper, 252 became enacted laws, and 712 resolutions were passed.

During a Fox interview last February, Senate Majority Leader Mitch McConnell (R-Kentucky) candidly admitted he prevented the consideration of hundreds of bills passed by the House that were sent over to the Senate for consideration.   McConnell’s “Legislative Graveyard” created by his controlling the legislative agenda by blocking debate, markup and refusing to allow a vote on House proposed legislation, was widely reported by the media and documented in a 33-page report, “2020 Democracy Score Card,” released last September by Common Cause, a watch dog advocacy group.

The results of tomorrow’s Georgia Senate runoff will determine if the GOP can maintain legislative control of the Senate. If Senate Democratic candidates win their seats, the Senate Democratic caucus will have the majority with 50 Senate seats, with Vice President Kamala Harris having a tie breaking vote. But if McConnell, called “the Grim Reaper” by his critics, continues to maintains political control of the upper chamber, Democratic legislative proposals introduced to improve the quality of life of America’s seniors and to help those struggling to financially make ends meet, would be rejected.  

Legislative Proposals to be Reconsidered by New Congress

During the116th Congress, Washington, DC-based aging advocacy groups, including the National Committee to Preserve Social Security and Medicare (NCPSSM) , AARP, Social Security Works, Leadership Council on Aging, and National Council on Aging, pushed for passage of legislative proposals to enhance the quality of life of America’s seniors and to strengthen and expand Social Security and Medicare, to keep these programs fiscally sound.  As the new Congress begins, lawmakers might consider bringing back legislative proposals that were not enacted in the previous Congressional session because of a Republican-controlled Senate.  Here are a few legislative proposals that have some merit and I hope to see reintroduced this year:

Congressman John Larson (D-Conn.) called on Congress to finally address the Social Security “Notch” issue. By ignoring this issue, workers born in 1960 and 1961, would likely see lower Social Security retirement benefits in the future, charged NCPSSM.  Last session, Larson, who chairs the House Ways and Means Social Security Subcommittee, introduced the “Social Security COVID Correction and Equity Act,” to increase benefits for those born in 1960 and 1961 without impacting the benefits for any other beneficiary. 

Larson also introduced the “Social Security 2100 Act” to strengthen and expand Social Security.  The landmark legislation would keep the program financially healthy for more than 75 years, while boosting benefits for all retirees. Congress must work during the 117th session to protect and expand the nation’s Social Security program.

The late Maryland Congressman Elijah E. Cummings, Chair of the House Oversight Committee, introduced the “Lower Drug Costs Now Act” which the House passed last session, would allow Medicare to negotiate prescription prices with Big Pharma, which would save the government and seniors nearly $350 billion in drug costs. The bill would also expand traditional Medicare by adding dental, vision, and hearing benefits. 

Additionally, a bipartisan crafted bill, the “Prescription Drug Pricing Reduction Act,” introduced by Senators Chuck Grassley (R-Iowa), and Ron Wyden (D-Ore.), was not allowed to be considered on the Senate floor by Senate Majority Leader McConnell.  According to the Congressional Budget Office, this legislation would save taxpayers $95 billion, reduce out-of-pocket spending by $72 billion and finally reduce premiums by $1 billion.

Almost three months ago, the Social Security Administration announced that approximately 70 million Americans would see a meager 1.3 percent cost of living adjustment (COLA) increase to Social Security benefits and Supplemental Security Income.  With retirees experiencing financial difficulties during the pandemic, a $20 increase in their monthly check might not help them to pay for spiraling health care and drug costs, along with the expenses of purchasing personal protective equipment and cleaning supplies to keep them safe. 

Following the announcing of the 2021 COLA, Congressman Peter DeFazio (D-Ore.), chair of the House Transportation Committee, introduced the “Emergency Social Security COLA for 2021 Act” to provide Social Security beneficiaries with a 3 percent increase (or a $250 per month flat increase) which would reduce the impact of the small 2021 COLA increase. 

With COVID-19 quickly spreading throughout the nation’s nursing homes and intermediate care facilities, U.S. Senators Bob Casey (D-Pa) and Sheldon Whitehouse (D-R.I.), “The Nursing Home COVID-19 Protection and Prevention Act,” to provide needed resources to facilities to protect frail residents and staff. Residents in these facilities are among the most vulnerable because of their age and underlying medical conditions.  Days after the introduction of the Senate bill, Congressman David N. Cicilline (D-R.I.), signed on as a cosponsor of the House version.  

This legislative proposal would help states implement strategies to reduce the spread of COVID-19 in congregate settings, including through the purchase of personal protective equipment (PPE) and testing and to support nursing home workers with premium pay, overtime and other essential benefits.

New Push to Reestablish House Aging Committee

“After a lifetime of hard work, seniors should be able to enjoy their retirement years with dignity and peace of mind,” says Rhode Island’s Cicilline. “It’s the best way to secure the future of Medicare and Social Security, bring down the cost of prescription drugs, and find solutions for housing, transportation and long-term care issues that are especially important to Rhode Island seniors,” he says.

A long-time advocate for seniors, Cicilline announces in this weekly commentary his intentions of reintroducing a House resolution in the 117th Congress to reestablish the House Aging Committee

During the previous three Congressional sessions, Cicilline, representing the state’s first legislative district, introduced a House Resolution (just 245 words) to reestablish a House Permanent Select Committee on Aging. Two of the times a Republican-controlled House blocked consideration of the House Resolution. 

According to Cicilline, the House can easily create an ad hoc (temporary) select committee by just approving a simple resolution that contains language establishing the committee—giving a purpose, defining membership, and detailing other aspects.  Funding would be up to the Appropriations Committee. Salaries and expenses of standing committees, special and select, are authorized through the Legislative Branch Appropriations bill.

The previous House Aging Committee was active from 1974 to 1993 (until it was disbanded because of budgetary issues) put the spot light on an array of senior issues including elder abuse, helped increase home care benefits for older adults and helped establish research and care centers for Alzheimer’s disease.  

Cicilline noted that a House Aging Committee would perform comprehensive studies on aging policy issues, funding priorities, and trends.  Like its predecessor, its efforts would not be limited by narrow jurisdictional boundaries of the standing committee but broadly at targeted aging policy issues, he notes.

“I look forward to working with my colleagues on both sides of the aisle to get the job done,” says Cicilline.

Herb Weiss, LRI’12, is a Pawtucket writer covering aging, health care and medical issues. To purchase Taking Charge: Collected Stories on Aging Boldly, a collection of 79 of his weekly commentaries, go to herbweiss.com.

Updated on Jan. 4, 2021