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.

Modest Social Security COLA increase seen as chump change by some

Published in RINewsToday on October 16, 2023

Last week, the Social Security Administration (SSA) announced that Social Security and Supplemental Security Income (SSI) benefits for more than 71 million beneficiaries will increase 3.2% in 2024, about $59 per month starting in January. The 2024 payment declined from last year’s 8.7%, but that had been the highest in four decades. And, its higher than the average 2.6% increase recorded over the past 20 years.

The Social Security Act determined how the cost-of-living adjustment (COLA) is calculated. Enacted on August 14, 1935, the Act ties the annual COLA to the increase in the Consumer Price Index for Urban Wage Earners and Clerical Workers (CPI-W) as determined by the Department of Labor’s Bureau of Labor Statistics.

More than 66 million Social Security beneficiaries will see that COLA increase 3.2% beginning in January 2024, and increased payments to approximately 7.5 million people receiving SSI will begin on December 29, 2023. (Note: some people receive both Social Security and SSI benefits).  

“Social Security and SSI benefits will increase in 2024, and this will help millions of people keep up with expenses,” observes Kilolo Kijakazi, Acting Commissioner of Social Security in an Oct. 12 statement announcing this year’s COLA increase.

According to SSA, some other adjustments that will also take effect in January of each year are based on the increase in average wages. Based on that increase, the maximum amount of earnings subject to the Social Security tax (taxable maximum) will increase to $168,600 from $160,200.

Advocacy groups on aging talk turkey about COLA

“The annual COLA is a reminder of Social Security’s unique importance. Unlike private-sector pension plans, whose benefits erode over time, Social Security is designed to keep up with rising prices, noted Nancy Altman, President of the Washington, DC-based Social Security Works (SSW), in response to SSA’s COLA announcement.  

“Retirees can rest a little easier at night knowing they will soon receive an increase in their Social Security checks to help them keep up with rising prices,” said Jo Ann Jenkins, AARP chief executive. “We know older Americans are still feeling the sting when they buy groceries and gas, making every dollar important,” she added, stressing that Social Security has been the foundation for financial security for hundreds of millions of retirees. “SSA’s COLA announcement shows that it’s continuing to deliver on this promise,” she says.  

However, Max Richtman, President and CEO, National Committee to Preserve Social Security and Medicare charges, “While we are grateful that Social Security is the only major retirement program with a built-in cost-of-living adjustment, the current formula for determining COLAs is inherently flawed. SSA’s current COLA formula doesn’t truly reflect the increase in prices for the goods and services that beneficiaries rely on.”

According to Richtman, the 3.2% 2024 COLA only represents a modest $59 increase in the average monthly benefit for retired workers, and that’s before deducting the projected increase in the 2024 Medicare Part B premium of about $10 per month. Because of this the average retirement beneficiary will receive a net COLA of about $50. 

Richtman notes, “That is not enough for a tank of gas or half a week’s worth of groceries in many states. The net COLA will barely cover one brand-name prescription co-pay for some patients.”  

Last year, Richtman noted that the COLA of 8.7% was unusually high, the highest in some 40 years. But post-pandemic inflation was also at record highs, he said, noting that historically, COLA’s have been relatively low. In fact, the COLA has been ZERO; three times since 2009.  

“Seniors deserve an accurate COLA formula that accounts for the impact of inflation on their living costs. That is supposed to be the entire purpose of a COLA. The current formula measures the impact of inflation on urban wage earners and clerical workers. How is that a reasonable formula for seniors? Seniors have different spending patterns than urban wage earners & clerical workers,” asks Richtman.  

Richtman notes that seniors spend more than other age group on expenses like housing, long-term care, and medical services. “We strongly favor the adoption of the CPI-E (Consumer Price for the Elderly) for calculating COLAs. The CPI-E would more accurately reflect the impact of inflation on the goods and services seniors need, he believes. 

The CPI-E is included in both major pieces of legislation to expand and protect Social Security that have been introduced in this Congress: Bernie Sanders’ Social Security Expansion Act and Rep. John Larson’s Social Security 2100 Act.  We have endorsed both of those bills as part of our commitment to boosting Social Security for current and future retirees. It’s past time for Congress to act,” says Richtman. 

Although the 3.2% COLA is well above the 2.6% average over the past 20 years, a newly released retirement survey released on Oct. 12, 2023, by The Senior Citizens League (TSCL) indicates that seniors are pessimistic about their financial well-being in the upcoming months and very concerned about growing calls on Capitol Hill for Social Security cuts. Sixty-eight percent of survey participants report that their household expenses remain at least 10 percent higher than one year ago, although the overall inflation rate has slowed. This situation has persisted over the past 12 months.

According to TSCL’s latest retirement survey, worry that retirement income won’t be enough to cover the cost of essentials in the coming months is a top concern of 56 percent of survey respondents. Social Security benefit cuts are an even bigger concern, ranked as the number one worry by nearly 6 out of 10 survey participants, or 59%. Over the past year, benefit cuts and trims have affected a large percentage of older Americans low-income households, individuals who can least afford them.

A year ago, TSCL warned that higher incomes due to the 5.9% and 8.7% COLAs in 2022 and 2023 could potentially affect eligibility for low-income assistance programs such as SNAP and rental assistance. Earlier this year, federal emergency COVID assistance for SNAP (food stamps) and Medicaid also ended. Surveys conducted in 2022 and this year suggest that significant numbers of lower-income older households have lost access to some safety net programs over the past 12 months, the survey finds.

A Final Note…

Social Security plans to start notifying beneficiaries about their new COLA amount by mail starting in early December. Individuals who have a personal “my Social Security account” can view their COLA notice online, which is secure, easy, and faster than receiving a letter in the mail. People can set up text or email alerts when there is a new message–such as their COLA notice—instead of waiting for them in my Social Security.

People will need to have a “my Social Security account” by November 14 to see their COLA notice online. To get started, visit www.ssa.gov/myaccount.

Information about Medicare changes for 2024 will be available at www.medicare.gov. For Social Security beneficiaries enrolled in Medicare, their new 2024 benefit amount will be available in December through the mailed COLA notice and my Social Security’s Message Center.

For details about SSA’s 2024 Changes, go to: https://www.ssa.gov/news/press/factsheets/colafacts2024.pdf.