Congress Releases Highly Anticipated Drug Pricing Legislation

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On May 23, 2019, the House Ways and Means Committee released draft legislation that would restructure how Medicare Part D pays for medications once beneficiaries enter the catastrophic coverage phase. Currently, the government pays 80 percent of a medication’s cost during the catastrophic coverage phase while the insurer pays 15 percent and the beneficiary pays 5 percent. This policy proposal would shift most of that cost to insurers over four years, resulting in the government contributing only 20 percent of a medication’s cost, while the insurer pays 75 percent and the beneficiary pays the remaining 5 percent.

While this is intended to reduce out-of-pocket costs for beneficiaries, it only shifts the cost burden from the government to insurers. This could result in seniors paying higher premiums as insurers shift these costs onto Medicare beneficiaries. Stakeholders have through June 6, 2019 to submit comments to PartDImprovements@mail.house.gov.

On the same day, the Senate’s Health, Education, Labor & Pensions (HELP) Committee released a bipartisan discussion draft of legislation designed to reduce the cost of care in the United States. Aimed Alliance offered recommendations to the Committee earlier in the year as they were drafting the legislation. The discussion draft touches on several parts of health policy, including the drug approval pipeline, surprise medical bills, telehealth, and pharmacy benefit managers. Stakeholders have through June 5, 2019 to submit comments to LowerHealthCareCosts@help.senate.gov.

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