WASHINGTON – Medicare beneficiaries will be able to get prescription drug plans that limit insulin copays, representing potential savings of hundreds of dollars, the White House announced Tuesday in a move that directly benefits citizens’ pockets and could influence the November elections.
The new benefit, which was formally unveiled at a Rose Garden event on Tuesday, is being touted as an achievement by Trump administration officials eager to change the topic of the coronavirus pandemic.
“The price of insulin has gone through the roof,” said the president. “It’s a great day for older adults, it’s a huge savings.”
Older adults who choose a drug plan that offers the new insulin benefit would pay a maximum of $ 35 per month starting next year, an estimated savings of $ 446 per year. The fluctuating cost-sharing amounts that are now common would be replaced by a manageable amount.
“We are not only protecting older adults, we are also ensuring that they have the best health care possible,” Trump said.
The new insulin benefit will be voluntary, so during open enrollment this fall, interested Medicare beneficiaries should be sure to choose an insurance plan that provides it. Most people with Medicare will have access to them.
Stable copays for insulin are the result of an administration-sponsored deal between insulin manufacturers and top insurers, Medicare chief Seema Verma told The Associated Press. The three main suppliers, Eli Lilly, Novo Nordisk and Sanofi, were involved.
“It was a delicate negotiation,” said Verma. Drug makers and insurers have disagreed in recent years, blaming each other for the high prices. “I think this is a great step.”
The deal comes as President Donald Trump returns to the issue of drug prices, trying to attract older people whose votes are critical to his reelection prospects.
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The cost of insulin is one of the biggest concerns for consumers who are generally concerned about high prices for brand name drugs. Millions of people with diabetes use insulin to keep their blood sugar levels within normal ranges and avoid complications that can include heart disease, blindness, kidney failure, and amputations. People with diabetes also have worse results with COVID-19.
Last week, Trump told Republican senators at a Capitol Hill meeting that he still wants to pass a bill this year to cut drug costs, saying “I think it needs to be done,” according to an assistant summary. Bipartisan legislation to limit price increases and reduce costs for older people with high drug bills is pending in the Senate.
The fate of drug pricing legislation ultimately rests with Speaker of the House of Representatives Nancy Pelosi, who has a much more ambitious plan for Medicare to negotiate prices for more expensive drugs, not just insulin.
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Pelosi would use the expected savings to provide vision, dental and hearing coverage for older adults. Most Republicans oppose that approach as an expansion of government pricing.
Although the White House and Pelosi’s office held talks last year about the prescription drug legislation, the relationship between the two leaders has been tense and angry for months.
One in three people with Medicare has diabetes and more than 3 million use insulin. At list prices, the drug can cost more than $ 5,000 a year. Although insured patients don’t pay that, they do notice an increase in copays based on full cost. People who cannot afford their insulin may try to cope by reducing their doses, a dangerous calculation that can be life-threatening.
Private insurers offer the Medicare prescription drug benefit, either as a stand-alone “Part D” drug plan added to traditional Medicare, or as part of a managed care plan under Medicare Advantage. Private taxpayer-subsidized plans are tightly regulated by the government, but the law prohibits Medicare from negotiating drug prices, something Democrats, including presidential candidate Joe Biden, want to change.
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The insulin benefit will be available in all 50 states, Washington, D.C. and Puerto Rico. Participation is voluntary for Medicare insurers and beneficiaries alike.
In a twist, Trump’s new insulin option stems in part from the experimentation authority that Medicare obtained under the Obama-era Affordable Care Act, which the White House is trying to overturn as unconstitutional.