President Biden Doubles Down on Medicare Drug Negotiation, Insulin Price Cap

Although President Joe Biden’s recent Build Back Better Act has stalled in Congress, the current administration has not backed down on insisting upon improved healthcare access for everyone, but specifically American retirees.

During his State of the Union Address earlier this year, the President not only renewed his call for reduced prescription prices, but doubled down on capping insulin prices at $35 a month for all Americans.

The Build Back Better Act had initially proposed a reduction in prescription medication costs by way of allowing Medicare, the U.S.’s federally-backed health insurance program for retirees and seniors, to negotiate prescription drug prices with Big Pharma on behalf of the program’s beneficiaries.

Currently, Medicare is not permitted to negotiate lower prices on prescriptions for the program’s over 63 million enrollees, which virtually allows pharmaceutical giants to set medication prices as high as they wish.

“I know we have great disagreements on this floor with this — let’s let Medicare negotiate the price of prescription drugs,” Biden said in his speech to Congressional lawmakers.

Biden’s $1.75 trillion Build Back Better bill was a reflection of the current administration’s dedication to strengthening the social safety net of all American citizens, but especially the most vulnerable populations of our society.

What happened to Build Back Better?

As mentioned, Medicare drug negotiation and the insulin price cap were both included as part of President Biden’s Build Back Better proposal, which was defeated in the Senate (after clearing the House) late last year.

Reports indicate that Congressional Democrats lobbied strongly for drastic reforms that would improve the health and wellness of seniors and those with certain disabilities, while Congressional Republicans were more concerned with the financial costs associated with making the changes, leading to the bill falling apart on the Senate floor.

Still, many parts of the bill remain popular with American citizens, including a proposal beginning in 2025 that would have allowed price negotiations of up to 10 drugs a year, with that number increasing to 20 drugs a year by 2028.

Additionally, the bill included a provision that would cap Medicare beneficiary out-of-pocket spending at $2,000 for Medicare Part D, the part of Medicare that is primarily responsible for Prescription Drug Coverage, which would have begun in 2024 with yearly adjustments as needed.

So, where does this leave the bargaining power of America’s 63.3 million Medicare beneficiaries?

The vast majority of current Medicare enrollees are retired seniors who worked and paid their fair share for their entire life. For them, limiting out-of-pocket expenses, capping insulin prices, and giving them the power to benefit from fair medication expense negotiation could literally mean saving thousands of dollars per year, or in some cases, their lives.

Currently, there is no cap on Medicare drug costs. In 2019, approximately 1.2 million enrollees spent more than $2,000 each on medically necessary drugs delivered through Medicare Part D. At this point, it remains uncertain whether Republicans and Democrats will be able to reach common ground on the issue anytime soon.

Although the future may look bleak for Medicare beneficiaries when it comes to drug costs, there are still ways to lower your medical costs via the private sector. Feel free to contact the licensed insurance agents and Medicare Advantage experts at MedicareInsurance.com in order to explore your most affordable options for Medicare.