Your Weekly Medicare Consumer Advocacy Update
Medicare Celebrates 50 Years
Department of Health and Human Services Hosts Medicare Anniversary Event
This week, to celebrate Medicare’s 50th anniversary, the Department of Health and Human Services (HHS) held a special event and panel discussion featuring many of today’s brightest Medicare luminaries. HHS Secretary Sylvia Mathews Burwell gave the keynote address and introduced a panel moderated by the Acting Administrator for the Centers for Medicare & Medicare Services, Andy Slavitt.
The panel led a rich discussion about Medicare and the future of the program. Panelists included Drew Altman, President and CEO of the Kaiser Family Foundation; Jason Furman, Chairman of the White House Council of Economic Advisors; Sister Carol Keehan, President and CEO of the Catholic Health Association of the United States; Nancy LeaMond, Chief Advocacy and Engagement Officer of AARP; and Steven Safyer, President and CEO of Montefiore Health System.
The event also featured a “Thunderclap” where over 350 supporters simultaneously posted a happy anniversary message to Medicare on social media, achieving a social reach of almost four million people.
AARP Voices Concern about the Trans-Pacific Partnership
This week, AARP called for revisions to the Trans-Pacific Partnership (TPP), a massive trade agreement currently being considered. The focus of their concern—shared by many consumer advocates, including Medicare Rights—surrounds provisions that would “add to the profits of the brand-name pharmaceutical industry at the expense of patients and older Americans.”
Specifically, AARP objects to intellectual property provisions in the draft TPP agreement that may restrict competition and delay consumers’ access to lower-cost generic drugs. These provisions include extending brand drug patent protections through “evergreening” drug products by linking approval to market generic drugs to existing patents in a way that protects brand drugs, and increasing protections for biological medications that further delay the ability of other companies to create generic versions of these extremely high-cost drugs.
AARP’s concerns are heightened by the existing and growing strain of high drug prices on consumers, state and federal budgets, and the U.S. health care system. AARP states that the “TPP will result in billions of dollars in unnecessary spending on medications. As it stands now, the TPP represents a very bad deal for the millions of people for whom affordable medicine can sometimes mean the difference between life and death.”
Negotiations about the deal will be taking place in Hawaii over the next several days. In a blog post, directed to U.S. Trade Representative Michael Froman other trade negotiators, AARP urges changes to these provisions to ensure consistency with prior U.S. free trade agreements with Peru, Panama, and Colombia. These existing frameworks “strike a better balance and give the TPP trading partners the ability to foster both innovation and competition in the pharmaceutical industry while ensuring access to affordable medicines for millions of people in the U.S. and around the world.”
Volume 6, Issue 29
The coverage gap, also called the doughnut hole, is a phase of Part D prescription drug coverage during which the amount you pay for your prescription drugs increases. In the past, most people had to pay the full cost of their drugs in the coverage gap. Due to the Affordable Care Act, you no longer have to pay the full cost of your drugs during this period.
The coverage gap starts when your total drug costs—including what you and your plan have paid for drugs—reaches a certain amount since the start of the calendar year. In 2015, this amount is generally $2,960.
In 2015, there is a 55 percent manufacturer’s discount on most brand-name drugs. This means you pay 45 percent for brand-name drugs listed on your Part D plan’s formulary, and the manufacturer plus the federal government pay 55 percent. For generic drugs, the government provides a 35 percent discount in 2015. You pay the remaining 65 percent of the cost.
These discounts will gradually increase each year until 2020. Starting in 2020, you will typically pay no more than 25 percent of the cost of your drug at any point during the year after you have met your deductible.
You get out of the coverage gap when you have paid $4,700 out-of-pocket for covered drugs since the start of the year. The costs that help you get out of the coverage gap include what you spent on drugs, most of the discount on brand-name drugs that you received in the coverage gap, and the cost of drugs that someone else pays on your behalf (such as family members, most charities, or State Pharmaceutical Assistance Programs).
This week, the National Journal hosted a policy forum to discuss the future of Medicare. As Medicare celebrates 50 years of providing a health and economic safety net for older Americans, a dialogue about the future of the program is vitally important.
Moderated by Julie Rovner of Kaiser Health News, the panel included Medicare Rights President Joe Baker and other Medicare thought leaders.