Health

Medicare urged to use its opportunities and cut premium growth

The head of the Senate Commission that oversees Medicare says the Biden administration should use its legal powers to curtail the massive premium increases that will soon affect millions of participants as more Democratic lawmakers call for action amid fears of rising inflation.

Medicare announced one of the largest increases in monthly Part B premiums for outpatient care last month – by nearly $ 22 – from $ 148.50 currently to $ 170.10 starting in January.

The agency attributed roughly half of the increase, about $ 11 a month, to the need for a contingency fund to cover Aduhelm, a new $ 56,000 Alzheimer’s drug from Biogen, whose benefits have been widely discussed. For most Medicare members, the premium is deducted from their Social Security checks. Without further action, it will absorb a significant portion of the 5.9% increase in the cost of living of the elderly.

“Rather than assessing the current premium increase of $ 21.60 per month … in full, I urge you to reduce that amount,” Health Secretary Xavier Becerra wrote Senate Finance Chairman Ron Weeden, Oregon. “This approach will reduce the short-term costs of fixed income seniors.” A copy of the letter was provided to the Associated Press on Monday.

There was no immediate response from the administration.

But Wieden wrote to Becerre that, as Minister of Health and Human Services, he has “broad authority” to determine “appropriate contingency margins” to use in setting premiums.

Given that Medicare is still developing its official policy for Aduhelm coverage, Wyden said there is a clear reason for collecting fewer advance payments at this particular time.

“It is possible that any short-term Medicare coverage for Aduhelm … may have limited and narrow coverage,” he wrote. “Uncertainty” about the drug’s financial impact on Medicare appeared to largely determine the calculation of the new premium, Wyden said.

Shortly after Medicare announced the increase last month, Senator-independent Vermont Senator Bernie Sanders called on the administration to repeal it. Wieden also said he has concerns and is exploring options. And last week, Democratic Senators Maggie Hassan of New Hampshire, Jackie Rosen of Nevada, Chris Van Hollen of Maryland, Mark Kelly of Arizona, and Jack Reed of Rhode Island wrote to President Joe Biden that “we must address this issue as best we can. faster”.

Some older groups expect a response from Medicare recipients if nothing is done.

“Once the 2022 Part B premium starts to deduct from their Social Security benefits, I think Congress will really do that,” said analyst Mary Johnson of the non-partisan Senior Citizens League, which advocates maintaining benefits for retirees.

The Labor Department said Friday that consumer prices jumped 6.8% over the past year, the largest rise in inflation in nearly four decades. It was based on the prices of basic necessities, from food to energy and housing costs. Fears about inflation exacerbate the political uncertainty of Democrats ahead of the 2022 midterm elections.

Biden’s Social Agenda Act will require significant action to lower the cost of drugs for Medicare recipients. But even if the bill gets passed, Medicare will have to wait for years to negotiate a price for new drugs like Aduhelm. Other provisions that would allow for faster cost savings will not come into effect in a couple of years. The first to hit is an increase in Medicare premiums.

Seniors “believe that young working families have benefited most from recent legislation and will continue to do so in accordance with the Recovery Efficiency Act,” said Johnson, an advocacy group analyst.

Usually, the financial consequences of expensive drugs are most borne by patients with serious medical conditions, such as cancer, rheumatoid arthritis, or multiple sclerosis. But with Aduhelm, the financial pain will spread to Medicare recipients in general, not just Alzheimer’s patients who need the drug.

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The problem has evolved into a case study of how one expensive drug can affect government spending and affect the household budget. People who do not have Alzheimer’s will not be protected from the cost of Aduhelm, as it is large enough to affect their insurance premiums.

Alzheimer’s is a progressive neurological disease with no known cure that affects about 6 million Americans, the vast majority of whom are old enough to be eligible for Medicare.

Aduhelm is the first cure for Alzheimer’s in nearly 20 years. It does not treat a vital condition, but the FDA has determined that its ability to reduce plaque build-up in the brain is likely to slow the progression of dementia. However, many experts say the benefits have not been clearly demonstrated.

Medicare currently covers Aduhelm on an individual basis pending a formal assessment, which may take several months.

Pharmaceutical company Biogen says it has priced Aduhelm fairly based on payments for other innovative drugs designed to treat intractable diseases.


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