Medicare Archives — Page 2 of 5

Kamala Harris Is A Health Care Champion

Watch Protect Our Care’s New Video Here.

Vice President Kamala Harris has proven to be a health care champion throughout her career in public service. She has fought tirelessly to improve the health and well-being of people across the country. Harris voted time and time again to protect Americans’ health care, to ensure those with pre-existing conditions have access to affordable health care, and to lower costs for American families. Protect Our Care Chair Leslie Dach issued the following statement:

“Thanks to Kamala Harris, millions of people no longer have to decide between their health care or prescription drugs and putting food on the table. She is a champion for lowering health care costs, expanding access to affordable coverage, improving maternal health, and protecting reproductive rights. Her health care agenda is a win for middle-class families and a win for our nation’s future — a stark contrast to MAGA Republicans who want to go backwards and try once again to repeal the ACA, rip away protections for pre-existing conditions, and raise prescription drug costs for seniors.”

Kamala Harris’s 100-day agenda prioritizes delivering lower prices for middle class families. As Democratic nominee, Harris has announced some of her plans for the first 100 days in office, including actions to further lower drug costs and provide relief for medical debt. Harris has called for:

Capping The Cost Of Insulin At $35 Per Month For Everyone, Not Just Seniors. The Inflation Reduction Act capped insulin costs at $35 per month for seniors, and now Harris wants to pass these savings on to everyone.
Accelerating The Speed Of Medicare Drug Price Negotiation. Building on the accomplishments of the Inflation Reduction Act, Harris would allow Medicare to negotiate the price of drugs faster, so prices can come down faster for seniors.
Increase Competition And Demand Transparency. Harris plans to hold accountable pharmaceutical companies that block competition and promote abusive practices that hurt small pharmacies and raise prices on Americans.
Cancel Medical Debt For Millions Of Americans. Harris’s plan builds on her accomplishments as vice president in removing medical debt from nearly all Americans’ credit reports and securing American Rescue Plan funds to cancel $7 billion of medical debt for up to 3 million Americans by the end of 2026.

As Vice President, Harris casted the deciding vote to pass the Inflation Reduction Act. She is responsible for lowering prescription drug prices, making tax credits available to lower premium costs for families, and capping insulin copays at $35 per month.

Gave Medicare The Power To Negotiate Prescription Drug Prices. Medicare drug price negotiation will save taxpayers billions of dollars and lower costs for the most popular and expensive prescription drugs. By 2030, 80 of the most expensive prescription drugs will have lower prices because of these negotiations. In the first year alone, these newly lowered prices will save seniors $1.5 billion in out-of-pocket costs and will save taxpayers $6 billion.
Lowered Costs Of Health Care Premiums For Millions Of Families. The Inflation Reduction Act lowered premium costs for millions of Americans through 2025 by increasing financial assistance for people who buy coverage on their own and making tax credit subsidies more widely available to middle-class families, ensuring people purchasing coverage through the ACA marketplaces will not pay more than 8.5 percent of their income for coverage. Families save an average of $2,400 a year on their health insurance premiums thanks to this provision.
Capped Insulin Copays At $35 Per Month. The Inflation Reduction Act capped insulin prices at no more than $35 starting January 2023 — saving seniors up to $1,500 annually. In response to calls from President Biden, the three largest insulin manufacturers announced $35 monthly out-of-pocket cost caps, lowering costs of about 90% of the insulin on the market.

As a senator from California, Harris has repeatedly helped defeat Republican efforts to repeal the Affordable Care Act and remove protections for people with pre-existing conditions. She also supported lowering prescription drug prices, which became a reality with Harris casting the deciding vote as vice president and passing the Inflation Reduction Act.

Harris Helped Protect The ACA. In 2017, then Senator Harris voted against the Obamacare Repeal and Replace Act, the Better Care Reconciliation Act, and the “Skinny Repeal.” All of these bills would have stripped health care from millions of people and increased premium costs.
Harris Took A Stand For People With Pre-Existing Conditions. Harris authored an op-ed with CNN in 2017 that illustrated how getting rid of protections for pre-existing conditions would have devastating effects on communities of color. People of color are more than twice as likely to die from diabetes as their white counterparts and Black people experience higher rates of heart disease than white people. Getting rid of pre-existing condition protections, as proposed by Republicans, would disproportionately impact communities of color’s access to affordable health care.
Harris Blocked The MAGA Plan To Expand Junk Plans That Don’t Cover Pre-Existing Conditions. Harris cosponsored two resolutions to overturn Trump administration health care policies that allow the expansion of short term health care plans that do not have to guarantee coverage for pre-existing conditions or cover essential health benefits.

As a senator from California, Harris protected women’s rights. Maternal and reproductive health freedoms were a key pillar of her work in Congress. Harris continued to fight for women as vice president and pledges to as the Democratic nominee.

Harris Fought For Maternal Health Protections. Harris was involved with creation and proposing of the first Black Maternal Health Momnibus Act to address this crisis in maternal health. The “Momnibus” would direct HHS to establish task forces to address social determinants of health and award grants to innovations in maternity care and maternal mortality tracking. It also would expand federal nutrition programs through increasing the postpartum and breastfeeding periods and reduce specific state funding to jurisdictions which have no laws restricting constraints on incarcerated pregnant people. Every year since 2020, the Momnibus Act has been reintroduced in the Senate. It is perhaps the most essential central piece of legislation existing to address maternal mortality rates and health equity.
Harris Protected Reproductive Freedoms And Abortion Access. Harris co-sponsored 14 pieces of legislation that would expand and protect the reproductive rights of Americans. From supporting the Women’s Health Protection Act to protecting access to birth control to fighting for the expansion and protection of insurance coverage for abortions, Harris has a remarkably consistent record when it comes to ensuring Americans have access to quality and affordable reproductive health care.

As Attorney General of California, Harris protected the ACA and stood up to big drug companies. Since the beginning of her career, Harris played a key role in making the ACA what it is today and ensuring pharmaceutical companies are held responsible for exploitative practices.

Harris Filed 10 Amicus Briefs Defending The ACA As California Attorney General. As Attorney General of California, Harris defended the constitutionality of the ACA in court by arguing the ACA regulates interstate commerce. In the 2011 press release of one of these filings, Harris stated, “Health care reform saves lives, and that is why I am determined to protect this law.” Harris also argued for the protection of contraception mandates, stating, “The right to healthcare services is justly protected under federal law, and the Supreme Court should uphold the ACA’s common-sense accommodation for religious organizations and protect women’s access to essential health care.”
Harris Held Pharmaceutical Companies Accountable Through Nearly $7.2 Billion in Fines. Then-Attorney General Harris broke records throughout her term when it came to settlements holding pharmaceutical companies accountable for deceptive and illegal practices. She was involved in the second largest recovery from a pharmaceutical company and the largest consumer protection settlement reached with a pharmaceutical company. Of the billions she was able to recover due to inflated drug prices and illegal marketing practices, $2.2 billion came from Johnson and Johnson, whose drugs Xarelto, Stelara, Imbruvica are currently up for Medicare price negotiation, $71 million came from Amgen, whose drug Enbrel is currently up for Medicare price negotiation, $68.5 million came from AstraZeneca, whose drug Farxiga is currently up for Medicare price negotiation, and $19.5 million came from Bristol-Myers Squibb, whose drug Eliquis is currently up for Medicare price negotiation.

ashoup In News

The Biden-Harris Administration Delivered on a Lifetime of Health Care

From Birth to Retirement, the Biden-Harris Administration Has Lowered Costs and Increased Coverage

Since the start, the Biden-Harris administration has been committed to making health care a right, not a privilege, and ensuring people across the nation have the same quality health care no matter where they live or the color of their skin — throughout their entire lives. Thanks to President Biden and Vice President Harris’s leadership, more people have health insurance coverage than ever before. Whether it’s lowering the cost of drugs, capping the monthly cost of insulin, or ensuring millions of Americans have access to affordable health insurance, this administration has fought for everyday Americans and won.

Meanwhile, Republicans are continuing a war on our health care system by trying to repeal the Affordable Care Act (ACA) and the Inflation Reduction Act, cut funding from critical programs like Medicare and Medicaid, and ban Medicare from negotiating lower drug prices. The MAGA Republican Project 2025, a dangerous policy roadmap for another Trump presidency, calls for full repeal of the Inflation Reduction Act’s prescription drug provisions that are saving Americans thousands of dollars on health care. In addition, big drug companies and their Republican allies are in court trying to ban Medicare from negotiating lower drug prices. They are determined to decimate our health care, leaving millions behind without coverage.

Over the past four years, the Biden-Harris administration has made advancements in health care for all stages of life:

Birth:
- Launched a government-wide strategy for preventing maternal deaths and improving birth outcomes through the Biden-Harris Administration’s Blueprint for Addressing the Maternal Health Crisis.
- Signed legislation giving states the option to extend postpartum Medicaid coverage from 60 days to a full year. Currently, 47 states including DC have elected to extend Medicaid coverage for a full year postpartum.
- Established the first National Maternal Mental Health Hotline to provide emotional support, resources, and referrals to pregnant and postpartum women and their loved ones.
- Invested $105 million in funding to support more than 100 community-based organizations working to improve maternal and infant health.

Childhood:

- Signed legislation to guarantee 12-month continuous coverage for children on Medicaid and CHIP once they are enrolled, ensuring millions of families have reliable, affordable health coverage.
- Fixed the “family glitch,” which blocked millions of families, primarily women and children, from accessing affordable coverage from the ACA. The fix will expand coverage and lower health care costs for more than one million Americans.
- Simplified how millions of Americans, including children, apply for and renew coverage through Medicaid, CHIP, and the Basic Health Program (BHP). The rule also applies new consumer protections from the ACA to Medicaid and CHIP enrollees, like banning lifetime limits and waiting periods.

Adult:
- Lowered health insurance costs for people buying coverage on their own through enhanced premium tax credits, making coverage affordable for more people than ever.
- Protected consumers and limited short-term junk plans that do not need to cover pre-existing conditions, which often use deceptive marketing practices and leave American families with staggering medical bills.
- Protected Americans from surprise medical bills from emergency room visits, non-emergency out-of-network visits at in-network facilities, and air ambulance services for out-of-network providers.

Senior:
- Capped insulin prices at no more than $35 monthly for all Medicare beneficiaries beginning in January 2023 — saving seniors up to $1,500 annually.
- Limited annual out-of-pocket spending to $2,000 starting in 2025, giving over 46.6 million Americans with Medicare Part D more reassurance and financial stability.
- Gave Medicare the power to negotiate lower drug prices, which will save taxpayers billions of dollars and lower costs for some of the most popular and expensive prescription drugs.
- Provided free vaccines, such as shingles and Tdap, at no cost starting in 2023.
- Required drug companies to pay Medicare a rebate when they hike prices faster than the rate of inflation. This will not only save the government billions of dollars, but it will drastically reduce out-of-pocket costs for seniors and people with disabilities.

ashoup In News

Reminder: MAGA Republicans Want to Raise Costs and Rip Away Health Care

As Democrats celebrate their accomplishments and lay out their vision for the future at the Democratic National Convention, Donald Trump and MAGA Republicans are working to take America backwards. Time and again, MAGA Republicans have made clear plans for American health care: they are going to fight tooth and nail to raise costs, deny coverage to millions of people, and slash funding for Medicare and Medicaid. In 2023 alone, Republicans tried to repeal the Inflation Reduction Act’s measures that make prescription drugs more affordable for seniors, impose burdensome Medicaid paperwork requirements designed to throw people off of coverage, and weaken protections for 135 million people with pre-existing conditions. Donald Trump has also reignited calls to repeal the Affordable Care Act (ACA) entirely, giving new life to Republicans’ longtime war on health care.

Key points of the GOP health care plan include:

Repealing the ACA
Repealing the Inflation Reduction Act
Hiking drug costs for seniors
Slashing Medicare and Medicaid funding
Putting drug and insurance companies back in charge

If Republicans are successful in enacting their health care plan, 46 million Americans across the country risk losing coverage, 20 million will see higher premiums, and 67 million people on Medicare will have to pay increased drug costs for lifesaving medications.

ashoup In News, Fact Sheet, Research

FACT SHEET: President Biden’s Health Care Legacy is a BFD!

As the Democratic National Convention kicks off, Protect Our Care celebrates President Biden’s health care legacy. During his Presidency, Joe Biden has built on the Affordable Care Act (ACA), safeguarding its consumer protections and boosting access to affordable health care for millions of Americans by lowering costs and addressing health inequities. He signed the American Rescue Plan and Inflation Reduction Act, lowering prescription costs and premiums, and he has fought to protect and strengthen Medicare and Medicaid. Protect Our Care Chair Leslie Dach issued the following statement:

“Joe Biden’s health care legacy is a BFD. There would not be an Inflation Reduction Act without Joe Biden – he created it, he fought aggressively for it for months, he refused to give up, and his legislative skills made it happen. As President, he built on the success of the ACA, standing up to greedy drug companies, lowering the cost of drugs and health insurance and expanding affordable health care to millions of people across America. He kept America safe during the pandemic and launched the cancer moonshot program. He has paved the way for a future where every American has the health care they need and where health care is a right, not a privilege.”

“Joe Biden has always been a health care champion; he sponsored a bill during his first year in the Senate establishing a Medicare drug price negotiation program and he partnered with President Obama to pass the ACA. Every American’s health care is better and more affordable today because of Joe Biden.”

The Inflation Reduction Act and the American Rescue Plan:

Protect seniors from prescription drug hikes. Under the Inflation Reduction Act, when drug companies hike prices faster than the rate of inflation, they will have to pay Medicare a rebate. This has not only saved the government billions of dollars, but it has drastically reduced out-of-pocket costs for people on Medicare. In June 2024 alone, the Biden-Harris administration announced that some seniors and people with disabilities will pay less for 64 drugs available through Medicare Part B thanks to the Inflation Reduction Act’s rebate program.
Give Medicare the power to negotiate lower drug prices, which will save taxpayers billions of dollars and lower costs for some of the most popular and expensive prescription drugs. By 2030, 80 of the most expensive prescription drugs will have lower prices because of these negotiations. This month, the Biden-Harris administration announced the new, lower prices for 10 of the highest-cost, most popular drugs taken by nearly 9 million people on Medicare who spent $3.9 billion in out-of-pocket costs in 2023. In the first year alone, these newly lowered prices will save seniors $1.5 billion in out-of-pocket costs and will save taxpayers $6 billion, slashing the list prices of the first ten drugs by 38–79 percent. Amidst negotiations, the Biden-Harris administration has also successfully fended off lawsuit after lawsuit from big drug companies and their allies seeking to ban Medicare from negotiating lower drug prices.
Cap drug costs for seniors. Under the Inflation Reduction Act, Part D plans are required to cap annual out-of-pocket spending to $2,000 by 2025, giving more than 50 million Americans with Medicare Part D more reassurance and financial stability. According to the Kaiser Family Foundation, this particularly helps seniors with serious conditions like cancer and Multiple Sclerosis. Seniors will also continue to save on insulin and vaccines.
Cut insulin costs. The Inflation Reduction Act capped insulin prices at no more than $35 starting January 2023 — saving seniors up to $1,500 annually. In response to calls from President Biden, the three largest insulin manufacturers announced $35 monthly out-of-pocket cost caps, lowering costs of about 90% of the insulin on the market.
Provide free vaccines for seniors. Millions of Americans enrolled in Medicare Part D have access to covered vaccines, such as shingles and Tdap, at no cost. HHS found that over 10 million people on Medicare received a free vaccine thanks to the Inflation Reduction Act.
Lower health insurance premiums for millions of Americans. The American Rescue plan lowered costs for millions by increasing financial assistance for people who buy coverage on their own and making financial assistance more widely available to middle-class families, ensuring people purchasing coverage through the ACA marketplaces will not pay more than 8.5 percent of their income for coverage. The Inflation Reduction Act carried on those provisions, and families continue to save an average of $2,400 a year on their health insurance premiums.
Cap the amount of money families pay for health insurance. The Inflation Reduction Act ensures families pay no more than 8.5 percent of their income towards coverage.
Eliminate premiums for low-wage workers. The Inflation Reduction Act and American Rescue Plan ensured no American with an income at or below 150 percent of the federal poverty level buying their coverage on the Marketplace will pay a premium.
Provide extra savings for low-income seniors. The Inflation Reduction Act expanded the Medicare Extra Help program, and the Biden-Harris administration announced investments in helping up to 3 million eligible seniors and people with disabilities enroll in the Extra Help program in 2023 to benefit from the program’s lower cost premiums, deductibles, and copayments.
Expand coverage and build on public health emergency continuous coverage protections. The American Rescue Plan provided robust financial incentives for the states that have not yet implemented Medicaid expansion.
Create a pathway to coverage for new mothers. The American Rescue Plan called on states to extend postpartum coverage under Medicaid from two months to a full year following pregnancy, when most negative health outcomes occur.

Safeguarding and Building on The Affordable Care Act

“This Is A Big F*cking Deal:” Then-Vice President Biden Championed The Affordable Care Act. In 2010, the Obama-Biden administration and Democrats in Congress passed the landmark Patient Protection and Affordable Care Act, transforming the American health care system. The ACA cemented protections for more than 100 million Americans with pre-existing conditions, expanded Medicaid coverage to about 24 million people, and established affordable health care marketplaces now providing quality coverage for over 21.3 million people who buy insurance on their own. Then-Vice President Joe Biden championed the bill, telling then-President Obama, “This is a big f*cking deal.” Not only did President Biden champion the law, but he worked to strengthen it and protect it from Republican attacks:

President Biden opened a Special Enrollment Period, allowing millions of Americans to enroll in affordable coverage. Just days into his presidency, President Biden issued an executive order reopening HealthCare.gov for a special enrollment period to help Americans gain coverage as they continue to suffer from the health and economic impacts of the pandemic. 2.8 million Americans enrolled during the Special Enrollment Period (SEP), with particularly large increases in enrollment for Hispanic, Black, and American Indian and Alaska Native people.
President Biden defended the ACA from lawsuits seeking to dismantle all or part of the law. Less than a month into his Presidency, President Biden defended the Affordable Care Act in California v. Texas, the lawsuit before the Supreme Court to completely dismantle the law. The Biden-Harris administration has also defended a major provision of the ACA that requires no-cost coverage of lifesaving preventive health care services in Braidwood Management v. Becerra.
President Biden rolled back the Trump administration’s efforts to undermine the ACA and revoke consumer protections. In his first days in office, President Biden directed federal agencies to re-examine Trump-era policies that undermine the ACA. His administration has since taken steps to revoke Trump administration actions undermining the ACA’s consumer protections. In March, the Biden-Harris administration issued a final rule to protect consumers and limit short-term junk plans that do not need to cover pre-existing conditions, often use deceptive marketing practices, and leave American families with staggering medical bills. In April, the Biden-Harris administration issued a final rule under Section 1557 of the ACA to advance health care protections against discrimination on the basis of race, color, natural origin, sex, age, and disability. That same month, the Biden-Harris administration also reversed a Trump-era regulation allowing insurance companies to sell junk plans known as association health plans.
President Biden invested millions in ACA outreach. The Biden-Harris administration made historic investments in outreach, announcing $500 million in grants over the next five years for the Navigators program. The program plays a key role in helping people across the country sign up for health care coverage through ACA marketplace plans.
President Biden launched executive actions strengthening building on the ACA by protecting people with pre-existing conditions and making it easier for low-income enrollees. The Biden-Harris administration announced new executive actions to lower health care costs and protect people with pre-existing conditions. The new actions eliminate surprise medical bills and limit junk insurance plans that do not need to cover people with pre-existing conditions like asthma, cancer, and diabetes. In April, the administration also announced new policies to strengthen the ACA, making it easier for low-income Americans to enroll in coverage, increasing access to routine adult dental services, and setting standards for the time and distance people need to travel for appointments for in-network providers.
President Biden expanded affordable health care to DACA recipients under the ACA. In May, the Biden-Harris administration finalized a policy to expand affordable health care to DACA recipients through the ACA. CMS estimates that this rule could lead to 100,000 previously uninsured DACA gaining coverage.
Under President Biden, a record-breaking 21.3 million Americans signed up for affordable health care through ACA marketplaces. Earlier this year, the Biden-Harris administration announced that a record 21.3 million Americans have signed up for health insurance through the Affordable Care Act (ACA) marketplaces – over nine million more than when President Biden took office. 80 percent of enrollees were also able to find a health plan through the Marketplace for $10 or less per month thanks to the Inflation Reduction Act lowering health insurance premiums.
President Biden fixed the “family glitch,” expanding ACA marketplace eligibility to over one million Americans. In October 2022, the Biden-Harris administration issued a final rule to fix the “family glitch,” which blocked millions of families from accessing affordable coverage through the ACA marketplaces – expanding coverage and lowering health care costs for more than one million Americans.

Strengthening and Protecting Medicaid and Medicare

President Biden Has Worked To Strengthen and Protect Medicaid and Medicare. Throughout his Presidency, President Biden has made protecting and strengthening Medicaid and Medicare – which cover hundreds of millions of Americans – a cornerstone of his health agenda. During his tenure, President Biden has:

Protected Medicaid from budget cuts.
Cracked down on Trump’s disastrous paperwork requirements.
Pushed to make it easier for millions of eligible people to enroll in Medicaid, reducing red tape and simplifying applications, verifications, enrollment, and renewals for health care coverage through Medicaid and the Children’s Health Insurance Program (CHIP).
Signed legislation guaranteeing 12-month continuous coverage for kids on Medicaid and CHIP and announced a rule standardizing enrollment and renewal processes nationwide. The rule also applied consumer protections from the ACA to Medicaid and CHIP enrollees, like banning lifetime limits and waiting periods.
Fought to protect people on Medicaid from disenrollment. In September 2023, the Biden-Harris announced that nearly 500,000 children and adults who were improperly disenrolled from Medicaid and CHIP would regain their coverage thanks to their actions.
Established national Medicaid and CHIP standards for patient wait times and travel distance, ensuring that people who rely on Medicaid have meaningful access to health care services including primary care, behavioral health and substance use disorder services, and OB/GYN care. The Biden-Harris administration also announced minimum staffing standards at nursing homes to promote safety and high-quality care for 1.2 million seniors and people with disabilities.
Pushed for prescription drug transparency in Medicaid.
Cracked down on Medicare Advantage plan providers publishing misleading ads.

Lowering Costs and Improving Health Care

President Biden Has Fought To Lower Drug Costs, Including Inhalers. In December 2023, the Biden-Harris administration announced plans to lower prices for certain high-priced medicines by developing a policy for using federal “march-in rights” to license drugs to other manufacturers who could sell them for less in order to stop price gouging and boost competition between drug manufacturers to lower prices for patients. That same month, the Biden-Harris administration announced a new policy to ensure the best value for taxpayers by establishing a fair pricing standard for medical products purchased by the Administration for Strategic Preparedness and Response. In March, President Biden hosted an event to celebrate lower inhaler costs following the FTC’s recent crackdown on drug companies that use improper patents to keep the price of inhalers too high. In response, two drugmakers have capped out-of-pocket costs for some top-selling inhalers at $35 per month.

President Biden Has Fought To Improve Health Equity and Access to Health Care. President Biden has taken steps during his presidency to address health inequities, issuing several executive orders and new agency rules. On his first day in office, President Biden signed an executive order calling for the federal government to advance an ambitious, whole-of-government equity agenda. In April 2022, he signed another executive order focused on continued efforts to expand access to affordable, quality health coverage, and in February 2023, President Biden signed a new executive order aiming to strengthen and reaffirm the administration’s commitment to deliver equity. In September 2023, the Biden-Harris administration released a historic proposed rule that strengthens prohibitions against discrimination for people with disabilities in any program or activity receiving funding from HHS.

President Biden Has Worked Tirelessly To Address Maternal Health. President Biden has worked to address the maternal mortality crisis and invest in maternal health. In June 2022, the Biden-Harris administration released a whole-of-government blueprint for combating maternal mortality and morbidity. In March, President Biden signed an executive order directing federal agencies to prioritize women’s health research, including studying conditions like menopause, arthritis, and heart disease and in April, the Biden-Harris administration invested $105 million in funding to support more than 100 community-based organizations working to improve maternal and infant health.

President Biden Has Prioritized Reproductive Health Care As MAGA Republicans Rolled Out Abortion Bans and Pushed For Limited Contraception Access. In the wake of the MAGA Supreme Court overturning Roe v. Wade and rolling back nearly 50 years of abortion protections, President Biden has made protecting reproductive health care a top priority. Following the Dobbs v. Jackson decision, President Biden signed an Executive Order seeking to protect access to reproductive health care services and defend women’s fundamental rights. He has issued executive orders strengthening access to affordable contraception and family planning services and rolling back Trump’s gag rule barring family planning providers from mentioning abortion to patients to receive Title X funding. The Biden-Harris administration also recently released new guidance reminding state Medicaid agencies that they must ensure enrollees have access to comprehensive family planning services.

ashoup In Fact Sheet, Research

FACT SHEET: 49 Million Seniors Will Save On Out-Of-Pocket Spending On Prescription Drugs

Seniors and hardworking families are paying too much for prescription drugs – more than any other country in the world – and it’s forcing them to choose between their medication and food for their families. But, that’s changing.

Medicare plans for 2024 will include new benefits and lower costs for seniors because of President Biden’s Inflation Reduction Act, including free vaccinations for illnesses like shingles and the flu, a $35 monthly cap on insulin costs, protections from outrageous price hikes, and a new annual cap of approximately $3,300 on out-of-pocket expenses for drugs.

Starting in 2025, Medicare beneficiaries will also see lower drug costs across the board thanks to the Inflation Reduction Act’s new $2,000 annual out-of-pocket cap on drug costs. Soon, seniors will save even more thanks to Medicare negotiation.

FAST FACTS:

49 million Medicare Part D beneficiaries will have out-of-pocket costs for prescription drugs capped at approximately $3,300 per year in 2024 and $2,000 per year beginning in 2025. More than 1.4 million Medicare enrollees paid more than $2,000 in out-of-pocket costs in 2020.
3.5 million seniors struggle to afford their medication, forcing them to skip or ration doses.
In 2024, 400,000 low-income seniors will receive more help affording prescription drugs through the Medicare Part D Low-Income Subsidy Program.
In 2025, nearly 19 million Medicare enrollees will save an average of about $400 per year on out-of-pocket prescription drug costs. Enrollees with the highest drug costs will save an average of $2,500 per year.

Capping Out-Of-Pocket Spending For Seniors. Seniors with serious conditions like cancer, multiple sclerosis, and rheumatoid arthritis will save thousands of dollars on prescriptions under the Inflation Reduction Act. More than 1.4 million Medicare enrollees paid more than $2,000 in out-of-pocket costs in 2020. The Inflation Reduction Act also allows out-of-pocket spending to be smoothed over the course of the year beginning in 2025, so patients are not forced to pay the entirety of their out-of-pocket cost all at one time.

Helping Millions Of Seniors Who Can’t Afford Their Prescriptions. The Inflation Reduction Act will help 3.5 million older Americans who have trouble affording their medication. Over the decade from 2009 to 2019, out-of-pocket spending for older Amerians rose by 41 percent. Seniors often have to sacrifice basic needs such as food or clothing to be able to afford their prescriptions due to rising costs.

Republicans Voted Against Lower Drug Prices For Millions of Americans. Every Republican in Congress voted against the Inflation Reduction Act effectively taking money out of the pockets of seniors and putting it in Big Pharma’s. Since its passage, Republicans in Congress have repeatedly introduced legislation to repeal the Inflation Reduction Act’s health care provisions, which would increase health care costs for millions. If the history of efforts to repeal the Affordable Care Act is any indication, the Republican party will continue to attempt to block life-saving programs, preventing Americans from getting quality and affordable health care.

ashoup In News, Report, Research

NEW REPORT: Reps. Castro and Gallego, UnidosUS Action Fund, and Protect Our Care Discuss Report on the Impact of the Inflation Reduction Act for Latino Families

Watch the Full Event Here.

Read the Full Report in English Here.

Read the Full Report in Spanish Here.

Washington, DC – Today, U.S. Representatives Joaquin Castro (D-TX-20) and Ruben Gallego (D-AZ-03) joined UnidosUS Action Fund and Protect Our Care for a press call discussing the importance of accessing lower healthcare costs through the ongoing Medicare and Affordable Care Act open enrollment periods, and how the Inflation Reduction Act is lowering health care costs for Latino families. During the call, UnidosUS Action Fund and Protect Our Care released a report detailing how the Inflation Reduction Act is benefiting Latinos nationwide.

According to the report, Latinos face disproportionately high adverse health outcomes with Latino seniors being the most likely to experience affordability challenges of any racial/ethnic group in America. The Inflation Reduction Act addresses this challenge by lowering the out-of-pocket cost of health coverage and prescription drugs, which will especially help Latinos who face barriers to care due to unaffordable costs.

The report also spotlights the states with the highest Latino populations, including Arizona, California, Florida, Nevada, New Mexico, and Texas. The report also details how half of the first ten drugs selected to have lower prices negotiated by Medicare are disproportionately taken by Latino Medicare enrollees.

“Last year, Congressman Gallego and I worked with our Democratic colleagues in the House and Senate to pass the Inflation Reduction Act, a historic investment in good jobs, affordable health care, and better lives for America’s families and seniors. More than a year later, the Inflation Reduction Act is capping prescription drug costs and lowering health care premiums for millions of Americans, especially in Latino communities that have disproportionately struggled with access to care,” said Representative Joaquin Castro (D-TX-20). “As we approach the final weeks of open enrollment, I strongly urge all Americans to visit Healthcare.gov and Medicare.gov and check out their coverage options today.”

“The report from Protect Our Care and UnidosUS underscores what we have long known: that the Inflation Reduction Act is saving Latinos in Arizona hundreds of dollars on health care,” said Representative Ruben Gallego (D-AZ-03). “Insulin is now capped at $35 a month, drug companies are finally being held accountable for their price gouging tactics, and even more savings are coming. I look forward to continuing my work to build on these improvements and lower prescription drug and health care costs for all Arizonans.”

“Increasing engagement between the Latino community and the benefits offered by programs like Medicare and the Inflation Reduction Act is imperative, not only to ensure the health of our communities but to our financial health and economic prosperity as a nation,” said Rafael Collazo, Executive Director of the UnidosUS Action Fund.

“I have lived with Type One Diabetes now for almost 28 years, so I have been through not having insurance, having to insulin ration – I understand those struggles,” said Yamelisa Taveras, founder of The Unidos Foundation. “I understand what our community needs, which is why I founded The Unidos Foundation. So seeing the huge changes, especially the insulin cap, I know that is something that benefits me personally, but it definitely benefits a great number of individuals who live within my community. These changes are necessary and we need to support them. ”

“The Inflation Reduction Act is a game-changer, especially for Latino families,” said Leslie Dach, Chair of Protect Our Care. “Between lowering premium costs for families, capping insulin costs and drug costs for seniors, penalizing drug companies for egregious price hikes, and giving Medicare the power to negotiate lower drug prices, the benefits of this historic legislation are already being seen across the nation. Thanks to President Biden and Democrats in Congress, not only will Latino seniors and families save thousands of dollars a year, but they will also be able to access the health care they need and deserve.”

“I was paying $780 in insurance, but that doesn’t include all my medicines for my asthma and I was not yet old enough to be on Medicare,” said Ana Valenzuela, Deputy Director of the Arizona LULAC. “Luckily, I was on Medicare when I was diagnosed with cancer. And eventually, the Inflation Reduction Act will limit my out-of-pocket spending to $2,000. The Inflation Reduction Act is really working for a lot of us. We need these programs that are really going to help our health care. Like President Biden said, ‘We are stronger as a Nation when we work together to lift everyone’s well-being.’”

ashoup In Press Call, News

PRESS CALL: UnidosUS Action Fund and Protect Our Care Release Report on the Impact of the Inflation Reduction Act on Latino Families

Rep. Joaquin Castro and Rep. Ruben Gallego will lead discussion on the importance of participating in Medicare open enrollment and leveraging the Inflation Reduction Act to bridge healthcare inequities.

Washington, D.C. — UnidosUS Action Fund and Protect Our Care will host a virtual press conference on Nov. 15 at 3 P.M. ET / Noon PT to discuss the open-enrollment period for the Affordable Care Act and Medicare and how the Inflation Reduction Act is benefiting Latinos nationwide. The conversation will feature Rep. Joaquin Castro (D-TX 20th District) and Rep. Ruben Gallego (D-AZ 3rd District).

The Inflation Reduction Act works to bridge the healthcare gap and improve access to medication by improving prescription drug coverage and lowering drug prices in Medicare. Americans pay 2 to 3 times more for their prescription drugs than people in other wealthy countries leading to racial and ethnic health inequities. States with the highest Latino populations like California, Arizona, Nevada, New Mexico, Florida and Texas benefit from the Inflation Reduction Act as half of the drugs selected for negotiation treat conditions that disproportionately impact Latinos.

DOWNLOAD: Lowering Health Care Costs for Latinos: How the Inflation Reduction Act Makes Coverage and Prescription Drugs More Affordable

PRESS CALL:

WHO:
Representative Joaquin Castro (D-TX 20th District)
Representative Ruben Gallego (D-AZ 3rd District)
Rafael Collazo, Executive Director, UnidosUS Action Fund
Yamelisa Taveras, founder, The Unidos Foundation
Ana Valenzuela, Deputy Director, Arizona LULAC
Leslie Dach, Chair, Protect Our Care

WHAT: UnidosUS Action Fund and Protect Our Care Press Conference to discuss ACA and Medicare open enrollment and Inflation Reduction Act benefits to recipients.

WHERE: Virtual Conference via Zoom registration

WHEN: Wednesday, November 15, 2023 at 3 P.M. ET // 12:00 P.M. PT

WHY: The Inflation Reduction Act has made health care and prescription drugs more affordable for more people in the United States and for Latinos in particular. Latino seniors are most likely to experience affordability challenges with the Inflation Reduction Act than any racial/ethnic group in America.

Latinos are among the most vulnerable to needing high-cost prescriptions.
Latino seniors are 1.5 to 2 times more likely to report difficulty affording prescription medications than their non-Hispanic White counterparts.
Latino seniors are among the least likely of any racial/ethnic group to have ever received a shingles vaccine compared to their non-Hispanic White, Black, and Asian counterparts.
Latinos are 1.7 times more likely than non-Hispanic white adults to have been diagnosed with diabetes.
Latinos are twice as likely to be hospitalized for treatment of end-stage renal disease related to diabetes compared to their non-Hispanic White counterparts.
Latinos are more likely to have higher levels of disability-related diabetes (3.2%) and hypertension (2.7%) compared to their non-Hispanic White counterparts.
Latinos are among the most likely to have activity limitations due to arthritis of any racial/ethnic group.

ashoup In Fact Sheet, Research

“Medicare Autumn” Fact Sheet: Protecting Seniors From Prescription Cost Price Hikes

Thanks to the Inflation Reduction Act, championed by President Biden and Democrats in Congress, Medicare is better than ever and seniors are protected from outrageous price increases by big drug companies as a result of the law’s penalties on price increases greater than inflation. Hundreds of drugs have seen their list prices grow faster than inflation, forcing seniors to make tough decisions between needed medication and basic necessities — all while big drug companies bring in tens of billions in revenue and spend lavishly to reward shareholders. The Inflation Reduction Act has also brought down the cost of prescription medications for seniors on Medicare by capping insulin costs at $35 per month, providing free vaccines, and allowing Medicare to negotiate drug prices directly with pharmaceutical companies.

This is just the beginning: In 2025, seniors’ total drug costs will be capped at $2,000 per year and, in 2026, new savings from Medicare’s drug price negotiation will take effect. Together, these provisions will save seniors thousands of dollars on prescription drugs. These policies lower costs and improve access to care, which are essential for improving the health and well-being of millions of Americans nationwide.

BY THE NUMBERS

Medicare beneficiaries save as much as $600 per dose thanks to the Inflation Reduction Act’s inflation-pegged price hike rebates.
Medicare beneficiaries only pay 20 percent of the inflation-adjusted amount in copays for drugs with prices that have increased faster than the rate of inflation,
34 drugs will have reduced copays until the end of the year thanks to the Inflation Reduction Act.

Seniors Will Continue To Save Hundreds On Prescription Costs Through Rebates For Drug Prices That Increase More Than Inflation. Thanks to the Inflation Reduction Act, Medicare beneficiaries save as much as $600 per dose. The new law requires drug companies to pay Medicare rebates if their drug prices rise faster than inflation, and those rebates are passed on as savings to seniors. For decades, big drug companies have been launching new drugs at sky-high prices and continuously raising prices faster than inflation, hurting the individuals reliant on them all while making record profits.

Drug Prices Have More Than Tripled Since Launch For The Top 25 Drugs By Medicare Spending. According to an analysis by the AARP, drug prices have more than tripled – an average increase of 226 percent – for the 25 drugs with the highest aggregate Medicare spending since launch. All but one of the top 25 drugs’ lifetime price hikes exceeded the lifetime average rate of inflation as well, with some increasing prices as much as nine times higher than inflation.

Over 100 Drugs Hiked Prices Above Inflation This Year. According to an analysis by the Center for American Progress, 112 drugs saw their list prices hiked above the annual inflation rate in July 2023, with an average rate increase of 30 percent.

1 In 3 American Adults Report Being Unable To Take Their Medications As Prescribed Due To High Costs. According to KFF, 1 in 3 American adults report being unable to take their medication as prescribed, demonstrating how high and rising drug prices are negatively impacting health outcomes for Americans struggling with affordability challenges. Existing racial and ethnic economic disparities place additional pressures on racial and ethnic minorities and make it even more challenging to keep up with drug prices rising faster than inflation.

…All While Big Drug Companies Bring In Record Profits and Reward Shareholders With Lucrative Stock Buybacks. As hundreds of drug prices rise faster than inflation, their manufacturers are bringing in record profits. Drugmakers of the first ten drugs eligible for Medicare price negotiation under the Inflation Reduction Act have made tens of billions in revenue from Medicare and other sources while spending billions of dollars on stock buybacks and lobbying. For example, Eliquis, a drug used to treat blood clots manufactured by Bristol Myers Squibb and Pfizer, has cost Medicare over $41 billion through 2021. Meanwhile, the two companies have executed more than $97 billion in stock buybacks while bringing in nearly $91 billion in global sales and spending over $172 million on lobbying since launch.

ashoup In Research, Fact Sheet

“Medicare Autumn” Fact Sheet: Shingles Vaccines Are Now Free For American Seniors

Thanks to the Inflation Reduction Act, Medicare is better than ever and seniors can get their shingles shots and all other vaccines recommended by the CDC’s Advisory Committee on Immunization Practices, such as COVID-19, RSV, and the flu, for free. Prior to the Inflation Reduction Act, seniors could be forced to spend hundreds of dollars out of pocket for these vaccines, contributing to particularly low vaccination rates for low-income seniors, seniors of color, and rural seniors. The Inflation Reduction Act also brought down the cost of prescription medications for seniors on Medicare by capping insulin costs at $35 per month, limiting outrageous price hikes, and allowing Medicare to negotiate drug prices directly with pharmaceutical companies.

BY THE NUMBERS

50.5 million American seniors can get their shingles vaccine free of cost, including over 9 million Medicare beneficiaries under 65 with disabilities, 15 million beneficiaries of color, and millions of rural beneficiaries.
Seniors will save up to $424 on their two-part shingles shots.
84.5 million Medicaid recipients will also benefit from increased access to vaccinations.

Seniors Will Continue To Save Hundreds On Their Shingles Vaccine. Thanks to the Inflation Reduction Act, 50.5 million seniors are saving up to hundreds of dollars when getting vaccinated against shingles. With a single shot of Shingrix costing $212, seniors on Medicare Part D are saving over $400 on average on vaccinations. The cost of the shingles vaccine has been a driving factor in keeping vaccination rates especially low for the Black and Latino communities. This will level the playing field for seniors on Medicare, given that Americans on private insurance typically can get their shingles vaccines at no cost.

33 Percent of Americans Will Develop Shingles In Their Lifetime. Shingles is a reactivation of the chicken pox virus, typically occurring in adults older than 50 years old. Symptoms include a painful rash, itching, fever, headache, chills, and nausea. The risk of shingles increases with age, making it paramount for vaccinations to be available and accessible. While complications or death from shingles is not common, seniors with weakened immune systems are particularly vulnerable, with 30 percent of shingles hospitalizations occurring within this population.

Required Vaccine Coverage For Medicaid Recipients Will Benefit Nearly 85 Million Americans. The Inflation Reduction Act also required state Medicaid and CHIP programs to cover vaccines recommended by the CDC’s Advisory Committee on Immunization Practices for no out-of-pocket costs. This allowed an estimated 4 million adults to gain access to shingles vaccines that didn’t previously have access before. Accessible vaccinations will particularly help low-income families on Medicaid, many of whom are people of color and people with disabilities, to help prevent illness and related work absences.

ashoup In Research, Fact Sheet

“Medicare Autumn” Fact Sheet: The Inflation Reduction Act Has Lowered the Cost of Insulin for Millions of Seniors

Thanks to the Inflation Reduction Act, Medicare is better than ever and seniors will pay no more than $35 per month on insulin. President Biden and Democrats in Congress worked tirelessly to lower health care costs for seniors who have worked hard their whole lives. Too many seniors on fixed incomes have been kept at night worried about paying the bills — gas, groceries, medicines and more. This $35 cap helps millions of insulin users on Medicare afford the medicines they need to stay alive. Before the passage of the Inflation Reduction Act, too many diabetic seniors had to skip doses because of the high costs. Now thousands more seniors are able to fill their prescriptions for insulin each month. While taking insulin as prescribed reduces the likelihood of costly complications such as vision loss, heart disease, and kidney disease.

This is just the beginning: In 2025, seniors’ total drug costs will be capped at $2,000 per year and, in 2026, new savings from Medicare’s drug price negotiation will take effect. Together, these provisions will save seniors thousands of dollars on prescription drugs. And while the Inflation Reduction Act addressed the insulin affordability crisis for seniors, Democrats in Congress are also working to extend that cap so no American will pay more than $35/month for their insulin.

WHAT THE INFLATION REDUCTION ACT’S $35 INSULIN CAP DOES FOR SENIORS WITH DIABETES

Makes Insulin Accessible and Affordable For Seniors. In 2020, there were more than 3.2 million insulin users on Medicare Part D, with nearly 1.7 million purchasing their insulin without low-income subsidies. On average, seniors with Medicare Part D who are not receiving subsidies pay an average of $572 every year for this life saving medication — an unthinkable sum for many on fixed incomes. Under the Inflation Reduction Act, insulin copays for seniors on Medicare are now capped at $35 each month.

Thousands More Seniors Are Filling Their Insulin Prescriptions. The Inflation Reduction Act’s cap on insulin copays has led to increases in the total number of insulin prescriptions filled for Medicare beneficiaries. A study from the USC Schaeffer Center for Health Policy & Economics and University of Wisconsin–Madison found that following the cap’s enactment in January 2023, the number of insulin fills among Medicare Part D enrollees increased from 519,588 to 523,564 per month.

Rural Seniors Are Able to Access Affordable and Quality Care. According to a 2018 study, rural Americans are 17 percent more likely to suffer from diabetes than urban Americans. Diabetes risk factors are higher in rural areas than their urban and suburban counterparts as they have limited access to health care providers, fewer transportation options to receive care, and higher rates of being uninsured. These seniors are forced to stop taking their medication or cut doses in half. Diabetics suffer severe effects such as numbness in feet and nerve damage in the eyes when they stop taking doses as prescribed. Patients who suffer chronic complications can expect to pay upwards of an additional $650 per year. The insulin cap provision in the Inflation Reduction Act vastly improves the lives of millions of these vulnerable insulin users.

Americans Of Color Are Disproportionately Affected By Diabetes. Deaths related to diabetes are three times more likely among people of color than their white counterparts. Over 12 percent of Americans of color experience diabetes due to a combination of genetic, socioeconomic, and environmental risk factors. 11.8 percent of Hispanic adults have diabetes and are 50 percent more likely to develop type 2 diabetes over the course of their lifetime than their white counterparts. Racial and ethnic minority populations are also at a higher burden of diabetes-related complications, such as kidney disease, blindness, and worse glycemic control. Despite the higher risk of complications, Americans of color are less likely to receive recommended preventive care and annual screenings, largely as a result of systemic access barriers to this care. Americans of color spend upwards of $10,000 a year on diabetes-related costs.

Americans Of Color Skip, Ration, Or Delay Insulin Doses At Higher Rates Than Their White Counterparts. With rates of uninsurance also being highest among people of color, these insulin users are at a higher risk of skipping, rationing, or delaying insulin doses. Nearly 24 percent of Black Americans ration insulin compared to 16 percent of their white and Hispanic counterparts. Black adults also continue to be the hardest hit when it comes to affording their prescription drugs and paying medical bills. The Inflation Reduction Act’s insulin cap is promoting health equity by expanding access and increasing affordability for diabetic seniors of color so much so that the prevalence of skipping doses is already beginning to fall.

REPUBLICANS ARE FIGHTING TO KEEP INSULIN PRICES HIGH

Republicans Blocked Insulin Cap for Millions of Americans. As the final negotiations were being made on the Inflation Reduction Act, Republicans in the Senate unified together to make sure that the $35 insulin cap was not universal. In a country where 80 percent of diabetics have had to go into debt in order to pay for insulin, this type of action by Republicans reeks of the influence of Big Pharma. An additional 21 million insulin users of all ages would have benefited from this universal program, including the nearly 300,000 young people under 20 who are diagnosed with diabetes. 1 in 5 people with private insurance pays more than $35 per month and, for people who are uninsured or have poor coverage, insulin can cost up to $1,000 per month. A striking 14 percent of insulin users spend catastrophic amounts, or at least 40 percent of their income, on insulin. The Affordable Insulin Now Act, which will build upon the gains of the Inflation Reduction Act, is supported widely by Democrats but has been continually shot down by Republican legislators.

Medicare