Low Part D Premiums Can’t Last If Rebate Rule Finalized

posted by Kristine Grow

on July 30, 2020

Last night, the Centers for Medicare & Medicaid Services (CMS) announced that the average basic premium for Medicare Part D prescription drug plans will be $30.50 in 2021 – among the lowest since 2013. But the Administration will likely see a sharp reversal if it finalizes its “rebate rule,” which will undermine the very negotiations that secure these savings for seniors.

For decades, health insurance providers have been an enthusiastic partner of the federal government – negotiating with drug makers for lower costs for seniors and taxpayers, increasing access to much-needed medications, and achieving high levels of satisfaction among the seniors they serve. They eagerly supported CMS’ Part D Senior Savings Model, which is helping to make insulin even more affordable for enrollees. And health insurance providers continue to ensure that seniors have access to their medications throughout the COVID-19 crisis.

As Americans’ bargaining power, we will continue to negotiate hard to make drug coverage more affordable for Americans. But the rebate rule would take us in precisely the wrong direction. CMS’ own actuaries have found that the rule would:

  • Increase Medicare premiums for seniors by 25%
  • Increase Medicare drug spending by $196 billion
  • Give drug makers a $100 billion bailout

The Problem Is Still the Price. But nothing in the proposed rule would require Big Pharma to lower their prices.

Instead, it undermines competitive negotiations – a misguided approach that makes the problem of out-of-control drug prices worse.

We’re winning great savings for seniors. But with the rebate rule, seniors will lose. Let’s focus on real, bipartisan solutions to out-of-control drug costs. In the midst of the COVID-19 crisis – seniors deserve those savings more than ever.