Medicare Is Asked to Leverage Its Position and Slow the Rate of Premium Increase

According to the head of a Senate subcommittee overseeing Medicare, the Biden administration should use its legal authority to reduce large premium hikes shortly, hitting millions of beneficiaries.

Medicare recently announced an almost $22 increase in its monthly “Part B” cost for outpatient treatment, from $148.50 to $170.10 starting in January.

The FDA said the increase was needed to cover Aduhelm, a new $56,000 Alzheimer’s medicine from Biogen whose advantages have been questioned. The Medicare premium is usually taken from Social Security benefits. It would absorb a large portion of the 5.9% cost-of-living increase for seniors.

“Rather than assessing the current $21.60 per month… premium increase in full, I ask you to reduce the amount,” wrote Sen. Ron Wyden, D-Ore. “Seniors on fixed incomes would benefit from this type of approach.” The AP received a copy of the letter on Monday.

The administration did not respond right away.

But Wyden responded to Becerra that as Health and Human Services secretary, he has “broad authority” to set the “appropriate contingency margin” for premiums.

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For now, Wyden said, there is a clear logic for collecting less money upfront from Aduhelm patients because Medicare is still establishing its formal policy.

“Any near-term Medicare coverage for Aduhelm… may be limited and narrow,” he added. Wyden attributed the additional fee to “uncertainty” about the drug’s financial impact on Medicare.

Last month, after Medicare, revealed the hike, Vermont Independent Sen. Bernie Sanders demanded that it be reversed. Wyden said he had concerns and was looking into it. Senators Maggie Hassan (NH), Jacky Rosen (NV), Chris Van Hollen (MD), Mark Kelly (AZ), and Jack Reed (RI) wrote President Joe Biden last week that “we must address this issue as swiftly as possible.”

If nothing is done, several older people’s groups expect a backlash from Medicare recipients.

“I think Congress will be in trouble once the Part B payment for 2022 starts being taken from their Social Security benefits,” said Senior Citizens League expert Mary Johnson.

The Labor Department announced Friday that consumer prices rose 6.8% last year, the highest rate in nearly four decades. Food, energy, and housing prices were at the basis of the problem. Concerns about inflation are adding to the Democratic Party’s political insecurity.

Biden’s social agenda proposal would significantly reduce Medicare drug prices. Even if the law passes, Medicare will have to wait years to negotiate new medicine prices like Aduhelm. Other policies that lower costs more quickly take effect in a few years. The Medicare premium hike comes first.

The Build Back Better Act will continue to help younger working families, according to Johnson, an advocacy group analyst.

Patients with significant ailments like cancer, rheumatoid arthritis, or multiple sclerosis usually bear the brunt of high-cost medications. With Aduhelm, the financial burden would be shared by all Medicare beneficiaries, not only those with Alzheimer’s.

The problem has become a case study of how one expensive drug may affect government spending and household budgets. The expense of Aduhelm is large enough to affect premiums for those without Alzheimer’s.

Alzheimer’s is a degenerative neurological illness that affects around 6 million Americans, most of whom are eligible for Medicare.

Alzheimer’s drug in nearly 20 years, Aduhelm. The FDA assessed that its capacity to remove clumps of plaque in the brain is likely to slow dementia. But many experts say the benefits are unclear.

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Prior to a formal review that might take months, Medicare covers Aduhelm on an individual basis.

Biogen said it priced Aduhelm properly after factoring in payments for other novel treatments for difficult-to-treat conditions.

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