The $1.7 trillion Build Back Better Act was approved by the House on Friday, which means improvements to Medicare could become law soon.
It is still possible for both chambers to produce a different final measure from what is in play now if the Senate passes its version.
For the first time, the federal government may negotiate with pharmaceutical companies the prices of certain drugs if the Medicare provisions remain intact. This is intended to bring down the cost of prescription drugs to make them less expensive.
In addition, Medicare Part D beneficiaries’ out-of-pocket spending on drugs will be capped at $2,000 per beneficiary per year (with annual adjustments) as of 2024. They will be able to make insulin available for $35 per month.
Part B (outpatient care coverage) will also cover hearing services beginning in 2023.
Services such as hearing rehabilitation and treatment, as well as hearing aids, would be provided.
This spending bill did not include dental or vision coverage anymore though they were included earlier.
“The proposal that would probably have the most direct effect on beneficiaries is the cap on [Part D] out-of-pocket spending, particularly for people who take expensive drugs,” according to Tricia Neuman, director of the Kaiser Family Foundation’s Medicare policy program.
Obstacles to Build Back Better
Medicare’s 63.3 million beneficiaries, the majority of whom are over 65, could save thousands of dollars per year if out-of-pocket drug spending is limited.
Currently, there is no out-of-pocket drug spending cap.
The Kaiser Family Foundation estimates that nearly 1.2 million beneficiaries spent more than $2,000 on drugs through Part D in 2019.
“In any given year, it’s a relatively small number of people who have high drug expenditures, but those who do tend to have serious medical conditions that require very pricey drugs,” Neuman told.
Then, in 2025, price negotiations will begin with about ten drugs, she said. This number is expected to reach 20 by 2028.