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Medicare Drug Price Negotiation Ban Being Pushed to an End

Donna Weiner, a Florida retiree who participates in the Medicare prescription drug program, would want to pay less for her medications, costing roughly $6,000 per year. And as a retired accountant with 50 years of experience in corporate accounting, she sees a way to get there. President Joe Biden’s ambitious healthcare policy hinges on negotiating drug pricing. Not only would seniors like Weiner benefit from lower expenditures, but the savings would also be put toward other objectives, such as dental coverage for them and cheaper premiums for others who have Obamacare policies.

To do so, Congress would have to remove a particular provision in the statute that prohibits Medicare from negotiating rates. Republicans in Congress intended insurers that administer drug programs to do the haggling, not the government, when they launched Part D outpatient prescription medication program in 2003. As a result, despite decades of expertise establishing costs for hospitals, doctors, and nursing homes, Medicare was left out.

The pharmaceutical business is keen to retain things as they are. Andy Slavitt, a former Medicare administrator, recalls suggesting a “small experiment” on price. When the pharmaceutical benefit was created about 20 years ago, drugs costing tens of thousands of dollars per month were uncommon. They’ve become more common in recent years. Democrats also want to give the ability to bargain over high-cost, brand-name pharmaceuticals that have little or no competition, as well as insulin.

Their bill would also cap annual out-of-pocket expenditures for recipients like Weiner and limit price increases for proven pharmaceuticals. Another section would revamp the inner workings of the approximately $100 billion-per-year drug program to save taxpayers money. Negotiations on Medicare have been backed by politicians such as former President Donald Trump and House Speaker Nancy Pelosi, D-Calif. But it’s Biden, with Pelosi’s help, who has come the closest to getting it done.

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