Inaction would trigger drug cost increases for Medicare beneficiaries with the highest expenses

Arlington, VA (December 16, 2019) — Seventy-one diverse national organizations representing millions of older adults, people with disabilities, patients, and providers are joining the National Council on Aging (NCOA) in urging Congress to take action this week to prevent scheduled Medicare prescription drug cost increases and extend critical expiring protections for Medicare and Medicaid beneficiaries.

“People with Medicare who have the highest prescription drug out-of-pocket costs were trusting that Congress would help them by enacting legislation into law to lower those costs this year,” said Howard Bedlin, NCOA Vice President for Policy and Advocacy. “In fact, they will be surprised, disappointed, and harmed to learn that their costs will actually go up if Congress does not stop an increase in the Medicare Part D catastrophic coverage eligibility threshold scheduled for January 1, 2020.”

Under Medicare Part D, once beneficiaries hit an annual prescription drug cost threshold, they can access catastrophic coverage that reduces their drug cost sharing from 25% to 5%. This threshold is scheduled to jump by an unprecedented $1,250 in 2020 (from $5,100 to $6,350), affecting over 1 million people with Medicare. According to initial estimates, this means that Medicare beneficiaries with the highest drug costs would have to pay an additional $2 billion for their medications next year.

NCOA, which has advocated for the rights of older Americans to age with dignity and economic security for the past seven decades, is joined by 59 other organizations in urging Congress to take action on this issue, as well as other improvements for Americans with Medicare or Medicaid in the health “extenders” package that Congress is expected to consider on December 20. Specifically, the groups are calling for Congress to:

• Make permanent the successful Medicaid Home and Community-Based Services Money Follows the Person program and Spousal Impoverishment protections, which help people remain with their families at home and in the community, rather than in expensive institutions.
• Extend and increase funding for national and community efforts to find and enroll eligible low-income Medicare beneficiaries into programs that help pay their prescription and health care costs.
• Modernize and simplify the Medicare Part B enrollment process.
• Extend current enhanced Medicaid funding in U.S. territories, which is scheduled to expire.

“NCOA believes this legislation is the right and fair thing to do to address the needs of Americans who depend on these benefits and programs. We urge our elected leaders to take action this week to make essential Medicare and Medicaid services more affordable and available to seniors and people with disabilities in need,” Bedlin said.

Read the group’s letter to Congressional leaders here.