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Celebrating 35 years of making Medicare more accessible, affordable, and equitable!

Lindsey Copeland

Federal Policy Director

Supreme Court Declines to Fast-Track Latest Challenge to the Affordable Care Act

On Tuesday, the Supreme Court declined to fast-track the latest challenge to the Affordable Care Act (ACA). This decision not to expedite review comes after a federal appeals court last month agreed with a federal judge in Texas that the ACA’s individual mandate is unconstitutional, but declined to say how much of the law should fall as a result. Instead, the appeals court sent the case back to the Texas court to reconsider that question—a process that could take months if not years.

Medicare Rights Testifies to Congress About the BENES Act

Yesterday, Medicare Rights Center President Fred Riccardi testified at a hearing of the House Committee on Energy and Commerce, Subcommittee on Health titled “Legislation to Improve Americans’ Health Care Coverage and Outcomes.”

In the testimony, Medicare Rights urged Congress to pass the bipartisan, bicameral Beneficiary Enrollment Notification and Eligibility Simplification (BENES) Act (H.R. 2477) without delay.

Now’s the Time to Tell Congress to Vote Yes on H.R. 3, the Elijah E. Cummings Lower Drug Costs Now Act

This week, the U.S. House of Representatives is expected to consider the Elijah E. Cummings Lower Drug Costs Now Act (H.R. 3). This landmark bill takes significant steps to rein in high and rising prescription drug prices and lower costs for people with Medicare, including authorizing Medicare to negotiate prices for certain drugs and capping beneficiary out-of-pocket drug spending at $2,000 per year.

Recent Changes Add Complexity to Medicare’s Fall Open Enrollment Period

Medicare’s Fall Open Enrollment Period (OEP) is a busy time for beneficiaries and those who help them evaluate their health care and prescription drug coverage options. From October 15 to December 7 each year, people with Medicare can make changes to their coverage, such as switching Part D prescription drug plans, or switching between Original Medicare and Medicare Advantage. This annual decision-making process can be complex, and several changes this year are making it even more so.

New Report Details High Out-of-Pocket Costs for Some with Medicare

A new analysis from the Kaiser Family Foundation (KFF) underscores these challenges. According to the report, people with Original Medicare spent an average of $5,460 out of their own pockets for health care in 2016. Nearly half of this spending was for services outside of Medicare, such as LTSS (32%) and dental care (14%). The other half was largely devoted to meeting beneficiary cost-sharing obligations, including for provider-based care (22%) and prescription drugs (21%).

House Committees Advance Drug Pricing Legislation

In recent weeks, several committees within the U.S. House of Representatives—Energy & Commerce, Education & Labor, and Ways & Means—have been working to finalize the House’s drug pricing bill, HR 3. While the bill advanced by each committee differs slightly, the underlying goals are unchanged from the version initially introduced.

U.S. House Moving Forward with Drug Pricing Bill

Lawmakers in the U.S. House of Representatives are continuing work on their drug pricing bill, H.R. 3, with hopes of holding a vote later this month.

Unveiled in September, H.R. 3 includes a number of provisions that would improve prescription drug access and affordability for people with Medicare. Among the bill’s critical reforms are those allowing Medicare to negotiate drug prices; the imposition of inflationary rebates on certain drugs in Parts B and D; and a restructuring of the Part D benefit that would cap out-of-pocket costs, reduce the federal government’s liability, and better align pricing incentives.

Trump Administration Releases Vague Medicare Executive Order

Last week, the Trump Administration released a wide-ranging yet ambiguous Executive Order (EO) focused on the Medicare program.

Many of the EO provisions lack specifics, making it difficult to predict what, if any, policies or recommendations may emerge. Since any policies that do emerge would likely require legislative or regulatory action before taking effect, the EO’s prospects for impacting the program are also unknown.

Medicare Extra Rx HELP Act Companion Bill Introduced in the House

This week, Rep. Brad Schneider (D-IL) introduced a House companion to the Medicare Extra Rx HELP Act (S. 691/H.R. 4583). Championed in the Senate by Bob Casey (D-PA), this bill would make improvements to the Medicare Part D Low-Income Subsidy (LIS), commonly known as Extra Help, to better reflect current needs.

CELEBRATING

YEARS

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