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Medicare Patients Could See Lower Drug Costs Under Revamped Bills Opposed by Big Pharma

(Associated Press) A bipartisan Senate bill to curb prescription drug costs for Medicare recipients got a makeover Friday to lower copays and make it easier for seniors to budget for their expenses.

The updated legislation unveiled by Sens. Chuck Grassley, R-Iowa, and Ron Wyden, D-Ore., would lower the standard copay to 20% from the current 25% for seniors enrolled in Medicare’s Part D prescription drug benefit.

It also introduces a feature that would let Medicare enrollees spread out their copays in monthly installments. Because of the current design of the system, seniors taking very expensive drugs can face unmanageable out-of-pocket costs in the first couple of months of any year.

The bipartisan Senate bill has the support of President Donald Trump, but it’s unclear if any significant drug pricing legislation can pass a Congress polarized by impeachment.

In the House, Speaker Nancy Pelosi plans to bring her own, more ambitious bill to a floor vote. The California Democrat’s legislation would empower Medicare to negotiate prices with drug companies and plow the savings back into expanded dental, vision and hearing benefits for seniors.

But congressional Republicans are opposed to the government negotiating drug prices. Trump, who supported the idea as a candidate, has since dropped it.

And Senate Majority Leader Mitch McConnell, R-Ky, is reluctant to bring the bipartisan Grassley-Wyden bill to the floor. It could trigger Democratic amendments designed to create political headaches for Republicans on other issues, such as protecting people with pre-existing medical conditions.

In terms of policy ideas, there’s considerable overlap between the Senate bill and parts of Pelosi’s plan. Both would cap out-of-pocket costs for Medicare beneficiaries and require drugmakers to pay rebates to the government if they hike prices above inflation. But the political challenges may be impossible to overcome.

The Grassley-Wyden bill would limit out-of-pocket medication costs faced by seniors to $3,100, starting in 2022. Currently there is no limit, and some Medicare recipients dealing with serious illness face copays rivaling a mortgage payment.

In a statement late Friday, the White House said “President Donald J. Trump applauds the work of Chairman Grassley and Ranking Member Wyden to lower prescription drug costs and further improve their bipartisan legislation, such as adding a provision to limit monthly out-of-pocket spending for seniors with chronic high costs.

The White House called on Congress “to act now to give Americans the relief they need by sending bipartisan drug pricing reform to the President’s desk this year.”

Supporters of the Senate bill are hoping a deal can still be had, and that major prescription drug legislation can be incorporated in a budget bill expected early next year.

The pharmaceutical industry opposes both the Senate and House bills and has poured millions of dollars into a lobbying battle to block them.

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