Amid high inflation, seniors have big hopes for prescription drug pricing reform

As midterm elections loom, advocates for voters ages 50 and up are hoping Congress will take up one issue that could help rein in rising costs — prescription drug prices.

A proposal to let the government negotiate some prescription drug prices covered under Medicare was included in Democrats’ Build Back Better legislative package, which was approved by the House of Representatives last year.

Lawmakers have since reached an impasse on that sweeping legislation, which Democrats had hoped to advance through a simple majority.

But the Medicare proposal and other moves to rein in prescription costs could be the best chance Congress has at reining in soaring prices for an age cohort often living on a fixed income, experts say.

“The best policy answer to rising prices is actually doing something about prescription drug prices, and that is particularly salient to this age cohort,” said Celinda Lake, a pollster and founder and president of Lake Research Partners, at a recent AARP panel focused on women voters ages 50 and up.

“That is literally our best answer to inflation right now, because it’s something people think could be done and it’s a very bipartisan issue,” Lake said.

Recent government data shows consumer prices for everyday items like food and energy have seen the biggest one-year increases since 1981.

Yet for the past several decades, prescription drug prices have risen faster than inflation, according to Bill Sweeney, senior vice president for government affairs at AARP.

If consumer prices rose as much as prescription drug prices over the years, a gallon of gas would cost around $12.20 today, based on AARP’s calculations, Sweeney said.

Prescription costs are felt by Medicare beneficiaries, who often take four or five drugs at a time to manage chronic conditions, he said.

Democrats’ Build Back Better plan included multiple initiatives aimed at helping to alleviate the problem, said Tricia Neuman, executive director of the program on Medicare policy at the Kaiser Family Foundation.

That included giving the government the authority to negotiate prescription drug prices, putting constraints on drug prices that rise faster than inflation, helping to reduce the cost of insulin and putting an out-of-pocket cap on how much people on Medicare pay for prescription drugs.

A recent Kaiser poll found the proposals are particularly popular with voters ages 50 and up.

About 65% of voters in that age cohort said it should be a top priority to limit how much prescription drug prices can go up each year to no more than the rate of inflation. Meanwhile, 59% of those voters said it should be a top goal to limit out-of-pocket drug costs for seniors, and 57% indicated a high priority for the federal government to negotiate lower prices for prescription drugs for people on Medicare.

As Congress works to revive parts of Build Back Better, which also includes deficit reduction and climate issues, it remains to be seen whether the prescription drug proposals will make the cut.

“It is unclear what the Senate will ultimately do,” Neuman said. “If it is a question of numbers, then the prescription drug proposals produced savings that can be used to offset other spending priorities.”

The issue is particularly salient for people covered by Medicare this year, due to above average Part B premium increases driven by the cost of an Alzheimer’s drug, Aduhelm.

The standard Medicare Part B premium went up by 14.5% to $170.10 in 2022. Those premiums are typically deducted directly from Social Security checks.

Now that the cost of the prescription drug Aduhelm has been reduced, advocates are hoping the Medicare Part B premiums will be adjusted, as well.

Meanwhile, the broader fight to lower prescription drug costs for seniors has been ongoing since 2003, when Medicare added its Part D prescription drug benefit, according to Max Richtman, president and CEO of the National Committee to Preserve Social Security and Medicare.

That legislation specifically prohibited negotiations on the costs of prescription drugs, according to Richtman.

“That was put in in the middle of the night,” Richtman said. “We were not in the room when that deal was made.”

The drug pricing provisions in Build Back Better could have gone further, Richtman said. The proposed legislation applies to a limited number of drugs and would be phased in over several years.

The National Committee to Preserve Social Security and Medicare would have preferred the changes to be across the board and immediate, Richtman said. Moreover, there is also the risk the Senate will further dilute the changes.

Still, Richtman said he hopes lawmakers will take the opportunity to act.

“There’s enough of an incentive that I think I am more optimistic than I have been,” Richtman said. “But then again, I’ve been optimistic in the past and it hasn’t panned out.”