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With Build Back Better’s future in question, Medicare changes tabled


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Medicare beneficiaries may not end up seeing improvements to the program they were hoping for — at least not anytime soon.

With Senator Joe Manchin D-W.Va. stating Sunday he cannot support his party’s Build Back Better Act in its current formMedicare provisions included in the bill worth $1.75 billion are also at risk. The House passed the bill in November. However, Manchin would have to support the Senate for it to pass.

Medicare provisions include one which would permit the federal government and pharmaceutical companies to negotiate prices for certain drugs. It is intended that this will lower some prescription drug costs.

With up to 10 drugs per year, price negotiations would be initiated with drugmakers in 2025. This number could reach 20 in 2028.

In addition, the bill will cap beneficiary’s out-of-pocket Medicare drug benefit (Part D), at $2,000 each beginning in 2024 with yearly adjustments. The cost of insulin would also be restricted to $35 per monthly.

For some of Medicare’s 63.3 million beneficiaries — the majority of whom are age 65 or older  — limiting out-of-pocket drug spending could mean saving thousands of dollars per year because there currently is no cap. Research by the Kaiser Family Foundation found that roughly 1.2 Million Medicare enrollees spent more $2,000 than necessary on Part D drugs in 2019. 

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Beginning in 2023, hearing services would also be covered by Part B (outpatient treatment coverage). These services would cover hearing rehabilitation, treatment and hearing aids. 

Senate Majority leader Chuck Schumer, D.N.Y. said he will bring the bill to a vote in some form early next year. This is despite Manchin not being supportive. The bill’s revised form and the inclusion of Medicare provisions are not yet known.