inside sources print logo
Get up to date Delaware Valley news in your inbox

JOHNSON: Biden’s IRA Betrays Medicare Seniors

The Biden administration is touting the Inflation Reduction Act as a transformative piece of legislation. The reality tells a different story for millions of seniors relying on Medicare. Rather than prioritizing older Americans, this act has raided Medicare to fund a broader agenda, diverting billions from healthcare to unrelated spending projects. As Americans grapple with higher costs and fewer options in Medicare, it’s essential to expose the effect of these policies.

The staggering $260 billion the IRA raided from projected Medicare savings and funneled to projects like tax credits for electric vehicles and solar energy is at the heart of the issue. According to the Congressional Budget Office, these funds could have been used to strengthen Medicare but were squandered on political agendas that have nothing to do with healthcare. 

In 2023, $10 billion of Medicare spending was paid in electric vehicle and solar energy tax credits. Simultaneously, large subsidies continued to fund prominent insurer-Pharmacy Benefit Managers and other non-Medicare programs.

The administration initially promised the spending bill would significantly lower drug prices for seniors. However, since the bill’s passage, Medicare premiums have surged by more than 20 percent on average, with some states experiencing more than 50 percent hikes. This is only the beginning, as insurers have warned their beneficiaries that hikes will continue to rise. Additionally, the administration has introduced a last-minute “demo” project, which the CBO just revealed would gut at least $21 billion from the Medicare Trust Fund to prop up big insurers— without congressional approval. This leaves seniors with fewer drug plan options and, for many, the uncertainty of whether their current plan will even exist next year.

Despite the White House’s talk about reforming the practices of big insurer-PBMs, the IRA quietly slipped in a provision that extended a little-known exemption these health cartels have from federal anti-kickback corruption laws. Although it may seem insignificant, these integrated conglomerates can legally pocket significant drug pricing rebates initially intended to lower patient costs. Instead of promoting savings for Medicare beneficiaries, they are being consumed by PBMs, which gives insurance oligarchs more reason not to oppose the IRA. While the White House publicly criticizes the influence of large corporations, the IRA’s provisions speak volumes about its priorities.

Perhaps the greatest betrayal comes from the so-called Medicare “negotiations” the administration has championed. With $260 billion already siphoned off for non-healthcare spending, President Biden proudly publicized drug price “negotiations” as one of the most significant milestones in healthcare. The reality is that 67 million seniors enrolled in Medicare will only save $1.5 billion collectively. Not only are these savings minimal, but they will also likely lead to intense Part D premium spikes. For millions of older Americans, this delayed relief means more waiting and financial strain.

The administration has claimed a victory on drug prices, but for many seniors, it feels more like a swindle. The IRA’s windfalls have gone to corporate interests, while seniors are left with higher costs, fewer options, and no real relief. This isn’t the Medicare reform Democrats promised older Americans — it’s a raid on Medicare, and America’s seniors are counting on Republicans in Congress to reignite their fight against the disastrous spending bill.

Please follow DVJournal on social media: X@DVJournal or Facebook.com/DelawareValleyJournal

 

REMAK: Inflation Reduction Act Is Not Helping Patients as Intended

The Lower Drug Costs Now Act purportedly sought to lower the cost of prescription medicines. Like the Inflation Reduction Act, it sounded like a good deal. However, there are significant concerns surrounding the IRA and how it will lower the costs of some drugs at the expense of access to many others.

When the law goes into effect, we can expect fewer treatment options and higher Medicare Part D premiums. While government negotiations (or price setting) might lower costs for Medicare, program enrollees aren’t seeing much of a benefit. In fact, the premiums they pay for standalone Part D (drug coverage) plans are rapidly rising.

The cost-cutting measures in the IRA benefit the program but create higher costs for health insurance plans. To make up for that lost revenue, those plan providers have increased the premiums, causing standalone prescription drug plans to rise by an average of 21 percent in the 2024 plan year.

It would be reasonable to assume that Medicare cost savings would be reinvested in the program to lower out-of-pocket costs for their beneficiaries. Reasonable, but wrong. The money goes not to seniors but partly to green energy. The federal government should not be doing so on the backs of older adults.

The government estimates that IRA Medicare provisions will save $266 billion from 2023 to 2031. Still, Medicare is not its own fiscal entity  —  it’s merely one part of the unified federal budget, a budget that will have to bankroll $670 billion in IRA environmental and clean energy spending. According to polling, seniors receive no benefit, which is the opposite of what they want.

One survey found that 86 percent of seniors thought Medicare savings should be used to lower prescription drug costs instead of spending on unrelated tax credits and subsidies. Unsurprisingly, the survey also found that 83 percent of seniors felt the IRA had not helped them as they thought it would.

Californians feel similarly, with more than half saying they skipped or postponed care due to cost in the last year. Seniors depend on Medicare to pay their medical bills in their retirement years, typically when most people face age-related healthcare issues and spend more on care than they did when they were younger. By cutting healthcare spending on Medicare and then using that money to support non-healthcare government programs, the IRA has done all seniors a big disservice.

Seniors fear that government price setting for medications will discourage pharmaceutical developers from investing in new drugs or finding innovative uses for existing ones and that price setting will limit access to already existing medications as insurers reduce plan options. Seniors deserve more access to drugs, not less.

Despite some positive provisions in the IRA, it has not done much for its foremost goal: helping seniors on Medicare. Should Congress and the federal government want to return to this vision, they will take immediate action on patient-centered legislation.

Please follow DVJournal on social media: X@DVJournal or Facebook.com/DelawareValleyJournal

KALAVRITINOS: Biden’s SOTU Shows How Far Democrats Are Willing To Socialize Medicine

President Joe Biden’s State of the Union address was his opportunity to promote his “successes” and lay out his roadmap. In touting the so-called Inflation Reduction Act (IRA) he wasted no breath, claiming it was a victory for patients due to the law’s new prescription drug price controls. That was one of many “misstatements” as it has been mislabeled and will soon hurt seniors with a raid on Medicare and Americans losing access to drugs that are currently in development.

After this election-year bill was passed, Democrats falsely declared victory over high drug prices. Sadly, too many Republicans were silent. The average American deserves to fully understand the IRA, who it really rewards, and how the law is nothing less than an ideological push aimed at furthering socialized medicine before delivering results.

In recent days culminating in the State of the Union address, the president claimed “historic progress” “on lowering health care costs under his watch, including steps to strengthen Medicare, Medicaid, and the Affordable Care Act (ACA)” and touting the new prescription drug provisions, which will mandate Medicare be able to negotiate drug prices.” His definition of progress is giving seniors fewer choices, innovators fewer incentives, redefining “negotiation” as “extortion,” expanding Obamacare and Medicaid and raiding Medicare for green new deal projects.

What the IRA actually does is not as straightforward as Democrats and aligned groups like AARP and left-wing think tanks would have you believe. The nasty side-effects of price controls on Medicare Part D drugs are impossible to ignore, considering this policy stunts American efforts to cure illnesses, harms drug access, and reduces options for patients relying on carefully designed drug regimens. How badly will this hurt the creation of new and life-changing drugs? A University of Chicago issue brief showed the law would result in a whopping 135 fewer new drugs, impacting the lives of 2.47 million patients. Four innovator-sponsored clinical trials have already been canceled in the first four months. How many of those drugs would have been breakthrough cures? How many would have changed the lives of patients hoping for better treatments?

Biden’s IRA victory lap does little to alleviate the unnecessary burden on Americans who are struggling with their health. America ought to lead the way in creating new and innovative treatments. The IRA even cuts back on the Trump administration’s anti-kickback regulations that limited the power of PBMs and would have lowered drug list prices. And perhaps it was a coincidence that President Biden conveniently forgot to mention that the IRA doles out billions in Medicare savings to giant health insurance companies.

It is truly something. On one hand, the Democrats crafted the IRA as a step toward an EU-style healthcare system. On the other hand, the law also hands taxpayer funding intended for Medicare to their friends in the insurance-PBM industry. Over $270 billion gone from Medicare in the name of socialist price controls, gifted to giant insurance corporations and PBMs. Isn’t that a slap in the face of people relying on Medicare?

All this being said, Biden, his party, big insurers, and supposedly “non-partisan” organizations are hijacking America’s health system for both personal benefit and ideological reasons. In the case of outside parties, they may have supported the IRA to earn a windfall. For the Democrats, moving healthcare closer to what citizens have in London and Toronto is becoming more and more their guiding light. As the IRA will soon prove, socialized medicine, with its rationed care and fewer choices for Americans, will have serious consequences for all Americans.

Please follow DVJournal on social media: Twitter@DVJournal or Facebook.com/DelawareValleyJournal

New Study Gives Medicare Advantage Edge in Quality of Care

Medicare Advantage is the best bet for seniors looking at their options as the open enrollment period begins, according to a new study published by the “Journal of the American Medical Association (JAMA) Health Forum.”Medicare Advantage, also known as Medicare Part C, gives seniors a choice about how to get their medical services delivered over the traditional fee-for-service Medicare plan. According to the JAMA study, that choice also gives seniors better value and better care.

Examining data from nearly two million Medicare beneficiaries, the JAMA-published study concluded that “those enrolled in MA had lower rates of hospital stays, emergency department visits, and 30-day readmissions.” Additionally, the study noted that “[a]mong Medicare beneficiaries with complex care needs, those enrolled in MA had lower rates of acute care utilization, suggesting that managed care activities in MA may influence the nature and quality of care provided to these beneficiaries.”

Medicare Advantage provides health care plans offered by approved private coverage providers. Unlike government-run fee-for-service Medicare, Medicare Advantage plans can cover additional services that seniors rely on and depend upon, such as prescription drugs and routine eye and dental care.

The option currently enjoys broad backing in the halls of Congress, with 63 members of the U.S. Senate signing a letter on the program’s behalf.

“We write to express bipartisan support for the Medicare Advantage program and the high-quality, affordable care it provides to over 27 million older adults and people with disabilities,” the letter read, signed by members as ideologically diverse as Sens. Mazie Hirono (D-Hawaii) and Tommy Tuberville (R-Ala.)

In September, the House of Representatives passed a bill on a voice vote to make it easier for seniors using MA to get approval for treatment and prescriptions.

Traditional fee-for-service Medicare does not limit seniors’ out-of-pocket costs and copays. As a result, beneficiaries pay nearly $2,000 more per year in total healthcare-related costs than those enrolled in Medicare Advantage plans.

Because Medicare Advantage relies on the private sector, some more progressive politicians oppose the option and have tried to limit its expansion or even kill it entirely. The progressive magazine “The American Prospect” wrote about Medicare advantage, and their opposition to it, in a piece headlined “The Dark History of Medicare Privatization.”

Some members of Congress have urged the Centers for Medicare and Medicaid (CMS) to protect eligible Medicare beneficiaries who might be subject to aggressive and potentially predatory marketing tactics related to the sale of Medicare Advantage plans or other insurance products.

However, based on the data, it appears seniors are satisfied with both the coverage and the quality of care received.

According to the non-partisan Kaiser Family Foundation, Medicare Advantage enrollment has doubled over the last 15 years. Currently, 32 percent of Medicare-eligible Granite State seniors choose Medicare Advantage over traditional fee-for-service Medicare.

Reports from the Better Medicare Alliance, a research and advocacy group, indicate 95 percent of Medicare Advantage beneficiaries are satisfied with their network of care and a full 88 percent say Medicare Advantage gives them more flexibility and choice.

A separate study published by JAMA found Medicare Advantage beneficiaries received 9.2 percent fewer “costly, potentially harmful” low-value services than fee-for-service Medicare enrollees. In other words, Medicare Advantage beneficiaries received better-quality care.

Please follow DVJournal on social media: Twitter@DVJournal or Facebook.com/DelawareValleyJournal

GOLDBERG: Medicare Will Use Death Panels to Set Drug Prices

Under the Inflation Reduction Act, death panels will determine what medicines Medicare should pay for to free up money for other government spending.

That’s not hyperbole. Under the Inflation Reduction Act (IRA), seniors still pay retail prices. (And only the 3 percent of Medicare beneficiaries who spend more than $2,000 out of pocket will see costs capped.) Medicare will determine the cost-effectiveness of medicine to generate discounts in the form of $250 billion in cash rebates. Specifically, under IRA, Medicare will set prices based on how much a medicine costs to add an additional year of healthy living (called a quality-adjusted year, or QALY) compared to or on top of existing therapies.

While Medicare can’t use cost-effectiveness research (CER) to “treat extending the life of elderly, disabled or terminally ill individuals as less valuable,” it can be used to establish at what price a drug should be made available.

CER is already approved by states to limit access to new medicines under Medicaid.  The therapies include those for cystic fibrosis, rare cancers and sickle cell anemia; treatments that primarily help minorities, the disabled and the terminally ill. Pharmacy benefit managers who administer the Medicare drug benefit and the Veterans Health Administration already use CER to negotiate drug prices.

They all contract with a group called the Institute for Clinical and Economic Review (ICER) to carry out CER.  Since 2016, ICER has deemed only 3 medicines out of nearly 100 evaluated for rare and life-threatening diseases cost-effective at or near the average 20 percent rebated price. Most other drug prices would have to be cut by 50 percent to 100 percent. That includes medicines for multiple myeloma, sickle cell anemia, ALS and chronic kidney disease.

Indeed, ICER counts the ability of a new drug to improve well-being by extending life as a cost, not a benefit. ICER claimed a medicine to reduce anemia from chronic kidney disease was not cost-effective “because more people will live longer, more people will be at risk of needing care for end-organ damage, increasing the cost of keeping people alive.”

Similarly, it noted that new sickle cell anemia drugs reduce the “risk of death from these chronic conditions,” making them “less cost-effective.” Incredibly ICER “chose to use the highest estimates of the risk of death to give an optimistic estimate of the (cost-effectiveness) of the treatment effect.”

Further, ICER claims that new medicines for rare diseases, especially those afflicting children, are too costly at any price. As ICER president Steve Pearson wrote, orphan drug spending places an “undue burden … on others for the sake of a few.” Specifically, ICER asserts, “The opportunity cost of supporting the use of ultra-orphan drugs necessitates that patients with a more common disease, for which a cost-effective treatment is available, are denied treatment.”

Most drugs for rare diseases also reduce the risk and severity of common diseases. While curative gene and cell therapies may cost hundreds of thousands of dollars, new methods of hedging financial risk and paying for treatments over time make their cost affordable. And in any event, since we can save $800 billion by eliminating wasteful health spending, why do ICER and CER target dying children to save money?

Because it’s a quick way to generate lots of money for other government programs.

Indeed, in 2016 ICER asserted:  “When we’re paying for drugs and don’t know the drug’s value, we will be “siphoning off resources for other things we need like better schools and more resources for local police, roads and bridges.”  Or, in the case of the IRA, siphoning money for 87,000 IRS agents and $249 billion in climate change tax credits for corporations. Ultimately, ICER and other comparative effectiveness firms are de facto death panels deployed by the Democrats to turn dying patients into cash cows for corporate welfare.

Please follow DVJournal on social media: Twitter@DVJournal or Facebook.com/DelawareValleyJournal