15 New Drugs Selected for 2025 Medicare Price Negotiation

On Friday, The Department of Health and Human Services (HHS) released a list of 15 new prescription drugs that Medicare will negotiate lower prices for. Under the law, HHS is required to negotiate a specific number of drugs each year. 

The list contains a number of drugs that older Americans use, including Janumet, which is used to treat diabetes, and Otezla, which is used to treat psoriatic arthritis. Ozempic, Rybelsus, and Wegovy – which are used to treat diabetes, cardiovascular disease, and obesity – are the most widely used drugs on the list, with about 2.2 million Medicare Part D beneficiaries taking them between November 2023 and October 2024. Trelegy Ellipta, used to treat Chronic Obstructive Pulmonary Disease, is the next most widely used drug, with about 1.2 million Part D enrollees using it for treatment.

“Lower prices for these drugs are needed and will save patients and taxpayers billions of dollars a year,” said Richard Fiesta, Executive Director of the Alliance. “We call on President-elect Trump and the next Administration to follow the law and negotiate a fair deal that puts the needs of patients first.”  

Drug corporations will have until February 28, 2025, to indicate whether they will participate in the negotiations. 

Out-of-Pocket Cap Expected to Save Medicare Beneficiaries More than $7 Billion in 2025

A new analysis indicates that the Inflation Reduction Act’s $2,000 cap on annual out-of-pocket prescription drug costs – which kicked in this year – will result in significant savings for seniors. About 11 million Americans with Medicare are expected to meet the cap and enter the catastrophic coverage phase in which they will no longer have to pay for their prescription drugs.

Beneficiaries with certain chronic conditions will get the largest amount of savings: Cystic fibrosis patients could save an average of $6,700 annually; multiple myeloma patients could save about $4,700; patients with metabolic and immune disorders could save about $3,600; and major organ transplant patients could save about $3,300 annually.

The $2,000 cap is one of several changes that have been implemented since 2022, when President Biden signed the Inflation Reduction Act into law. Medicare negotiated lower prices for the 10 most expensive drugs for the first time ever last year, and since 2023, seniors have not had to pay more than $35 a month for their insulin copays and can access all recommended vaccines for free.

“The cap on out-of-pocket drug expenses is yet another example of how the Inflation Reduction Act was and will continue to be a boon for seniors and people with disabilities,” said Robert Roach, Jr., President of the Alliance. “It’s also a powerful tool to combat rising drug prices and corporate greed.”

Medicare Advantage Does Not Provide More Supplemental Coverage for Beneficiaries

Despite Medicare Advantage plans being able to offer beneficiaries dental, vision, and hearing services, a new study shows that beneficiaries do not actually receive more of these services than people with traditional Medicare. 

The study found that people enrolled in Medicare Advantage plans are unaware of the supplemental benefits they have, with a mere 54% of participants reporting knowledge that they had dental coverage and/or vision coverage. Additionally, they are no more likely than traditional Medicare beneficiaries to take advantage of these benefits, getting hearing aids, eye exams, and eyeglasses at similar rates.

“Medicare Advantage plans receive more money from taxpayers compared to traditional Medicare with the expectation that some of those payments go toward supplemental coverage. But that’s not happening,” said Joseph Peters, Jr., Secretary-Treasurer of the Alliance. “It’s time to add hearing, dental, and vision benefits to traditional Medicare and make sure all beneficiaries receive the health care they need.”

KFF Health News: Trump’s Return Puts Medicaid on the Chopping Block

by Phil Galewitz

Under President Joe Biden, enrollment in Medicaid hit a record high and the uninsured rate reached a record low.

Donald Trump’s return to the White House — along with a GOP-controlled Senate and House of Representatives — is expected to change that.

Republicans in Washington say they plan to use funding cuts and regulatory changes to dramatically shrink Medicaid, the nearly $900-billion-a-year government health insurance program that, along with the related Children’s Health Insurance Program, serves about 79 million mostly low-income or disabled Americans.

The proposals include rolling back the Affordable Care Act’s expansion of Medicaid, which over the last 11 years added about 20 million low-income adults to its rolls. Trump has said he wants to drastically cut government spending, which may be necessary for Republicans to extend 2017 tax cuts that expire at the end of this year.

Read more here.

Remembering Dr. Martin Luther King, Jr.’s Pro-Worker Legacy

As we celebrate the Martin Luther King, Jr. holiday – Monday, January 20 – it’s important to remember his work to connect the labor and the civil rights movements.

Dr. King understood that unions ensure that working people have a voice.

He told the 1961 AFL-CIO Convention that “(t)he labor movement did not diminish the strength of the nation but enlarged it. By raising the living standards of millions, labor miraculously created a market for industry and lifted the whole nation to undreamed of levels of production. Those who today attack labor forget these simple truths, but history remembers them.”

Dr. King’s legacy was highlighted last week at the Dr. Martin Luther King Jr. Civil and Human Rights Conference in Austin, Texas. Event speakers included AFL-CIO President Liz Shuler, AFL-CIO Secretary-Treasurer Fred Redmond, Rep. Jasmine Crockett (D-TX), and Rep. Greg Casar (D-TX). Members of the Texas Alliance attended and staffed an information booth.

“Dr. King’s work to intertwine civil rights with workers’ rights was invaluable,” said President Roach. “We must advance his work by continuing to preserve everyone’s right to join together in union and have a voice on the job.”

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