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Insider’s Report: The Fight to Pass Critical Improvements to Medicare Continues

Woman with breathing device and nurse

Happy New Year from all of us at the National Committee! As we head into a new year, we are gripped with déjà vu.

A battle we waged last year on behalf of our members and supporters is now spilling over into the new year. As you know, just before the holidays, Senator Joe Manchin (WV) indicated he would be a no vote on the Build Back Better (BBB) Act, a historic bill that will benefit millions of older Americans.

Now that Congress is back in session, we are ramping up pressure on the Senate to resume negotiations on the BBB and ensure this bill is passed without delay. The National Committee is optimistic this historic bill will pass in the weeks ahead — and older Americans will receive critical and long-overdue improvements to Medicare, including:

  • Allowing Medicare to directly negotiate with drug companies for lower drug costs (currently forbidden under the law);
  • Expanding Medicare to include coverage for hearing aids and examinations;
  • $150 billion in new funding for Home and Community-based Services (HCBS); and
  • Ensuring that seniors never pay more than $2,000 a year for their drugs under Medicare Part D.

As a reminder, the Build Back Better Act is paid for in large part by requiring the wealthy to pay their fair share in taxes. Given that this is an election year and there are a number of priorities competing for lawmakers’ attention, Congress is now under the gun to get this important bill passed and onto President Biden’s desk for his signature.

 
 
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Medicare Alert
 

Medicare beneficiaries may be alarmed to learn that there is an insidious, but largely unpublicized effort underway to gradually privatize Medicare. According to media reports, some traditional Medicare patients are now being placed in for-profit managed care plans without even knowing, thanks to a Trump Administration policy that is still in effect.

As we understand this pilot program, called “Direct Contracting,” private companies are supervising selected Medicare patients’ care, even though the beneficiaries signed up for traditional Medicare. This model incentivizes profits over patient care, and ultimately could lead to higher out-of-pocket costs, denied claims and limited networks of health care providers. That’s why the National Committee is urging Health and Human Services Secretary Xavier Becerra to put a stop to this dangerous program ASAP.

 
 
Free Home Health Webinar
 

Our friends at the Center for Medicare Advocacy are offering a free webinar on January 12 at 2pm EST to review the services the Medicare home health benefit covers, including skilled nursing; physical, occupational and speech therapy; medical social services; and home health aides. The webinar will also discuss current challenges and possible strategies for beneficiaries who are trying to access or maintain home health services, especially if they have longer-term, chronic conditions. There will be an opportunity for questions. Register today!

 
 
Ask Web
 

Our resident Social Security expert, Webster Phillips — a Senior Policy Analyst for the National Committee and a 31-year veteran at the Social Security Administration — is here to answer your questions about Social Security.

You can either search our archives for valuable advice on a broad range of concerns or submit your question here.

This week's question is: Someone told me if you don't sign up for Social Security as soon as you are eligible, but do sign up a few years later, you get back pay to when you were first eligible. Is this true?

Click here to read the answer.

 
 
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How One Drug Can Hike Up Your Part B Premium
 

NCPSSM President Max Richtman explains that the largest Medicare Part B premium increase in years is due to the controversial new Alzheimer's drug, Aduhelm. (December 17, 2021, KEX, Radio Interview with NCPSSM President Max Richtman)

Listen Here

 
 
 
Biogen halves price of Alzheimer's drug to $28,200
 

Biogen Inc (BIIB.O) on Monday cut the price of its Alzheimer's drug by about half to $28,200 for an average weight person after facing slower-than-expected U.S. sales on complaints from hospitals that its high cost was not worth its benefits. (December 20, 2021, Reuters, Amruta Khandekar)

Read More

 
 
 
Doctors Urge Medicare to Deny Coverage for Alzheimer’s Drug With Unproven Efficacy and Safety
 

As Medicare officials grapple with whether to cover Aduhelm—an Alzheimer's medication approved by federal regulators despite a lack of evidence that the exorbitantly priced and potentially dangerous drug helps patients—many doctors are urging them not to. (January 1, 2022, Common Dreams, Kenny Stancil)

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'Enough Is Enough': Outrage as Big Pharma Hikes Prices on 442 Drugs
 

Patient advocates on Monday condemned the U.S. pharmaceutical industry for ushering in the new year with price hikes on more than 440 medications, a move that came as congressional Democrats' plan to lower prescription drug costs remained stuck due to Sen. Joe Manchin's persistent obstruction. (January 3, 2022, Common Dreams, Jake Johnson)

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Social Security offices have been closed for most of the pandemic. That effort to protect public health has wounded some of the neediest Americans.
 

The first cars bearing the needy pulled into the parking lot as the lights went on in the squat brick Social Security office, three miles north of the luxury condos and boutique hotels rising in booming Music City. (December 24, 2021, The Washington Post, Lisa Rein)

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