Patient Advocacy Groups Call for Bipartisan Action to Alleviate Older Americans’ Undue Medicare Part D Cost Burden

Before the Coronavirus disease 2019 (COVID-19) pandemic, many older Americans and people with chronic diseases were foregoing their prescribed medications due to high out-of-pocket costs. The ongoing pandemic has only exacerbated prescription drug affordability concerns. This is the impetus behind the Alliance for Aging Research (the “Alliance”), along with 48 partner organizations, in urging Congress to make two key reforms to Medicare Part D in the next COVID-19 financial relief package.

The reforms were detailed in a letter sent today from the Alliance-convened Project LOOP (Lowering Out-of-Pocket Costs) initiative. The letter asks Congressional leaders – Speaker of the House Nancy Pelosi, Minority Leader Kevin McCarthy, Majority Leader Mitch McConnell, and Minority Leader Chuck Schumer – to address out-of-pocket (OOP) costs in Medicare Part D by placing a cap on beneficiaries’ costs and providing the option to smooth costs over the course of a year. While the timing and content of the next relief package are still under consideration, health care affordability should be addressed in addition to priorities like education and jobless benefits.

The COVID-19 pandemic has made already high OOP costs even less affordable, especially for older Americans on fixed incomes and those living with chronic diseases like diabetes, heart disease, and chronic obstructive pulmonary disease. Before the pandemic, 1 in 5 adults age 60 and older reported struggling to afford their prescription drugs, and in many cases abandoned treatment altogether, leading to life-threatening consequences. Not filling, delaying, or curtailing the use of prescription medications can have life-threatening consequences. As a result, excessive OOP costs can lead to patients making difficult choices between financial solvency and their health.

COVID-19 has intensified the burden of out-of-pocket costs for patients, further amplified by the accompanying economic downturn. Though Medicare covers necessary services in case of COVID-19 infection, patients are still responsible for copayments and deductibles.

“The pandemic has disproportionately impacted older Americans and those living with chronic disease, making a bad situation worse for Medicare beneficiaries,” says Susan Peschin, MHS, Alliance president and CEO. “Alleviating patients’ financial strain is not just the right thing to do—it is essential. Congress needs to act now. It simply cannot wait any longer.”

The letter released today implores Congress to create an annual cap on patient costs and a smoothing mechanism in Medicare Part D. Instituting a cap on the total costs that patients are required to pay each year would help beneficiaries afford the medicines they need rather than forcing beneficiaries to abandon treatment due to financial strain.

In addition, a smoothing mechanism would help spread out the cost of prescription drugs over time, like a monthly payment plan. It would ensure patients are not required to pay an entire year’s worth of out-of-pocket costs in January or upon starting a new course of treatment. These proposed policy solutions would provide financial security for the most vulnerable patients and ensure access to needed medicines.

Project LOOP also cautions in the letter that solutions to OOP costs should not be accompanied by proposals such as international reference pricing which relies on methodologies that devalue patients based on their disability, age, or chronic illness and potentially limits access to treatment. Rather, beneficiaries ought to have equitable coverage for medically necessary treatments without regard to personal characteristics or health status.

The following organizations signed the Project LOOP letter:

Allergy & Asthma Network
Alliance for Aging Research
Alliance for Patient Access
American Association on Health and Disability
American Society of Hematology
Amyloidosis Support Groups, Inc.
Caregiver Action Network
COPD Foundation
Cure HHT
Cutaneous Lymphoma Foundation
Depression and Bipolar Support Alliance
FND Hope
Genetic Alliance
Global Healthy Living Foundation
Global Liver Institute
GO2 Foundation for Lung Cancer
Haystack Project
Hermansky-Pudlak Syndrome Network
HIV + Hepatitis Policy Institute
International Pemphigus Pemphigoid Foundation
Kids With Heart National Association for Children’s Heart Disorders, Inc.
Lakeshore Foundation
Lupus and Allied Diseases Association, Inc.
Lupus Foundation of America
Men’s Health Network
MLD Foundation
Movement Disorders Policy Coalition
National Alliance for Caregiving
National Alliance on Mental Illness
National Association of Area Agencies on Aging
National Kidney Foundation
National Organization for Tardive Dyskinesia
National Psoriasis Foundation
National Urea Cycle Disorders Foundation
NBIA Disorders Association
Parkinson & Movement Disorder Alliance
Partnership to Fight Chronic Disease
PTEN World
RASopathies Network
Respiratory Health Association
Sophie’s Neighborhood
The Mended Hearts
The Michael J. Fox Foundation for Parkinson’s Research
The Myositis Association
Tuberous Sclerosis Alliance

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Janelle Germanos
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