Latest News on the Medicare Advantage Program

HHS decides to maintain a higher Medicare 2022 premium

Progressives are criticizing the Biden administration’s recent announcement that the 2022 Medicare premium will not be cut despite lower-than-expected costs for a new Alzheimer’s drug.

The cost of a premium rose $ 21.60 to a low of $ 170.10 and a high of $ 578.30 in 2022, the largest increase in program history. Premiums are based in part on income and tax return status.

The jump was attributed in part to the need to raise funds in case Medicare covered Aduhelm, the first Alzheimer’s drug approved by the Food and Drug Administration (FDA) in nearly 20 years. The drug is created by the American biotech company Biogen and initially had an annual cost of $ 56,000, before the company halved that price.

The Department of Health and Human Services (HHS) said last week that the Medicare premium will fall in 2023, but that it will maintain the $ 21.60 increase next year.

Critics have criticized the decision because it poses an undue financial burden to many people living on a fixed income.

Alex Lawson, executive director of the progressive group Social Security Works, criticized the administration’s decision not to lower premiums until next year, calling it “false.”

Faiz Shakir, an adviser to Sen. Bernie Sanders (I-Vt.), Asked the Biden administration to send discount checks to Medicare beneficiaries this year, while his Sanders staff colleague Warren Gunnels tweeted, ” Imagine being able to put more money in the pockets of seniors who are struggling to put food on the table right now and do nothing. That’s how you make a splash. ”

Sanders himself has not publicly criticized the decision.

HHS Secretary Xavier Becerra said he hoped to reduce premiums sooner, but that it was not “viable.” HHS itself cited “legal and operational hurdles” for the lack of a reduction.

There had been fears that Aduhelm’s coverage would greatly increase Medicare costs, but HHS announced separately that it would not cover the drug outside of clinical trials.

Lawson praised the decision, saying HHS had avoided a “potentially catastrophic situation.”

The controversy over Aduhelm’s actual effectiveness has also been a point of discussion for many critics of his approval and administration. Several members of the FDA’s advisory panel resigned last year after the drug was approved, citing the lack of clear evidence that it actually works for Alzheimer’s patients.

Tricia Neuman, executive director of Medicare policy for the Kaiser Family Foundation, said reducing Medicare premiums over a calendar year would have been “unprecedented.”

“I can’t say if it’s feasible, but I would imagine it would require a lot of obstacles and administrative costs. The other part that’s true is that it’s unprecedented, ”Neuman said. coming”.

Lawson rejected the idea that making financial adjustments this year was too complex, arguing that the federal government has proven on multiple occasions that it can send payments to many people across the country.

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“We know for sure that the Treasury can receive checks from people very quickly. So the idea that it’s too complex, we reject it,” he said, echoing Shakir’s call for discount checks to be sent.

The initial decision to increase premiums for the good of Aduhelm was also criticized by left-wing groups and lawmakers who argued it was unnecessary. Neuman noted that it was an “unusual scenario,” as many people on Medicare could potentially benefit from the new drug, with very few effective treatments for Alzheimer’s currently available on the market.

“It is plausible that there is a substantial demand for a drug that would have a significant impact on this disease,” Neuman said. “As it turned out, the evidence was weak and there were concerns about side effects. And there were a lot of questions about what the drug would do, but the drug was approved by the FDA.”

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