Agreement would channel $80B to Medicare, Medicaid drugs

Pharmaceutical makers may soon fund brand-name drugs for lower- and middle-income seniors stuck in the Medicare's "donut hole" under a deal emerging in negotiations with the White House; the deal would provide $80 billion over the next 10 years.

Under the agreement, Medicare patients with incomes up to roughly $80,000 would get some benefit from the program. Right now, many beneficiaries pay the entire cost of prescriptions after initial coverage runs out but before catastrophic coverage can be accessed.

Meanwhile, the agreement would cut the payments anticipated to go to pharmas under Medicare and Medicaid. Legislators expect to use those savings to pay for health insurance for uninsured Americans, though no one seems to be sure exactly how much the overall reform package will cost.

A current draft of reform legislation circulated by House Democrats would create a government-sponsored plan that will compete with private health plans (the so-called public option) and would end medical underwriting by the plans. It would also require individuals to get coverage and employers to provide it.

To learn more about this deal:
- read this Modern Healthcare piece (reg. req.)

Post a comment