It’s rare that a program covering more than 50 million individuals can achieve the popularity that Medicare Part D has achieved and maintained for over two decades now. This voluntary health benefit has impressively continued to appease America’s seniors who rely on it for prescription drug coverage. As the old saying goes, “Don’t fix what isn’t broken.” However, structural changes brought about by 2022’s Inflation Reduction Act (IRA) threaten this vital program’s success.
Since the IRA’s passage, Part D premiums have skyrocketed. Average premiums have gone up 21% this year and are expected to double in 2025. For seniors, many of whom are on fixed incomes, these premium increases can have major detrimental lifestyle impacts, particularly when it comes to budgeting for the future. Unstable and unexpected costs can really put a wrench in your plans. This, combined with the fact that over 17 million older adults are economically insecure, should sound alarm bells for decision-makers in health policy. Put simply, America’s aging population cannot afford to see their premiums surge.
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Despite increased payments, Part D beneficiaries are seeing a steep decline in the number of plans available to them. In 2006, there were 1,429 Medicare prescription drug plans (PDPs). In 2024, that number has halved, with just 709 plans available. This is occurring at a rapid pace, with the number of plans decreasing by 92 in the past year alone. Furthermore, the number of PDPs and the number of firms sponsoring these plans (11 firms) have both dipped to their lowest-ever point — lower than any other year since the benefit was introduced in 2006. At least one other firm has already indicated they will exit the market in 2025. The cascading impacts of just one of the few firms becoming unavailable will ripple throughout the senior population and create yet another obstacle between patients and their treatments.
As we age, more and more health concerns can arise that need prompt treatment, which is why it’s so imperative that seniors’ Part D plans offer coverage of a variety of high-quality medications. If option one doesn’t work, for example, doctors should be able to prescribe beneficiaries option two or three to see if those treatments are more appropriate for their health conditions. However, the IRA will only fragment these care plans, as it has worsened their coverage options. With additional roadblocks to care, seniors could face worse outcomes for health conditions that should be manageable.
The IRA has changed a program that should be improving lives to one that will make it much more difficult for Americans to get better care. Before it’s too late, Congress must stand up for our aging population and ensure they get the medication and coverage they deserve.
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Mark Gibbons is the President and CEO of RetireSafe, an organization that promotes and protects the well-being, independence, and rights of seniors through advocacy and education. Before joining RetireSafe, Gibbons was senior director of external programs at Caregiver Action Network (CAN). In 10 years of service to the U.S. Army, Gibbons served as Commander in Operation Desert Shield/Storm and Operation Provide Comfort.
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