Affordable senior healthcare access is essential for the well-being and financial security of America’s seniors. The Inflation Reduction Act (IRA) introduced measures like the Medicare Part D Smoothing Option and caps on out-of-pocket insulin expenses. These have been positive steps in addressing healthcare costs. However, certain provisions of this legislation may have unintended consequences, potentially worsening healthcare access for many seniors.
The IRA was created with good intentions. But its complex structure may stifle innovation, reduce treatment options, and increase costs for Medicare beneficiaries. It’s crucial to examine both the benefits and drawbacks of the IRA. We must ensure it serves the best interests of seniors without compromising affordable senior healthcare access.
To address these issues, we urge Congress to adopt the following three legislative fixes to protect affordable senior healthcare access:
Here are three legislative fixes we urge Congress to adopt to address unintended consequences:
1. The Ensuring Pathways to Innovative Cures (EPIC) Act for Affordable Senior Healthcare Access
The IRA currently allows small-molecule drugs to be subject to price negotiations after nine years, while biologics get 13 years. This imbalance discourages investment in small-molecule drugs, which are vital for treating conditions like cancer. The EPIC Act seeks to fix this by extending the timeline for small-molecule drug price negotiations to 13 years. By leveling the playing field, the EPIC Act encourages continued innovation and ensures affordable access to these crucial treatments for seniors.
2. The Optimizing Research Progress Hope and New Cures (ORPHAN Cures) Act
Rare disease treatments often serve small patient populations, making them less financially viable under stringent pricing controls. The ORPHAN Cures Act would protect incentives for developing orphan drugs, which are essential for treating rare diseases. Safeguarding these incentives ensures that patients with rare conditions continue to have access to potentially life-saving treatments.
This legislation protects and incentivizes the development of treatments for rare diseases by maintaining critical funding and protections. Tell your member of congress to sign ORPHAN Cures! Take Action Here.
3. The Protecting Health Care for All Patients Act
This legislation is designed to prevent discrimination in healthcare decision-making, particularly for vulnerable populations, including seniors. It reinforces the IRA’s commitment to non-discrimination and guarantees equitable access to healthcare for all patients, particularly those most in need of protection from biased policies or restrictive practices.
Increasing Accountability and Oversight in Medicare Drug Price Negotiation
In addition to these legislative fixes, we also call for increased transparency and oversight in the Medicare Drug Price Negotiation Program. Several key actions are essential:
- Enhancing transparency: CMS must fully disclose the criteria, methodologies, and data sources used in value assessment tools and negotiation processes.
- Improving patient engagement: Patients, caregivers, and advocacy organizations should be involved at every step to ensure decisions are patient-centered.
- Protecting against predatory formulary practices: Congress must implement safeguards to prevent Medicare beneficiaries from losing access to necessary medications due to restrictive formularies or utilization management tactics.
- Ensuring conflict-free negotiations: The Medicare Transaction Facilitator should operate with complete independence to avoid any conflicts of interest and preserve the integrity of the negotiation process.
These steps are crucial for protecting Medicare beneficiaries from unintended consequences. They also promote a more patient-centered approach. Unfortunately, the current system is opaque, often placing more value on academic perspectives than real patient experiences. Moving forward, CMS must do better at incorporating patient insights and ensuring that affordable senior healthcare access is prioritized.
Now is the time for Congress to act. By supporting these legislative fixes, we can ensure that Medicare truly functions in the best interest of seniors and safeguards affordable senior healthcare access to the world’s best medicine for years to come.
Join Us at the Patients Rising Town Hall
Want to stay updated and get involved? Patients Rising will host a Town Hall on Federal Issues on September 26 at 7:00 PM ET. Join us to discuss these key legislative efforts and learn how you can make a difference. REGISTER HERE.
Your Advocacy Matters
Ultimately, Congress’s work this week could have a lasting impact on patient access to life-saving treatments. At Patients Rising, we rely on passionate advocates like you to stand with us and help drive the change patients need. By joining our community, you can stay informed, engage with other advocates, and take action to ensure every patient has access to the care they deserve. Your voice matters, and together, we can make a difference. Join us today and become a part of the movement to improve healthcare for all!