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It’s a CMS-heavy day, as we look at what patient advocates are saying about Medicaid, and what CMS itself is saying about what’s driving Medicare premium increases. (694 words, 3 minutes, 28 seconds) |
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At the BIO Patient and Health Advocacy Summit on Monday, a group of patient advocates explained why we should care about Medicaid.
Why it matters: 87 million Americans rely on Medicaid—including 2 million people with cancer and 50% of people living with rare diseases.
Challenges abound—from unwinding (the end of a COVID coverage policy that’s leading to a lot of patients being taken off Medicaid) to proposed changes to the drug rebate program and limitations as states try to scale back coverage.
“Medicaid is really complicated,” said Pam Traxel of the American Cancer Society Cancer Action Network. “But what should not be complicated is we should not be kicking people off of their health insurance due to paperwork mistakes. And what we know is that roughly 72% of the people and the children who are being kicked off this program are essentially being kicked off due to some administrative error.”
“On the bright side, we are seeing some positive changes with expansion of Medicaid in some states,” said Virginia McMillin of Jazz Pharmaceuticals – read more.
“Everyone in this room should care about Medicaid coverage, because not only is there a huge chunk of individuals for whom Medicaid is where they get their health care, but also because Medicaid access, or lack thereof, really determines some of the most expensive coverage that we as a nation have to manage,” said Erika Sward of the American Lung Association. “The better coverage Medicaid patients have, and the better their conditions are managed, or prevented, and the better off we all are.” |
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Good Day BIO Live at PHAS: What we need to do about Medicaid |
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Annie Kennedy, Chief of Policy & Advocacy at the EveryLife Foundation for Rare Diseases, discusses why Medicaid provides an opportunity for patients with rare diseases—read more at Bio.News. |
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CMS admits Alzheimer’s treatments are not driving Medicare premium increases |
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Recent news articles have wrongfully blamed a new Alzheimer’s treatment as the reason for a projected increase in Medicare Part B premiums in 2024. But health spending trends—and Centers for Medicare and Medicaid Services (CMS) itself—say otherwise.
As CMS itself has admitted, multiple factors impact Medicare premiums, including overall program costs, utilization of other Part B items and services, and spending offsets from the aftermath of COVID-19.
When announcing Part B premiums for 2024 earlier this month CMS admitted treatment for Alzheimer’s is not a significant factor in premium increases: “The estimated impact of broader Medicare coverage of drugs to treat Alzheimer’s disease has a minimal impact and is not the primary reason for the 2024 increase,” a spokesperson told Inside Health Policy.
The reality: Prescription medicine costs are a small and stable share of overall health care spending (14% of the total).In 2020, total net spending on prescription medicines increased just 0.8%. And over the next five years, net medicine spending is projected to increase 0% to 3% annually. Between 2021 and 2025, annual net price growth for brand medicines is projected to be -3 to 0%.
This is a trend: In 2021, after Congress directed CMS to pay back Part B premiums, premiums increased only by $3.90 per month. In 2022, CMS admitted lower than projected spending on Alzheimer’s treatment and other Part B items and services, leading to a decrease in Part B premiums in 2023.
Public opinion matters: The Alliance for Aging Research found that nearly 87% of voters favor requiring Medicare to cover the cost of FDA-approved Alzheimer’s treatments.
Looking ahead: Alzheimer’s places a significant burden on more than 6 million Americans who live with the disease, their caregivers, families, and communities. The University of Chicago found that providing public coverage for Alzheimer’s drugs could produce long-term savings of between $13.1 billion and $545.6 billion. |
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Good Day BIO Live at PHAS: ‘Advocates really are the experts’ |
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Leah Howard, President and CEO of the National Psoriasis Foundation (NPF), explains why grassroots advocacy is so important—and why patients are the best advocates at the federal and state levels. |
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