What’s Happening on the Hill: Medicare Update - Western Asset Protection
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What’s Happening on the Hill: Medicare Update

With so much happening on Capitol Hill, you might have missed some developments that could impact Medicare. Here’s a quick recap of recent events to get you caught up.

Medicare’s Blue Button 2.0

The Blue Button at MyMedicare.gov lets beneficiaries download their personal health information to a file. This information can be saved on the beneficiary’s computer, printed or emailed, and the easy access to important health information is supposed to facilitated good decision-making.

Now CMS has announced Blue Button 2.0. This feature allows beneficiaries to share Medicare Part A, Part B and Part D claim information with authorized applications, services and research programs. Information will only be shared if the beneficiary provides authorization.

CMS Announces 2021 Medicare Advantage Numbers

Just ahead of AEP, CMS has announced that the average 2021 premium for Medicare Advantage plans is estimated to be $21.00. This is a 34.2% decrease since 2017 and the lowest price since 2007. In 2020, the average was $23.63. At the same time, the average number of plan options will increase to 47 plans per county, up from 39 plans per county in 2020. Enrollment in Medicare Advantage is expected to reach an all-time high of 26.9 million.

Another Executive Order Takes Aim at Drug Prices

On September 13, the Executive Order on Lowering Drug Prices by Putting America First was announced. According to the order, Americans pay more for prescription drugs per capita than residents in any other developed country. The order states that the Medicare program should not pay more for prescriptions than the most-favored-nation price, which is the lowest price, after adjusting for volume and national gross domestic product, for a pharmaceutical product sold in a country belonging to the Organization for Economic Cooperation and Development.

According to NPR, experts have said the order likely won’t have an immediate effect. It should also be noted that this order is similar to another order issued earlier this year. In June, four Executive Orders were announced. Among other things, these orders aimed to end a system of kickbacks and to require federally qualified health centers that purchase insulin and epinephrine in the 340B program to pass discounted drug savings on to medically underserved patients.

Medicare and Coronavirus

The pandemic has negatively impacted Medicare funding. According to Healthcare Dive, a CBO report says that the trust that finances Medicare Part A is now forecasted to become insolvent by 2024 because of the pandemic, two years earlier than previously forecasted. This means that Medicare spending will have to be cut by 17% without congressional action.

At the same time, the economic impact of the pandemic has raised questions about what the Medicare Part B premium might be in 2021. According to CNBC, the premium has not been announced yet, but a bill has been passed to cap the potential increase, limiting the increase to 25% of what it would otherwise be.

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