Opinion

Lower Costs, More Cures Act

Wednesday, February 9, 2022

As inflation soars, Congress must seek out solutions that reduce consumer costs while spurring a strong economic recovery. In that spirit, the Lower Costs, More Cures Act, which I reintroduced last year, would meaningfully improve prescription drug affordability. Through dozens of patient-focused policies, virtually all of which enjoy bipartisan support, this legislation presents an opportunity to drive down drug costs, increase transparency, and expand coverage options for seniors.

Nearly two decades ago, I joined a bipartisan majority of my colleagues in enacting the Medicare Modernization Act, which created Part D, Medicare’s prescription drug benefit. Thanks to the program’s unique design, through which plans negotiate steep discounts and offer wide-ranging coverage options, Part D has proved highly successful, coming in roughly 50 percent under budget while delivering stable premiums and an 87 percent satisfaction rate. Still, as market dynamics and seniors’ needs evolve, both this program and the prescription drug landscape more broadly demand improvements.

To that end, the Lower Costs, More Cures Act would cap out-of-pocket spending for all Medicare Part D enrollees, alleviating catastrophic burdens for millions of seniors, including many of the more than 235,000 Idahoans with Part D coverage. The bill would also encourage the creation of new prescription drug plans by incentivizing options that pass more discounts directly to seniors at the pharmacy counter. Furthermore, for many of the roughly 33 percent of Medicare beneficiaries diagnosed with diabetes, the legislation would protect and make permanent a Trump Administration program providing access to plans with a guaranteed monthly copay of no more than $35 for insulin.

The Lower Costs, More Cures Act would also promote insulin affordability for the sizable share of the workforce enrolled in high-deductible health plans. Since Obamacare’s enactment, deductible shave risen dramatically, exposing Americans to exorbitant expenses before their coverage kicks in. Our legislation offers meaningful relief for many of these workers by permanently enabling high-deductible health plans to offer pre-deductible coverage for a range of preventive health services, including insulin. For the nearly 10 percent of adults in Idaho living with diabetes, these policies could prove lifesaving and life-enhancing.

In addition to reducing out-of-pocket expenses, the Lower Costs, More Cures Act would increase drug price transparency. While brand-name drug net prices, which account for discounts and rebates, declined by 2.9 percent in 2020, list prices, or ‘sticker’ prices, for these same drugs increased by 4.4 percent. Given that both price-points can impact out-of-pocket expenses, the legislation would establish transparency requirements that empower consumers through meaningful oversight of pricing practices.

Beyond these provisions, the Lower Costs, More Cures Act would advance dozens of other pro-patient policy solutions. A new Chief Pharmaceutical Negotiator, for instance, would be tasked with combatting foreign freeloading, ensuring the best trade deals possible for domestic job creators and consumers, who subsidize a disproportionate share of biomedical innovation. Our proposal would also strengthen cost comparison tools, remove disincentives for prescribing lower-cost medications, and facilitate outcomes-based arrangements to expand access to cutting-edge personalized medicines, to name just a few key provisions.

To date, Congressional Democrat Leadership and the Biden Administration have chosen to pursue a partisan plan that would lead to higher launch prices for new drugs, fewer new treatments on the market, and an increasingly bureaucratic health system, in addition to compromising our global life sciences leadership and providing rivals like China with a competitive opening. I sincerely hope that my colleagues course-correct and instead embrace commonsense solutions like the Lower Costs, More Cures Act.

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