SCHUMER REVEALS: THANKS TO THE INFLATION REDUCTION ACT, NEW YORK SENIORS NOW, FOR FIRST TIME EVER, HAVE A CAP ON THEIR MEDICARE PRESCRIPTION DRUG SPENDING HELPING LOWER COSTS FOR 3+ MILLION NY-ERS ON MEDICARE AND SAVING SENIORS THOUSANDS OF DOLLARS ON HEALTHCARE
Senator Says New Rules Will Lower Costs For Thousands Of Seniors Across The State By Capping Total Out Of Pocket Drug Costs At ~$3,300
Inflation Reduction Act, Which Schumer Led To Passage As Majority Leader, Has Already Helped Make Vaccines Free And Deliver $35 Insulin For Those On Medicare – And Now More Is Helping Save Seniors Major $$$
Schumer: Major Shot In The Arm For More Affordable Healthcare For NY Seniors Is Here!
With more than 3 million seniors in New York on Medicare, U.S. Senate Majority Leader Charles E. Schumer today revealed that for the first time ever NY seniors on Medicare now have a cap on total out-of-pocket prescription drug costs.
Schumer said this first-of-its-kind cap of an estimated $3,300 on prescription drug out-of-pocket costs in Medicare Part D will hold down costs for millions of New Yorkers. Schumer said this new Medicare drug cost capping will work in with other major healthcare provisions he secured including making vaccines free for seniors and a $35 insulin cap for those on Medicare, to help make healthcare more affordable for more than 3 million New York seniors.
"A major shot in the arm to lower sky-high drug costs for New York’s seniors has just arrived thanks to the Inflation Reduction Act. Now New York seniors will not have to pay more than $3,300 a year for prescription drugs, and will help end the decision making like choosing between buying life-saving medications and keeping food on the table,” said Senator Schumer. “It means more money in the pockets of New York seniors and less in the pockets of Big Pharma, a win-win and just what the doctor ordered.”
Schumer said that on January 1, 2024 one of the most significant changes he secured in the Inflation Reduction Act was enacted creating an annual cap on prescription drug out-of-pocket costs in Medicare Part D with costs capped at $3,300, providing substantial relief for individuals facing high medication expenses. Schumer said that the cap will go even lower the following year in 2025 to a $2,000 out-of-pocket cap on prescription drugs.
Schumer said, “This cap is not just about saving money for those who routinely face the highest costs. It’s a peace of mind for seniors in every corner of the Empire State.”
Each year, roughly 1 in 25 seniors spend above this cap on prescription drugs. This includes people with numerous cancers, including leukemia, multiple myeloma, bone, lung and brain cancer, cystic fibrosis, organ transplant patients, hypertension and more. Schumer highlighted that this cap is not just for those who have chronic, ongoing conditions, but those who over the course of their life may be diagnosed with one of these conditions.
For example, last year seniors who took any of three commonly-used cancer drugs - Lynparza, Ibrance, and Xtandi – averaged about $12,000 per year in spending on those drugs alone. Seniors who take those drugs in 2024 will save about $9,000 in spending on that drug alone, not to mention any other drugs they need that would given to them free-of-charge once they hit the out-of-pocket limit.
Schumer added, “Every single year, people with a previously clean bill of health are told they have something like cancer or cystic fibrosis or they need an organ transplant. It’s not something you can plan for or expect. It comes out of the blue and upends your entire world. And with that diagnosis, they’re told the drug they need to save their life could be more than $10,000. Never again. Now, seniors can rest assured that if God forbid they do receive a hard diagnosis, the drugs they need will be affordable.”
Below is a breakdown of Medicare enrollment across NY by region:
|
NY Region |
Estimated Medicare Enrollment |
|
Capital Region |
237,000 |
|
Western NY |
249,000 |
|
Central NY |
194,000 |
|
Rochester-Finger Lakes |
249,000 |
|
Hudson Valley |
214,000 |
|
Southern Tier |
53,000 |
|
North Country |
78,000 |
Schumer explained that many key provisions in the IRA have already gone into effect, making significant strides in improving the lives of New Yorkers across the state:
- More than 3 million New York seniors can now receive the shingles and other recommendation vaccinations, which often could have costed hundreds of dollars, now for free. Before the IRA, Medicare beneficiaries were the only patients in the country required to pay for vaccines.
- The 75,000+ New Yorkers on Medicare who use insulin are now charged a max of $35 per month for their insulin.
Schumer added, “We are already seeing the Inflation Reduction Act help our seniors save on healthcare costs whether it be the $35 cap on insulin for those on Medicare, going after big pharma with new tools to negotiate drug prices, or making vaccines free, including the shingles vaccine, which has already saved thousands of New Yorkers hundreds of dollars every month. This is just what the doctor ordered to help New York seniors get the healthcare they need.”
When combined with the new out-of-pocket spending cap, these policies will save nearly a million New York seniors an average of $212 on their prescription drugs in 2024.
In 2025, when the annual cap on drug spending is lowered to $2,000 per year, more than 1.1 million New York seniors will save an average of $390 per year on their prescription drugs.
In addition, starting in 2024 thanks to provisions Schumer secured in the IRA, the feds will be able to go after Big Pharma to pay rebates to Medicare for price hikes on prescription drugs that over 750,000 seniors take per year. The White House recently announced 48 Medicare Part B drugs raised their prices faster than inflation, and some drug companies raised prices of certain medications faster than inflation for every quarter over the last year. Schumer said that this form of price gouging is unacceptable, and the provisions he delivered will now require these companies to pay rebates back to Medicare, saving seniors who take these drugs between $1 and $2,786 per dose depending on their medication. These drugs range from cancer fighting medication to those used to treat infections. As example includes Signifor, used to treat an endocrine disorder, whose manufacturer raised prices faster than inflation every quarter since the Inflation Reduction Act’s inflation rebate provision went into effect. Now thanks to the provisions Schumer secured, Medicare beneficiaries who take Signifor could save $311 per monthly dose starting January.
More work to reduce prescription drug costs remains underway. Medicare is currently negotiating lower prices for 10 of the most expensive, commonly used drugs in Medicare. Together, more than 653,000 New Yorkers take these 10 drugs. Each year moving forward, Medicare will negotiate lower prices for even more drugs.
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