Needing to focus on making healthcare reform work, the Obama administration backed away last week from major changes proposed for the Medicare Part D prescription drug program, in the face of fierce political opposition from the healthcare industry and some patient advocacy groups.
The retreat offered political protection to Democrats running for election but disappointed experts who believe the proposals could have reduced costs and enhanced beneficiary choice and access without hurting coverage under the popular program. When the CMS released the proposed rule in January, it projected it would save the government $1.3 billion over five years. The agency's retreat showed once again that while everyone says they support controlling Medicare costs, actual measures to do so encounter intense political opposition.
The draft policy that the CMS introduced in January was intended to increase price competition, decrease fraud, and improve seniors' ability to make cost-effective choices among the participating private drug plans.
But many of the proposals were panned by various interest groups, particularly pharmacy benefit managers, and created political headaches for Democratic candidates asked to explain the policies. They included stripping a requirement that health plans provide coverage for most drugs in certain protected classes of medications. One industry-funded study said the proposed rule would have increased Medicare costs by up to $1.6 billion in 2015.