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May 23, 2019 03:22 PM

House leaders propose restructuring Medicare Part D

Susannah Luthi
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    U.S. House of Representatives health committee leaders have drafted new reforms to Medicare Part D as Congress prepares for a final legislative sprint on drug pricing.

    On Thursday, the Democratic chairs and ranking Republicans of the Ways and Means and Energy and Commerce panels released the discussion draft of a bill to cap what people have to pay out-of-pocket for medications under Medicare Part D.

    The bill would also whittle down the government's share of catastrophic coverage from 80% to 20% over four years.

    Both these ideas have support in Washington, following both Medicare Payment Advisory Commission recommendations and policy requests from the Trump administration.

    But lawmakers are looking for input from interested parties by June 6, including feedback for potentially going further with Part D restructuring, including potential changes to the coverage gap, catastrophic threshold, low-income subsidies, and ways to boost generics over brand-name drugs.

    Committee leaders are mulling changes for low- to moderate-income people in Part D, including help with out-of-pocket coasts below the catastrophic threshold.

    They also want feedback on whether the financial responsibility should shift for the enrollee, the Part D plans and the manufacturers if the drug companies have to assume more liability in the catastrophic phase.

    The discussion draft from Chairs Richard Neal (D-Mass.) and Frank Pallone (D-N.J.) and ranking Republicans Kevin Brady of Texas and Greg Walden of Oregon dropped as Congress left town for recess.

    When they come back, lawmakers expect to wrap up work on the various healthcare bills by July.

    The Senate health committee also on Thursday unveiled its 165-page discussion draft of provisions to lower healthcare costs. The Senate Finance Committee is aiming to release its slate of drug pricing bills related to Medicare Parts B and D and Medicaid shortly after recess, with a mark-up in mid-June.

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