Sen. Warnock introduces standalone bill to cap Medicare prescription drug costs

With the Build Back Better Act having passed the U.S. House of Representatives last fall only to come screeching to a halt when it reached the U.S. Senate due to all 50 Republicans + Dem. Senator Joe Manchin refusing to support it, Congressional Democrats have started introducing standalone bills in an attempt to push through at least some of the more popular provisions.

One of these, which would limit co-pays for insulin to no more than $35/month or less, passed the House last week.

Today, U.S. Senator Raphael Warnock, who also sponsored the Senate version of the insulin co-pay cap bill, introduced a second stand-alone bill plucked from the ashes of Build Back Better:

Senator Reverend Warnock Introduces New Legislation to Cap Prescription Drug Costs for Georgia Seniors

• Today, Senator Reverend Warnock introduced the Capping Drug Costs for Seniors Act, which would create an annual $2,000 out-of-pocket cap on prescription drugs under Medicare Part D

• Additionally, the legislation would shift more of the cost burden on drug manufacturers, reducing government subsidies and saving taxpayer dollars

• Senator Reverend Warnock has championed lowering drug costs for seniors, including introducing legislation to cap the cost of insulin at $35 a month, and supporting legislation to allow for Medicare to negotiate drug prices

Washington, D.C. – Today, Senator Reverend Warnock (D-GA), a member of the U.S. Senate Special Committee on Aging, introduced new legislation to cap out-of-pocket costs at $2,000 a year for Georgia seniors on Medicare Part D. The out-of-pocket cap for Medicare Part D participants is currently set at approximately $3,250. Additionally, the bill requires drug manufactures to take on more of the cost burden, reducing government subsidies and saving taxpayer dollars. In 2019, over 1.2 million seniors paid over $2,000 in out-of-pocket costs for prescription drugs. This will save those 1.2 million Americans, including thousands of Georgians, around $1,250 in out-of-pocket cost savings. Additionally, Senator Warnock is a cosponsor of legislation that would let Medicare directly negotiate drug prices and believes this legislation goes hand-in-hand with his out-of-pocket cost cap.

“Our country should never allow for our seniors to have to ration or skip the medication they need because they can’t afford it,” said Senator Reverend Warnock. “That’s why I’m proud to introduce the Capping Drug Costs for Seniors Act to cap seniors’ out-of-pocket prescription drug costs at $2,000 a year. This legislation puts a higher cost burden on greedy drug manufacturers, who are making record profits while Georgians are skipping meals and rationing drugs to stay alive. I’m working to get this legislation over the finish line as soon as possible. Georgians can’t wait another day for more affordable drugs, and Congress shouldn’t wait another day to act.”

The Capping Drug Costs for Seniors Act would:

• Create an annual $2,000 out-of-pocket limit on prescription drugs under Medicare Part D.

• Currently the limit on patient out-of-pocket costs is about $3,250 (total out-of-pocket costs, including plan contribution and other payments is $7,050). This cap means that beneficiaries who have more than $2,000 in prescription drug spending will face no additional cost-sharing over that amount – approximately $1,250 in savings for many individuals.

• Require manufacturers to pay more in the catastrophic coverage phase and reduces government reinsurance subsidies, saving taxpayer dollars.

• This would add drug manufacturer liability by requiring them to pay 20% of the liability for name brand drugs. The government would also cover 20%. For generics, the government would cover the full 40%, thus incentivizing manufacturers to offer cheaper generics for Medicare plans.

• Expand the current Medicare coverage gap discount program into a benefit-wide responsibility, thereby increasing incentives for plans to better manage drug spending.

• Additionally, manufacturers would be required to pay 10% costs in the initial coverage phase for brand name products.

Senator Reverend Warnock is a proud advocate for Georgia’s aging population, and has pushed to invest in elder care, defend Social Security and Medicare, and protect Georgia seniors from COVID-19. The Senator urged both the White House and Congressional leaders to support strong federal investments in home care so that the nearly 8,000 Georgians on waiting lists for home care can finally get the care they need. Senator Warnock voted against and strongly oppose privatizing or cutting Social Security and Medicare. Additionally, the Senator supported a provision in the American Rescue Plan to provide nursing homes with personal protective equipment, testing supplies, and support for staffing needs. Lastly, Senator Warnock championed the American Rescue Plan, which provided $20 billion to improve COVID-19 vaccine administration and distribution.

The Capping Drug Costs for Seniors Act is the Senate companion bill to Congressman Horsford’s legislation.