A New Era in Drug Pricing The Biden administration is on the point of a significant announcement. They are about to reveal the first batch of prescription drugs for which Medicare will negotiate prices. This move has been met with resistance, especially from drugmakers who are not in favor of this change. This initiative is… Read More

Introduction to Medicare Part D Medicare Part D, a program that offers outpatient prescription drug benefits, is a lifeline for older adults and individuals with long-term disabilities. These beneficiaries can enroll in private plans, including stand-alone prescription drug plans (PDPs) and Medicare Advantage prescription drug plans (MA-PDs). These plans supplement traditional Medicare and include drug… Read More

“It is time to call out so-called Medicare Advantage for what it is,” said Rep. Rosa DeLauro. This statement underscores the growing concern among Democratic U.S. lawmakers about Medicare Advantage. This program, essentially private insurance, has been accused of profiting by denying coverage and using the name of Medicare to trick our seniors. On July… Read More

The House Republicans’ CHOICE Act has been making headlines recently, signaling a shift in the political landscape of health insurance. This legislation aims to reduce health insurance costs for specific businesses and consumers, partly by rolling back some consumer protections established under the Affordable Care Act, commonly known as Obamacare. A Subtle Shift from “Repeal… Read More

The Affordable Care Act (ACA) Under Threat The Affordable Care Act (ACA), a landmark health insurance law, has faced numerous challenges since its inception 13 years ago. Today, it finds itself in new jeopardy. The focus this time is on a vital provision of the ACA – the requirement for free coverage of preventive health… Read More

Retirees may need to brace themselves for a potential increase in one of their regular costs — Medicare Part B premiums — in 2024. This projected increase is primarily driven by a new Alzheimer’s treatment recently entering the market. The Projected Increase in Medicare Part B Premiums Earlier this year, the Medicare trustees projected that… Read More

In a significant development, Johnson & Johnson (JNJ.N) has taken legal action against the U.S. government. The healthcare giant seeks to prevent the enforcement of a new program that empowers Medicare to negotiate drug prices. This move makes Johnson & Johnson the latest drugmakers to rally against the policy. The Inflation Reduction Act and Its… Read More

The Inflation Reduction Act’s Medicare drug price negotiation provision is set to revolutionize the affordability and accessibility of medications for millions of Americans. This groundbreaking reform is particularly significant for women, Black, Hispanic or Latino, LGBTQI+, and disabled beneficiaries who have historically faced challenges accessing necessary medications due to high costs. The Inflation Reduction Act:… Read More

The Chamber of Commerce has stepped into the legal limelight. The organization recently filed a preliminary injunction against the Medicare Drug Price Negotiation Program. This move, falling under the auspices of the Inflation Reduction Act, is designed to halt the program’s progression while it is under judicial review. The reason behind this strategic action is… Read More

The Inflation Reduction Act and the Drug Price Negotiation Program Under the Inflation Reduction Act, the federal government is now mandated to negotiate the price of high-spending drugs covered by Medicare Part D, the outpatient prescription drug benefit program, and Medicare Part B. This gave birth to the new Medicare Drug Price Negotiation Program, a… Read More

Chair of the House Energy and Commerce Committee, Cathy McMorris Rodgers (R-WA), and the Chair of the Subcommittee on Health, Brett Guthrie (R-KY), revealed the plans for a subcommittee hearing titled “Innovation Saves Lives: Evaluating Medicare Coverage Pathways for Innovative Drugs, Medical Devices, and Technology.” Medicare’s Evolution: The Chairs’ Vision The Chairs highlighted the urgency… Read More

The Medicare Advantage Quality Bonus Program (QBP) was born out of the Affordable Care Act and carried the expectation to revolutionize Medicare Advantage (MA) plans by reducing payments to MA organizations. However, according to the Urban Institute report, the program must still meet these expectations. The report highlights several instances where the QBP is found… Read More

Proposed Medicare cuts pose a significant risk to patients and communities nationwide. Challenges such as workforce shortages, rising costs, and supply chain disruptions have already strained America’s hospitals and health systems. These institutions play a vital role in providing quality and accessible care 24/7, meeting the needs of communities in times of illness and crisis…. Read More

In a groundbreaking move, the U.S. Department of Health and Human Services (HHS) recently announced actions to reduce healthcare costs significantly. This move is part of the implementation of President Biden’s lower-cost prescription drug law – the Inflation Reduction Act (IRA). This law has already started to provide financial relief to covered seniors and people… Read More

Early detection is crucial in a world where cancer remains a leading cause of death. That is the aim of the Multi-Cancer Early Detection Bill, a groundbreaking piece of legislation that can potentially change the landscape of cancer screenings in the United States. The bill, introduced in the Senate, seeks to increase equitable access to… Read More

A Groundbreaking Proposal The Republican Study Committee (RSC), a group that includes 175 GOP members of the U.S. House of Representatives, has recently proposed two substantial changes to Social Security and Medicare as part of their federal budget for the fiscal year 2024. These proposals represent significant shifts in the structure and delivery of these… Read More

The Biden-Harris Administration recently unveiled new tools to lower prescription drug costs for low-income seniors and people with disabilities. These tools focus on expanding the Extra Help program, a vital initiative that provides financial assistance for individuals enrolled in Medicare Part D. This program is a lifeline for many people, helping to cover their Medicare… Read More

Merck vs. The US Government: The Lawsuit Explained Pharmaceutical giant Merck has filed a lawsuit against the US Government, taking issue with a newly-implemented program under the Medicare system that allows for the negotiation of drug prices. The program is a provision of the Inflation Reduction Act, a recent law that has raised contentious debates… Read More

On April 13th, 2023, President Joe Biden announced that DACA (Deferred Action for Childhood Arrivals) recipients would be able to apply for Medicaid and the Affordable Care Act’s health insurance exchanges

On Thursday, March 30, 2023, a Texas federal judge invalidated the Affordable Care Act (ACA) mandate requiring insurers to cover specific preventive services for free, such as certain cancer screenings and medicines for preventing heart disease. The ruling could affect over 150 million Americans’ out-of-pocket costs for these services. Immediate implications are unclear, and health experts don’t expect significant short-term changes. The Biden administration is expected to appeal the decision, which could lead to further legal proceedings.

Make sure to enroll, change plans, or change cost assistance before January 15, 2023. Open enrollment 2023 ends January 15, 2023, in most states! Are you looking for health insurance coverage or considering changing your existing plan? If so, it’s important to know that open enrollment for health insurance under the Affordable Care Act (ACA),… Read More

Medicare open enrollment 2023 ends December 7th. Don’t forget to shop for Medicare Advantage and Medicare Part D plans! Every year during Medicare’s Annual Enrollment you can make changes to your coverage and enroll in a Medicare plan. During this period: You can switch from Original Medicare to Medicare Advantage with or without a drug… Read More

President Biden’s proposed rule to fix the family glitch has been finalized. A fix to the long-standing “Family Glitch” was finalized on October 11th, 2022. The so-called glitch stopped some family members from being able to get marketplace insurance and assistance if they had access to employer-based coverage that was technically affordable under the ACA… Read More