Passage of Inflation Reduction Act muab Medicare keeb kwm lub zog tshiab

Medicare tau npaj rov sib tham txog cov nqi ntawm qee yam ntawm nws cov tshuaj kim tshaj plaws los ntawm kev nthuav dav keeb kwm ntawm nws lub zog, uas tuaj yeem txo cov nqi rau ntau tus neeg laus nrog rau tsoomfwv kev siv nyiaj rau nws cov phiaj xwm tshuaj.

Cov kev hloov pauv tau ntim rau hauv daim nqi siv nyiaj-thiab-ua se loj hauv Congress uas suav nrog $ 433 nphom hauv kev nqis peev hauv kev saib xyuas kev noj qab haus huv thiab lub zog huv. Cov Democrats hauv tsev tau dhau txoj cai txo qis nyiaj txiag rau hnub Friday hauv 220 txog 207 pov npav raws cov kab hauv tog, xaus cov txheej txheem tsim kev tsim txom uas siv ntau tshaj ib xyoos.

Tsab cai no txhawb nqa Tus Tuav Haujlwm Saib Xyuas Kev Noj Qab Haus Huv thiab Tib Neeg los sib tham tus nqi rau qee yam tshuaj uas muaj nyob rau hauv ob qhov sib txawv ntawm Medicare thiab rau txim rau cov tuam txhab tshuaj uas tsis ua raws li txoj cai. Txoj cai lij choj tseem raug them tus nqi tawm ntawm lub hnab tshos ntawm $ 2,000 pib txij xyoo 2025 rau cov neeg uas koom nrog Medicare Part D, txoj kev npaj tshuaj rau cov neeg laus.

Democrats tau sib ntaus sib tua rau ntau xyoo los muab Medicare lub zog rau cajole cov neeg tsim tshuaj rau hauv cov nqi qis. Tab sis lub chaw muag tshuaj muaj zog thiab Republican tawm tsam tau tua cov kev siv zog yav dhau los. Medicare Part D tam sim no txwv HHS los ntawm kev sib tham tus nqi nrog kev lag luam.

Tab sis HHS tam sim no nyob rau hauv qhov kev txiav txim siab kom tau txais lub hwj chim los sib tham. Thawj Tswj Hwm Joe Biden cia siab tias sai sai no yuav kos npe rau tsab cai lij choj.

Lub Koom Haum Asmeskas Cov Neeg Laus, uas sawv cev rau 38 lab tus tib neeg, tau piav qhia txog txoj cai lij choj uas yog keeb kwm yeej rau cov neeg laus. AARP CEO Jo Ann Jenkins tau hais tias pab pawg tau tawm tsam ze li ob xyoo caum kom tso cai rau Medicare sib tham txog cov nqi tshuaj. Ntau lab tus neeg laus yog tam sim no "ib kauj ruam ze dua rau kev pab tiag tiag los ntawm kev tswj hwm tus nqi tshuaj noj," Jenkins tau hais ua ntej lub lim tiam no.

Txawm hais tias txoj cai lij choj yog keeb kwm, cov kev sib tham yog "nruj heev" hauv kev tsim, raws li Andrew Mulcahy, tus kws tshaj lij ntawm cov nqi tshuaj noj ntawm RAND Corporation. Thiab cov kev sib tham yuav tsis muab kev pab kom txog rau thaum 2026 thaum cov nqi rov sib tham ntawm kaum ntawm qhov kev pab cuam cov tshuaj kim tshaj plaws tau pib.

Cov neeg tsim cai lij choj sab laug xws li Sen. Bernie Sanders, I-VT, tau thuam txoj cai lij choj rau kev tawm ntawm cov neeg Asmeskas feem coob uas tsis nyob hauv Medicare. Rau kev lag luam kws tshuaj, ntawm qhov tod tes, txawm tias qhov txwv tsis pub dhau ntawm daim nqi yog tus choj hla dhau.

Raws li txoj cai lij choj, HHS tuaj yeem sib tham tus nqi rau qee cov tshuaj kim tshaj plaws nyob rau hauv Medicare Part B thiab Medicare Part D. Cov qub no suav nrog cov tshuaj tshwj xeeb uas tswj hwm los ntawm cov kws kho mob, thaum lub sijhawm tom kawg suav nrog cov tshuaj uas tau sau hauv khw muag tshuaj.

Qhov kev zov me nyuam yog phased nyob rau hauv plaub theem nyob rau ntau xyoo. Nov yog qhov nws ua haujlwm li cas:

• Theem 1: HHS sib tham txog 10 Medicare Part D tshuaj. Cov nqi siv rau xyoo 2026.
• Theem 2: HHS sib tham txog 15 Tshooj D tshuaj. Cov nqi siv rau xyoo 2027.
• Theem 3: HHS tuaj yeem sib tham txog 15 Medicare Tshooj B lossis D tshuaj. Cov nqi siv rau xyoo 2028.
• Theem 4: HHS sib tham 20 Tshooj B lossis D tshuaj. Cov nqi pib siv rau xyoo 2029. Tus tuav ntaub ntawv tuaj yeem sib tham txog 20 tshuaj hauv txhua xyoo tom ntej.

Muaj pes tsawg tus neeg laus yuav tau txais txiaj ntsig los ntawm kev sib tham nyob ntawm qhov loj ntawm cov tshuaj uas HHS tus tuav ntaub ntawv txiav txim siab rau lub hom phiaj. Ntau tshaj 63 lab tus neeg Asmeskas raug pov hwm los ntawm Medicare tag nrho thiab kwv yees li 49 lab tau tso npe rau hauv Medicare Part D.

Ua ntej tsab cai txo nqi nce nqi tau tsim los rau hauv txoj cai lij choj, Medicare Part D tau kwv yees tias yuav raug nqi ntau dua $ 1.6 trillion nyob rau kaum xyoo tom ntej, raws li lub koom haum Congressional Budget Office. Medicare Part B tau kwv yees tus nqi ntawm $ 6.5 trillion nyob rau kaum xyoo tom ntej. CBO cov phiaj xwm kev sib tham txog tus nqi tshuaj ib leeg yuav txuag cov neeg them se kwv yees li $ 102 nphom txog 2031.

HHS tsuas tuaj yeem sib tham tus nqi rau cov tshuaj uas Medicare Tshooj B thiab D siv nyiaj ntau tshaj plaws rau thiab tau nyob hauv khw rau xyoo tsis muaj kev sib tw lossis lwm yam sib tw, raws li Mulcahy. "Kev tsom mus rau cov tshuaj laus no uas yog vim li cas lossis lwm qhov tsis muaj kev sib tw," nws hais.

Tsis muaj ib daim ntawv teev npe tshuaj, uas tau tshaj tawm rau pej xeem uas HHS npaj rau lub hom phiaj rau kev sib tham. Tab sis Bank of America tau hais txog qee qhov muaj peev xwm Medicare D cov neeg sib tw raws li Medicare siv ntau npaum li cas rau lawv hauv 2020:

• Bristol-Myers' Eliquis, $ 9.9 nphom. Nws yog ib qho anticoagulant los tiv thaiv cov ntshav txhaws kom txo tau txoj kev pheej hmoo ntawm mob stroke.
• J&JXarelto, $ 4.7 billion. Nws yog lwm cov ntshav nyias.
• MerckJanuvia, $ 3.8 nphom. Nws yog ib ntsiav tshuaj los txo cov ntshav qab zib rau cov neeg mob ntshav qab zib hom 2.
• Abbvie's Imbruvica, $ 2.9 nphom. Nws yog ib ntsiav tshuaj rau ntau hom mob qog noj ntshav.

Thiab Bank of America pom cov tshuaj Medicare B no tuaj yeem cuam tshuam los ntawm kev sib tham. Nov yog lawv cov nqi rau Medicare hauv 2020:

• Merck's Keytruda, $ 3.5 nphom. Nws yog ib qho kev tiv thaiv kab mob rau qee yam qog nqaij hlav.
• RegeneronEylea, $ 3 nphom. Nws yog kev txhaj tshuaj rau macular degeneration.
• AmgenProlia, $ 1.6 nphom. Nws yog kev txhaj tshuaj rau osteoporosis.
• Bristol Myers 'Opdivo, $ 1.5 nphom. Nws yog kev tiv thaiv kab mob kev kho mob qee yam mob qog noj ntshav.
• Roche's Rituxan, $ 1.3 nphom. Nws yog ib qho tshuaj tiv thaiv kab mob rau qee yam mob qog noj ntshav thiab kab mob inflammatory.

Tab sis nws nyuaj rau txiav txim siab seb cov tshuaj HHS yuav yog hom phiaj tiag tiag. Daim ntawv teev cov tshuaj uas yuav tsim nyog rau kev sib tham yuav hloov pauv ntau yam los ntawm lub sij hawm daim nqi cov kev cai yuav siv tau vim tias ntau tus neeg poob lawv cov kev tiv thaiv patent los ntawm lub sijhawm ntawd, raws li Bank of America tshawb fawb sau tseg.

Tseem, kev sib tham los ntawm Medicare tuaj yeem txo tus nqi los ntawm 25% rau 25 cov tshuaj uas qhov kev zov me nyuam siv ntau tshaj plaws nyob rau hauv 2026 thiab dhau mus, raws li Bank of America.

Tus nqi txo qis npaum li cas thaum kawg yog nyob ntawm seb HHS puas ua rau kev sib tham nrog cov tuam txhab tshuaj, Mulcahy tau hais. Bill Sweeney, tus thawj coj ntawm tsoomfwv txoj haujlwm ntawm AARP, tau hais tias kev ua raws li daim nqi no yog qhov tseem ceeb. AARP xav kom HHS sib ntaus sib tua nyuaj rau tus nqi zoo tshaj plaws rau cov neeg laus thiab tsis muaj qhov khoob uas kev lag luam tuaj yeem siv tau, Sweeney tau hais.

Kev lag luam tuaj yeem ua si lub kaw lus los ntawm kev tso cai txwv kev sib tw rau lawv cov tshuaj kom tsis txhob muaj kev tswj hwm tus nqi, raws li cov kws tshuaj ntsuam xyuas los ntawm SVB Securities.

HHS yuav muaj hwj chim tswj hwm. Cov tuam txhab raug nplua nyiaj txiag ntau rau qhov tsis ua raws li kev sib tham tus nqi, $ 1 lab nplua rau kev ua txhaum cov lus pom zoo, thiab $ 100 lab nplua rau kev muab cov ntaub ntawv tsis tseeb.

Txawm hais tias cov neeg laus yuav tsis pom tus nqi qis dua kom txog rau thaum 2026, txoj cai lij choj yuav nplua cov tuam txhab tshuaj rau kev nce nqi tshuaj Medicare sai dua li tus nqi nce nqi tom qab xyoo no. Yog tias tus nqi tshuaj nce ntau dua li kev nce nqi, lub tuam txhab yuav tsum them rau tsoomfwv qhov txawv ntawm tus nqi them thiab tus nqi nce ntxiv rau tag nrho Medicare muag ntawm cov tshuaj ntawd, raws li AARP.

Cov nqi tau nce sai dua li kev nce nqi hauv 2020 rau feem ntau ntawm 25 cov tshuaj Medicare Tshooj B thiab D tau siv nyiaj ntau tshaj plaws rau, raws li Kaiser Family Foundation.

Tebchaws Asmeskas tau siv ntau dua $ 1,000 rau ib tus neeg ntawm cov tshuaj noj hauv xyoo 2019, ob npaug ntawm $ 552 uas lwm lub tebchaws tau nyiaj tau los siv rau ib tus neeg nyob nruab nrab, raws li KFF thiab Peterson Lub Tsev Haujlwm Saib Xyuas Kev Noj Qab Haus Huv. Kev siv nyiaj hauv Teb Chaws Asmeskas rau cov tshuaj noj tau nce 69% txij xyoo 2004 txog 2019, piv rau 41% nce hauv cov teb chaws sib piv.

'Tus me nyuam kauj ruam tom ntej'

Sanders tau hu lub zog sib tham tau muab rau HHS tus tuav ntaub ntawv yog "tus menyuam yaus mus tom ntej." Tus thawj tswj hwm tau taw qhia tias thawj zaug ntawm kev txo nqi yuav tsis siv rau plaub xyoos, thiab cov neeg uas tsis nyob hauv Medicare - feem coob ntawm cov neeg muaj hnub nyoog qis dua 65 xyoos - raug tso tawm tag nrho.

"Yog tias leej twg xav tias vim li cas ntawm daim nqi no peb mam li pom tus nqi qis dua rau Medicare koj tau yuam kev," Sanders tau hais thaum hais lus hauv Senate ua ntej lub lim tiam no. "Yog tias koj muaj hnub nyoog qis dua 65 xyoos, daim nqi no yuav tsis cuam tshuam rau koj txhua lub sijhawm thiab cov tuam txhab tshuaj yuav muaj peev xwm txuas ntxiv mus rau lawv txoj kev zoo siab thiab nce nqi mus rau txhua qib lawv xav tau."

Kev lag luam kws tshuaj, ntawm qhov tod tes, tau sib cav tias daim nqi mus dhau lawm. Stephen Ubl, CEO ntawm Pharmaceutical Research thiab Cov Chaw Tsim Tshuaj ntawm Asmeskas, tau hais tias txoj cai lij choj yuav ua rau muaj kev hloov pauv tshiab thiab ua rau tsawg dua kev kho tshiab thiab kev kho mob rau cov kab mob.

Bank of America tsis pom daim nqi no yog qhov tsis zoo rau kev lag luam loj hlob, raws li kev tshawb fawb sau tseg txij lub Yim Hli. Cov kws tshuaj ntsuam xyuas ntawm UBS tau hais tias Medicare cov kev sib tham, uas txwv tsis pub muaj, nyob deb ntawm qhov xwm txheej phem tshaj plaws rau kev lag luam. Txoj cai lij choj yuav muab kev pom tseeb rau kev ua lag luam thiab yuav siv qhov kev hem thawj ntawm tus nqi tshuaj hnyav dua tawm ntawm lub rooj, raws li UBS.

"Peb xav tias qhov kawg ntawm kev hloov kho tus nqi tshuaj tam sim no sawv cev rau qhov kev tshwm sim qhia meej txog cov nyiaj tau los ntawm kev lag luam yav tom ntej, tshem tawm qhov kev pheej hmoo ntawm tus nqi tshuaj ntau dua uas tau hnyav rau kev ntsuas biopharma txij li qhov teeb meem nqi tshuaj thawj zaug tau nce mus rau nom tswv hauv xyoo 2015, ” UBS cov kws tshuaj ntsuam tau sau hauv tsab ntawv tshawb fawb ua ntej lub lim tiam no.