PDP Premium Increases And Hidden Hurt
Healthcare policy group KFF examined the standalone Part D (PDP) market. Of course, the Trump administration says the end of the suspect premium stabilization program will not mean major impacts to beneficiaries, but hidden hurt can be seen in the details.
KFF finds that PDP availability and premiums for 2027 show a mixed picture. There are modest premium increases for many Part D enrollees for their current plan, but steeper increases are in store for others. There also is a reduction in the number of PDP options for the fourth year in a row.
KFF’s key takeaways include:
- The number of stand-alone PDPs available from 11 in 2026 to 9 in 2027, on average.
- Enrollees in six of the eight PDPs that will continue to be offered on a national basis in 2027 will see premium reductions in some states if they keep their current plan.
- But enrollees in many other states will see higher premiums for these same plans if they don’t switch.
- There will be no zero premium PDPs available for Part D enrollees who do not receive low-income subsidies (LIS) in 2027. About 4 million who paid no monthly premium in 2026 will face higher premiums in 2027 whether they keep their current plan or switch. This is a clear sign that the stabilization fund’s end did have impact.
In related news, Devoted Health has garnered major financing for expansions of their Medicare advantage business.
Additional article: https://www.beckerspayer.com/payer/medicare-advantage/devoted-health-closes-1-2b-financing-deal-amid-expansion-push/
#partd #pdp #kff #medicare
340B Pilot Proceeds
After an initial failure and a second published rule, the Health Resources and Services Administration is ready to launch a 340B rebate pilot as of January 1. Ten pharmaceutical companies will participate and the rebates vs. upfront discounts will apply to 21 drugs.
Brand drug makers believe 340b is being abused and audits and rebates will help. Hospitals attack the conversion, but studies seem to show that the program is a giveaway to 340b facilities, which seem to have a worse track record on ultimate drug costs for vulnerable Americans.
#340b #drugpricing #hospitals
https://www.modernhealthcare.com/politics-regulation/mh-hrsa-340b-rebate-pilot-drugs/
Democrats’ Midterm Healthcare Message
Democrats say they will substantially change healthcare’s trajectory if they win control of Congress. They say they would rollback changes in the Exchanges and Medicaid and re-establish enhanced premium subsidies that expired. They also want to reduce the Medicare eligibility age.
At the same time, many Democratic states are seeking to institute single payer healthcare.
#healthcare #midterms
Govs Want More Time On Medicaid Work Requirements
The governors of Oregon, California, Maine, New York, and Virginia don’t think it’s possible for states to meet the Jan. 1 deadline to stand up Medicaid work requirements and want more time. They argue beneficiaries must be protected.
In other news, Wakely has published a good briefer on what is driving commercial health insurance’s annual growth. I covered this recently in blogs and a podcast at this site.
Additional article: https://www.wakely.com/blog/what-is-driving-commercial-health-insurance-premium-growth/
#medicaid #workrequirements
— Marc S. Ryan
