CLSA Submits Recommendations to House W&M and E&C Leadership on Lowering Medicare Part D Costs for Seniors

June 13, 2019
By Molly Fishman

Late last month, House Ways and Means Committee Chairman Richard Neal (D-Mass.) and Ranking Member Kevin Brady (R-Texas), and House Energy and Commerce Committee Chairman Frank Pallone (D-N.J.) and Ranking Member Greg Walden (R-Ore.), released a discussion draft text of legislation proposing updates to reform and improve the Medicare Part D program.

In particular, the draft bill would establish an out-of-pocket cap for seniors and individuals who have Medicare Part D prescription drug coverage. The cap would be based on the current catastrophic threshold in Part D, which is $5,100 annually for 2019, and is set to increase to $5,350 in 2020 due to the fiscal cliff. The creation of an out-of-pocket cap for Medicare Part D beneficiaries would offer seniors a benefit similar to relief provided to individuals with commercial coverage, whose out-of-pocket expenses were capped through a provision of the Patient Protection and Affordable Care Act.

In coordination with our membership, CLSA submitted comments to Committee Leadership in support of the concept of a cap or limit on the amount that seniors pay out-of-pocket for prescription drugs in Part D. CLSA also urged the Committees to ensure that a cap does not inadvertently result in other barriers to accessing medications and to carefully consider the impact of cost-containment policies on innovation. Comments were due to the Committees by June 6th. For more information, see CLSA’s comment letter, and other comments submitted to the Committees.

Questions? Please contact Molly Fishman, CLSA’s Director of Federal Government Relations (