Medicare beneficiaries across the nation felt deceived this January when they went to fill their first prescriptions of the new year. Prices were touted to go down. The media lavished praise on the Biden Administration’s efforts to reign in drug costs. The Inflation Reduction Act promised relief from predatory drug pricing.
Yet, the prices went up. Many people called our office to complain that their drug premiums doubled. I had warned people for months, but they believed the media. Why are the prices going up this year, faster than the last few years? Precisely because of the Inflation Reduction Act.
Next year in 2025, no one on Medicare Part D will have to pay more than $2,000 for their medications. Sounds wonderful! But who pays for this?
The rich pay for the poor. The healthy pay for the sick. This is how the Affordable Care Act (also known as Obamacare) works. This is how Medicare Part D works. The drug companies will not settle for lower profits. No one is sure how this $2,000 cap on drugs will play out, and it’s an election year to boot. But the drug companies rallied to raise prices a lot this year to hedge against next year.
If you are sick and save thousands next year, you’ll be happy. But those who are healthy, not taking any medications, and buying a drug plan just to avoid the penalty will see large increases.
The current media darlings are the 10 drugs that Medicare is allowed to “negotiate” price on. While 10 drugs is pitifully low, it is nonetheless a start! If you are taking these 10 drugs, your prices will be massively lower in 2026. Yes, 2026: Eliquis, Jardiance, Xarelto, Januvia, Farxiga, Entresto, Enbrel, Imbruvica, Stelara, and Fiasp.
The answer to every question is money. We have a for-profit healthcare system.
Sylvia Gordon is co-founder of The Medicare Family, headquartered in Noblesville, where she educates thousands on Medicare and Social Security in all 50 states. You can learn more at TheMedicareFamily.com.
And don’t be surprised if your needed drug is suddenly not in the Formulary.