Promised lower out of pocket cost for Rx meds – reality or an illusion ?

This appears to be another bill/law that Congress plans on passing, when they don’t understand what they are really dealing with.  All out pt meds are provided by Part D and/or Medicare-C (advantage).  Which are all FOR PROFIT INSURANCE COMPANIES.  The Feds pay these companies a fixed $$/pt/month and the insurance company has got to figure out — how to spend less than they are paid for my the feds to provide medications to Medicare folks.  The PBM industry already negotiates prices with the pharmas and as the graphic below demonstrates the Insurance/PBM industry keeps the “lion’s share” of those discounts to pad their bottom lines. The top 5 PBM’s are owned by insurance companies, if those PBM’s are forced to share those discount/rebates/kickbacks with pts, I expect that pts will see higher premiums, deductibles and co-pays.  Even perhaps they will be forced to use the PBM’s mail order facility are in the case of CVS Health – be forced to have their Rxs filled at one of their community/retail pharmacies or their mail order.  Other PBM may “make a deal” with one of the chain pharmacies where the pts can get their Rxs filled and get some coverage by Part D or Medicare-C..  This article mentions some undefined “certain prescription drugs” that they will be seeking LOWER PRICES ON.

What tax hikes are in the Manchin-Schumer reconciliation bill?

Prescription drug pricing reforms: $288 billion

Under the bill, the government would have the power to negotiate with drugmakers in order to lower prices for certain prescription drugs. The proposal would cap what seniors on Medicare pay out of pocket for drugs each year at $2,000.

If pharmaceutical companies raise the prices of their drugs more than the rate of inflation, pharmaceutical companies would be required to rebate Medicare.

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