| Democrats are on the cusp of making the most significant changes to Medicare in more than a decade, which would bring lower drug prices and out-of-pocket costs for some of the program's 64 million enrollees, Axios' Caitlin Owens and Adriel Bettelheim write. Why it matters: New limits on how much patients have to pay for medicines annually could offer a lifeline to seniors facing thousands of dollars in drug bills, and lower overall prices would provide relief to even more enrollees. The details: If the Senate-passed plan is cleared by the House, as expected, it would beginning this fall penalize drug companies who raise prices faster than inflation. Starting next year, it would eliminate out-of-pocket costs for adult vaccines covered under Medicare's Part D drug benefit. - In 2024, the legislation would strike a requirement that enrollees pay 5% of total drug costs if they exceed a catastrophic threshold while expanding eligibility for low-income subsidies.
- By 2025, it would cap out-of-pocket spending in Part D to $2,000.
- In 2026, it would trigger direct government negotiations with manufacturers, making 10 yet-to-be-determined high-cost drugs subject to spending controls. That number would rise to 15 in 2027 and 20 in 2029.
- From 2024 to 2029, the Democrats' plan would limit Part D plan premium growth to 6%.
Yes, but: While the bill is projected to save taxpayers hundreds of billions of dollars over the next decade, opponents of the bill argue these savings won't be felt by patients. The pharmaceutical industry argues such negotiations would quash innovation and cut off venture capital funding for promising cures. - The Congressional Budget Office estimates 15 out of 1,300 drugs, or 1%, wouldn't come to market over the next 30 years as a result of the bill.
The bottom line: The Democrats' plan caps years of futile efforts to change the drug pricing equation and, despite its limitations, lets Medicare for the first time use its purchasing power. Go deeper. | 
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