Medicare

A proposal in Congress would allow the federal government to negotiate prices with drug companies for some high-cost drugs. Companies that do not agree to take part in negotiations or comply with the negotiated price would face an excise tax.
We analyzed the drug industry’s claims that the proposal would allow the federal government to decide which medicines people on Medicare can get. Those claims are not accurate. The proposal would not let the government restrict access to medicines, but it may result in fewer drugs coming to market.

With the Medicare open enrollment period set to begin October 15, our analysis finds that 7 in 10 beneficiaries (71%) say that they didn’t compare their coverage options during a recent open enrollment season. Twenty-nine percent said they did compare Medicare plans. The share of beneficiaries who did not compare was higher among beneficiaries who are Black and Hispanic, those ages 85 and older, those with low incomes, and those enrolled in both Medicare and Medicaid. Not shopping around can have a big impact on enrollees’ coverage and costs. The Centers for Medicare & Medicaid Services recommends that beneficiaries review and compare Medicare plans each year.

Many Medicare beneficiaries face high annual out-of-pocket costs for dental and hearing care — services that generally aren’t covered in traditional Medicare, but typically are covered by Medicare Advantage plans though the scope and value of these benefits vary.
Our analysis shows that, among beneficiaries who used each type of service, average annual out-of-pocket spending was $914 for hearing care and $874 for dental care in 2018, but considerably less ($230) for vision care. Among those who were in the top 10 percent in terms of their out-of-pocket costs for such services, 2.7 million beneficiaries spent $2,136 or more on their dental care, while 360,000 beneficiaries spent $3,600 or more on hearing services. 
Beneficiaries can face high out-of-pocket costs whether they are in traditional Medicare or privately-run Medicare Advantage plans.

COVID-19 deaths among older adults in the U.S. have been on the rise amid the Delta variant outbreak, though they have not reached the levels seen earlier in the pandemic. Our analysis finds that older adults – as a group considered to be at highest risk from COVID-19 – have fared worse in states with low vaccination rates during the recent Delta surge. Had the death rate in the 10 least vaccinated states been the same as the death rate in the 10 most vaccinated states, there would have been 7,623 fewer deaths among older adults during the Delta surge in these states.

Rates of cost-related problems are higher among beneficiaries in Medicare Advantage than in traditional Medicare with supplemental coverage, but highest among beneficiaries in traditional Medicare without supplemental coverage. Among Black beneficiaries specifically, a larger share of those in Medicare Advantage reported cost-related problems than those in traditional Medicare (32% vs. 24%). The rate of cost-related problems was lower still among the subset of Black beneficiaries in traditional Medicare who had Medicaid or other sources of supplemental insurance (20%).