Bipartisan Legislation Would Reduce Prescription Drug Costs for Seniors in Programs of All-Inclusive Care for the Elderly
WASHINGTON, DC – Sens. Tom Carper (D-DE) and Bill Cassidy (R-LA) today introduced the PACE Part D Choice Act, which would reduce prescription drug costs for seniors enrolled in Programs of All-Inclusive Care for the Elderly (PACE).
Many PACE participants are eligible for Medicare and Medicaid, but those who do not qualify for Medicaid pay an average monthly Part D plan premium cost of $1,015, which is considerably higher than the $43 average monthly cost of a marketplace plan. The PACE Part D Choice Act would increase access to PACE for Medicare-only beneficiaries by enabling them to choose between a PACE or marketplace Part D plan.
This notable cost disparity was significantly exacerbated by the passage of the Inflation Reduction Act and its $2,000 out-of-pocket cap for Part D. The PACE Part D Choice Act provides a policy solution that has been cited by non-partisan think tanks like the Bipartisan Policy Center.
“PACE participants in Delaware and across our nation are dealing with rising prescription drug costs every time they need a refill for their live-saving medications,” said Sen. Carper. “It makes no sense that these older Americans cannot choose which Medicare Part D plan makes the most financial sense for them. I’m glad to introduce this bipartisan legislation that would give these individuals a choice, lowering monthly costs and, thanks to the Inflation Reduction Act, ensuring PACE participants won’t pay a dime over $2,000 a year for their medications. I urge my colleagues to join me in supporting this overdue legislation and hope to see it reach the president’s desk by year’s end.”
“This bill ensures patients in the PACE program have the same access to lower premiums and affordable prescription drugs that lead to better health outcomes as those in other Medicare programs,” said Sen. Cassidy, MD.
The National PACE Association (NPA) applauded the ongoing leadership of Sens. Carper and Cassidy in making PACE more affordable and accessible to seniors across the country, said Shawn Bloom, president and CEO of NPA. “PACE is a proven model of care for the elderly, and it has continued to demonstrate its benefits even more profoundly during the pandemic. We urge Congress to pass this bill quickly so many more older adults and their families can be served by PACE and receive the care they need in their homes and communities.”
U.S. Reps. Earl Blumenauer (D-OR-4), Jackie Walorski (R-IN-2), Debbie Dingell (D-MI-12), and Christopher Smith (R-NJ-4) introduced companion legislation (H.R. 4941) in the House last year.
“Evidence of PACE’s impact on Medicare and Medicaid costs is unequivocal,” AARP reported. “A 2021 study of PACE beneficiaries who were eligible for both Medicare and Medicaid found that they were less likely to be hospitalized, less likely to visit the emergency department, and much less likely to be institutionalized than their peers in Medicare Advantage Plans. PACE improves the LTSS system by reducing institutionalizations, improving outcomes, decreasing costs, and empowering older adults to live at home.”
Bloom said that “making PACE more affordable for older adults who are eligible only for Medicare is common sense. Expanding access to PACE is a bipartisan, cost-effective solution to the nation’s senior care crisis. It increases quality of life, reduces dependency on nursing home care, and treats our seniors with the respect they deserve.”
PACE programs use interdisciplinary care teams to keep older adults with long-term care needs healthy and cared for around the clock while living independently in their own homes. PACE enrollees receive care at home, are transported to their local PACE center and other appointments, and visit a PACE center to socialize, receive therapy and other services, and see a physician.
The National PACE Association (NPA) works to advance the efforts of PACE programs, which coordinate and provide preventive, primary, acute and long-term care services so older individuals can continue living in the community. The PACE model of care is centered on the belief that it is better for the well-being of seniors with chronic care needs and their families to be served in the community whenever possible. For more information, visit www.npaonline.org and follow @TweetNPA.