Bill Overview
Title: Make Medicine Affordable Act
Description: This bill establishes several programs and requirements to address the prices of prescription drugs, including (1) requiring the Centers for Medicare & Medicaid Services to negotiate the prices of certain brand-name drugs and insulin under Medicare, (2) capping annual out-of-pocket spending under the Medicare prescription drug benefit, and (3) limiting cost-sharing for insulin products.
Sponsors: Rep. Slotkin, Elissa [D-MI-8]
Target Audience
Population: People needing access to affordable medications worldwide
Estimated Size: 65000000
- The bill requires CMS to negotiate Medicare drug prices, affecting all Medicare beneficiaries who require medications.
- Capping annual out-of-pocket Medicare spending would impact Medicare beneficiaries, especially those needing costly medications.
- Limiting insulin cost-sharing will directly impact individuals with diabetes using insulin, particularly those on Medicare.
Reasoning
- The Medicare beneficiaries primarily benefit due to reduced drug costs, directly affecting their out-of-pocket expenses.
- Diabetic patients who rely on insulin will experience immediate relief due to the capping on insulin products.
- Patients with chronic conditions requiring brand-name medications will see notable changes in their expenses, especially those on fixed incomes.
- Various socioeconomic backgrounds within Medicare beneficiaries mean different levels of wellbeing changes post-policy.
- Non-Medicare beneficiaries may still be indirectly affected through eventual impacts on private insurance markets.
- The policy might have significant impacts in its initial years due to immediate out-of-pocket reductions, then stabilize as negotiations become routine.
- Not all Medicare beneficiaries will be affected if they do not require high-cost medications or insulin.
- Given the size of the American market and healthcare system, spillover effects into private sector pricing might take longer but could be substantial.
Simulated Interviews
Retired (Florida)
Age: 70 | Gender: female
Wellbeing Before Policy: 5
Duration of Impact: 20.0 years
Commonness: 16/20
Statement of Opinion:
- The cost of insulin is a major burden.
- This policy sounds like it could significantly help with my monthly expenses.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 6 | 5 |
| Year 2 | 7 | 5 |
| Year 3 | 7 | 5 |
| Year 5 | 8 | 5 |
| Year 10 | 8 | 5 |
| Year 20 | 7 | 5 |
Retired teacher (California)
Age: 82 | Gender: male
Wellbeing Before Policy: 4
Duration of Impact: 20.0 years
Commonness: 14/20
Statement of Opinion:
- I struggle with medication costs every month.
- If this act reduces my expenses, I'll be less stressed financially.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 6 | 4 |
| Year 2 | 6 | 4 |
| Year 3 | 7 | 4 |
| Year 5 | 7 | 4 |
| Year 10 | 8 | 4 |
| Year 20 | 8 | 4 |
Part-time consultant (New York)
Age: 65 | Gender: female
Wellbeing Before Policy: 6
Duration of Impact: 15.0 years
Commonness: 10/20
Statement of Opinion:
- Managing new medical costs has been overwhelming.
- This bill provides hope for more predictable medical expenses.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 7 | 6 |
| Year 2 | 7 | 6 |
| Year 3 | 8 | 5 |
| Year 5 | 8 | 5 |
| Year 10 | 8 | 5 |
| Year 20 | 7 | 5 |
Software engineer (Texas)
Age: 45 | Gender: other
Wellbeing Before Policy: 7
Duration of Impact: 5.0 years
Commonness: 18/20
Statement of Opinion:
- I don't expect this to affect me directly right now.
- Maybe it could indirectly lead to lower premiums eventually.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 7 | 7 |
| Year 2 | 7 | 7 |
| Year 3 | 7 | 7 |
| Year 5 | 8 | 7 |
| Year 10 | 8 | 7 |
| Year 20 | 8 | 7 |
Factory worker (Illinois)
Age: 58 | Gender: male
Wellbeing Before Policy: 5
Duration of Impact: 20.0 years
Commonness: 12/20
Statement of Opinion:
- I'm really hoping this makes my medication affordable.
- Now I depend on assistance from my family to afford it.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 6 | 5 |
| Year 2 | 6 | 5 |
| Year 3 | 7 | 5 |
| Year 5 | 7 | 5 |
| Year 10 | 7 | 5 |
| Year 20 | 8 | 5 |
Retired nurse (Ohio)
Age: 68 | Gender: female
Wellbeing Before Policy: 6
Duration of Impact: 8.0 years
Commonness: 15/20
Statement of Opinion:
- My medication costs are manageable right now.
- I support this for those struggling with high costs, though.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 6 | 6 |
| Year 2 | 6 | 6 |
| Year 3 | 6 | 6 |
| Year 5 | 6 | 6 |
| Year 10 | 6 | 6 |
| Year 20 | 5 | 6 |
Retired engineer (Arizona)
Age: 74 | Gender: male
Wellbeing Before Policy: 7
Duration of Impact: 20.0 years
Commonness: 16/20
Statement of Opinion:
- If this helps with general pricing and not just insulin, it would be beneficial.
- Currently doing okay but worried about future drug price changes.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 7 | 7 |
| Year 2 | 7 | 7 |
| Year 3 | 7 | 6 |
| Year 5 | 8 | 6 |
| Year 10 | 8 | 6 |
| Year 20 | 8 | 6 |
Recently retired (New Jersey)
Age: 63 | Gender: male
Wellbeing Before Policy: 5
Duration of Impact: 20.0 years
Commonness: 14/20
Statement of Opinion:
- I'm newly experiencing Medicare's drug pricing.
- A change that lowers my expenses could significantly improve my living situation.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 6 | 5 |
| Year 2 | 6 | 5 |
| Year 3 | 7 | 5 |
| Year 5 | 7 | 5 |
| Year 10 | 8 | 5 |
| Year 20 | 8 | 5 |
Freelance artist (Georgia)
Age: 35 | Gender: female
Wellbeing Before Policy: 4
Duration of Impact: 10.0 years
Commonness: 11/20
Statement of Opinion:
- Although not directly affected, I hope general pressure to lower insulin costs extends to everyone.
- Currently, I have to manage my health expenses very carefully.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 4 | 4 |
| Year 2 | 4 | 4 |
| Year 3 | 4 | 4 |
| Year 5 | 5 | 4 |
| Year 10 | 6 | 4 |
| Year 20 | 6 | 4 |
Unemployed (Michigan)
Age: 55 | Gender: female
Wellbeing Before Policy: 3
Duration of Impact: 0.0 years
Commonness: 10/20
Statement of Opinion:
- This policy isn't directly going to help me yet.
- I hope when I qualify for Medicare, such policies will ease my burdens.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 3 | 3 |
| Year 2 | 3 | 3 |
| Year 3 | 3 | 3 |
| Year 5 | 3 | 3 |
| Year 10 | 3 | 3 |
| Year 20 | 3 | 3 |
Cost Estimates
Year 1: $3000000000 (Low: $2500000000, High: $3500000000)
Year 2: $3100000000 (Low: $2600000000, High: $3600000000)
Year 3: $3200000000 (Low: $2700000000, High: $3700000000)
Year 5: $3400000000 (Low: $2900000000, High: $3900000000)
Year 10: $3700000000 (Low: $3200000000, High: $4200000000)
Year 100: $5000000000 (Low: $4500000000, High: $5500000000)
Key Considerations
- The pharmaceutical sector might resist changes, potentially leading to delays or modifications in implementation.
- There is a potential legal and political challenge from pharmaceutical companies which could alter proposed savings and costs.
- Savings estimates are highly contingent on successful negotiation outcomes for drug pricing and market responses.