Bill Overview
Title: Innovative Technologies Impacted by COVID–19 Act
Description: This bill extends for one year certain Medicare pass-through payment adjustments for new drugs or biologics that would otherwise expire on December 31, 2022.
Sponsors: Rep. Schneider, Bradley Scott [D-IL-10]
Target Audience
Population: Medicare recipients who benefit from new drugs with Medicare pass-through payment adjustments
Estimated Size: 6400000
- The bill impacts Medicare recipients who are beneficiaries of new drugs or biologics that have Medicare pass-through payment adjustments. These individuals rely on Medicare for healthcare coverage, particularly for advanced and costly treatments.
- Globally, the impact may extend indirectly to pharmaceutical and biotechnology companies that produce these drugs. Their production may be dependent on ongoing market access and financing mechanisms such as those afforded by the Medicare pass-through payment adjustments.
- While the bill directly affects US citizens enrolled in Medicare, the existence of similar programs in other countries means that foreign citizens utilizing such medical programs may also be interested in the policy outcomes.
Reasoning
- We focused on simulating interviews with a diverse group of Medicare recipients who are directly affected by the policy due to their dependence on new drugs with Medicare pass-through payment adjustments.
- The target population is a subset of Medicare recipients who use specialty drugs. Assuming a commonness score of 3, we infer they represent a niche yet significant group in the larger Medicare community.
- The budget constraints imply that not all affected individuals will experience high impact due to resource allocation limits. We estimate varying impacts from none to high across individual profiles.
Simulated Interviews
retired teacher (Florida)
Age: 67 | Gender: male
Wellbeing Before Policy: 5
Duration of Impact: 1.0 years
Commonness: 4/20
Statement of Opinion:
- I'm relieved that the price of my medication won't suddenly skyrocket next year.
- Healthcare costs are a real concern for people like me who are retired.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 7 | 4 |
| Year 2 | 6 | 4 |
| Year 3 | 5 | 4 |
| Year 5 | 5 | 3 |
| Year 10 | 5 | 2 |
| Year 20 | 5 | 2 |
retired nurse (California)
Age: 72 | Gender: female
Wellbeing Before Policy: 6
Duration of Impact: 1.0 years
Commonness: 3/20
Statement of Opinion:
- This act makes a huge difference to my wellbeing because it reduces financial stress.
- I dread the thought of choosing between medication and other essentials.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 7 | 5 |
| Year 2 | 7 | 5 |
| Year 3 | 6 | 4 |
| Year 5 | 6 | 4 |
| Year 10 | 5 | 3 |
| Year 20 | 5 | 3 |
retired accountant (Texas)
Age: 70 | Gender: female
Wellbeing Before Policy: 4
Duration of Impact: 1.0 years
Commonness: 2/20
Statement of Opinion:
- This bill is crucial for me as I start new treatments that are financially overwhelming.
- Without such measures, my treatment might become unaffordable.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 6 | 3 |
| Year 2 | 5 | 2 |
| Year 3 | 5 | 2 |
| Year 5 | 5 | 2 |
| Year 10 | 4 | 2 |
| Year 20 | 4 | 2 |
retired engineer (New York)
Age: 74 | Gender: male
Wellbeing Before Policy: 5
Duration of Impact: 1.0 years
Commonness: 3/20
Statement of Opinion:
- The extension is a short-term relief but necessary to manage through the coming year.
- The price of healthcare seems to rise endlessly, even in retirement.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 6 | 5 |
| Year 2 | 5 | 4 |
| Year 3 | 5 | 4 |
| Year 5 | 5 | 4 |
| Year 10 | 4 | 3 |
| Year 20 | 4 | 3 |
retired librarian (Ohio)
Age: 69 | Gender: female
Wellbeing Before Policy: 7
Duration of Impact: 1.0 years
Commonness: 3/20
Statement of Opinion:
- This policy may only be a temporary measure, but it's nonetheless a relief.
- Not having to worry about cutting back on my medication is a big weight off my shoulders.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 8 | 6 |
| Year 2 | 7 | 5 |
| Year 3 | 7 | 5 |
| Year 5 | 7 | 4 |
| Year 10 | 6 | 4 |
| Year 20 | 6 | 4 |
retired factory worker (Michigan)
Age: 66 | Gender: male
Wellbeing Before Policy: 4
Duration of Impact: 1.0 years
Commonness: 2/20
Statement of Opinion:
- It’s good that they’re doing something, but I worry about what happens after this extension.
- It's like I'm always racing against time to afford my treatment.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 5 | 4 |
| Year 2 | 5 | 3 |
| Year 3 | 4 | 3 |
| Year 5 | 4 | 3 |
| Year 10 | 3 | 2 |
| Year 20 | 3 | 2 |
retired social worker (Georgia)
Age: 75 | Gender: female
Wellbeing Before Policy: 5
Duration of Impact: 1.0 years
Commonness: 3/20
Statement of Opinion:
- This additional support from Medicare is a blessing, though it's temporary.
- The costs of my medication shouldn't be ignored just because I'm retired.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 7 | 5 |
| Year 2 | 6 | 5 |
| Year 3 | 6 | 4 |
| Year 5 | 5 | 3 |
| Year 10 | 5 | 3 |
| Year 20 | 5 | 3 |
retired professor (Arizona)
Age: 73 | Gender: female
Wellbeing Before Policy: 6
Duration of Impact: 1.0 years
Commonness: 2/20
Statement of Opinion:
- I'm grateful for the support but I wish it were longer term.
- Such policies should consider a wider scope for more comprehensive support to seniors.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 7 | 6 |
| Year 2 | 6 | 5 |
| Year 3 | 6 | 4 |
| Year 5 | 5 | 4 |
| Year 10 | 5 | 4 |
| Year 20 | 5 | 3 |
retired farmer (Illinois)
Age: 80 | Gender: male
Wellbeing Before Policy: 5
Duration of Impact: 1.0 years
Commonness: 3/20
Statement of Opinion:
- Every assistance counts, and I appreciate this extension.
- The lessening of financial strain is always welcome, especially at my age.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 7 | 5 |
| Year 2 | 6 | 4 |
| Year 3 | 5 | 3 |
| Year 5 | 5 | 3 |
| Year 10 | 5 | 3 |
| Year 20 | 5 | 3 |
retired school administrator (Washington)
Age: 71 | Gender: female
Wellbeing Before Policy: 6
Duration of Impact: 1.0 years
Commonness: 3/20
Statement of Opinion:
- Being able to afford my medication without compromise is what I need right now.
- The focus should also be on more long-term solutions for seniors.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 8 | 5 |
| Year 2 | 7 | 4 |
| Year 3 | 7 | 4 |
| Year 5 | 6 | 4 |
| Year 10 | 6 | 3 |
| Year 20 | 6 | 3 |
Cost Estimates
Year 1: $50000000 (Low: $40000000, High: $60000000)
Year 2: $0 (Low: $0, High: $0)
Year 3: $0 (Low: $0, High: $0)
Year 5: $0 (Low: $0, High: $0)
Year 10: $0 (Low: $0, High: $0)
Year 100: $0 (Low: $0, High: $0)
Key Considerations
- The primary cost driver is the extension of Medicare pass-through payments, intended to allow uninterrupted access to necessary drugs affected by COVID-19 disruptions.
- Focusing costs on specialized drugs can lead to a concentration of spending, which amplifies financial uncertainty.
- The demographic affected involves potentially vulnerable populations relying heavily on Medicare assistance for advanced treatments, underscoring the importance of the policy.