In March, 2018, the notoriously pro-Democrat CNN reported in an article by Wayne Drash that a congressional report identified a big problem: "…prices of the 20 most commonly prescribed brand-name drugs for seniors have risen nearly 10 times more than the annual rate of inflation over the past five years," Medicare drug prices soar at 10 times rate of inflation, report says, Wayne Drash, 3/26/18.
Formularies, the insurance company lists of what prescriptions are covered have also been shrinking, as reported by CMS.gov and that there has been a decline in coverage of prescription drugs from 2013 to 2016. Fewer drugs are covered.
With all the ridiculous carrying on of Congress, again, we return to the obvious answer to WHY life-saving drugs or quality of life preserving drugs have increased in price and are often NOT covered by insurance as insurance companies exclude them from formularies and the answer comes back the same, Congresspeople aren't worried, after all, they get benefits, premiums, pensions, salaries all paid for by American taxpayers (including insurance premiums which we pay around 72 percent of their insurance premiums) so why should they worry? Especially when no angry protester seems as upset about this denial of access to drugs based on cost as they do about issues that affect far fewer Americans.
Obamacare and ex-President Obama who takes credit for it, did not address these costs. Left to their own devices, the prices have gone up 10X the rate of inflation. Combined with this 10X the rate of inflation increase, with the reduced coverage of prescription drugs by insurers, THIS IS A CRISIS.
But Obamacare's ageism made things even worse. Ageist because while talking out of one side of his mouth about a single risk pool, what Obama really did was single out TWO groups of people for HIGHER premiums, those who use tobacco and OLDER Americans. Those two distinctions are in Obamacare and clearly identify using age as a justification to charge older Americans 1.5 more in premiums.
Now while Obama fans will note that insurers have always penalized people based on age because of statistics that they'll need more medical care, and the same for tobacco, what they ignore is that Obamacare PROHIBITS using other statistically significant "risks" to charge obese, drug addicted (legal or illegal), alcoholic or anyone else with significant risk factors "more" in premiums including those with pre-existing conditions. By removing the "metrics" or statistical justification for charging higher rates from every other category EXCEPT age and tobacco use and because AGE is a protected class under federal law, the law really discriminates against people based on age and is ageist.
With Obamacare and its failure to address the cost of prescription drugs, we see drug companies not surprisingly raising their prices at 10X the rate of inflation. With Obamacare and its failure to address the cost of prescription drugs we see, not surprisingly, insurance covering fewer drugs (reduced formularies).
But Obamacare went further: Obamacare also let lapse the medical expense deduction available to individuals who had medical expenses in excess of 7.5 percent of their income, anything more and they could deduct it letting that deduction amount revert to a 10 percent threshold.
Why does the lapse of the medical expense deduction of 7.5 percent, making it instead a 10 percent threshold matter? Because if you are paying higher prices for your meds AND we know that fewer meds are covered by insurance, then the ONLY way to get relief from the costs is the MEDICAL EXPENSE DEDUCTION.
Again, this is a problem that Obama created, but Donald Trump could have pushed for the re-establishment of the 7.5 percent threshold for medical deductions and hasn't.
The Medical Expense Deduction becomes more significant still because of the out-of-pocket maximum which absurdly exceeds some families' entire income at this point sitting at $7,350 for an individual and $14,700 for a family, and doesn't count towards that maximum certain costs to individuals, including premium costs, the costs of getting insurance, and more significantly ANYTHING THAT ISN'T COVERED BY AN INSURANCE PLAN.
If a prescription drug is excluded from an insurance company formulary, which more and more are, then there is no out-of-pocket maximum. None. Therefore, the Medical Expense Deduction is the ONLY recourse individuals have and naturally, they have to have income and enough income to deduct from, so in the case of these expensive drugs, it's obvious that the deduction is not a complete rescue, but at least it's SOMETHING.
Returning to another obvious failure of the bragging promises of the "AFFORDABLE Care Act," medical bankruptcy is still the NUMBER ONE reason for bankruptcy in the United States.
President Trump needs to address Obamacare in some very meaningful ways since repeal by his party was botched by the yea, soon to be gone Paul Ryan and is a gaping failure in his presidency. There are things President Trump COULD do but hasn't.
FIRST, reinstate the 7.5 percent threshold for the medical expense deduction, reducing it from its current 10 percent that the Obama presidency made law.
SECOND, remove public employee and Congress loopholes of the Obama presidency allowing public employees and Congress to be immune to the Obamacare burdens placed on Americans who, adding insult to injury, are paying for public employee superior benefits. President Trump owes this basic drain the swamp fix to the American people and should undo the Obama cheat that wheedled these benefits for public employees by saying they were employees of the federal government and therefore weren't bound by any but the rules of their employer and their employer (the government) decided they got great benefits (omitting the fact that we, the taxpayers pay for them.
THIRD, at least suspend if not REDUCE the OOP maximum for the next five years. While the OOP maximum is established by CMS supposedly based on Medicare costs (so watch out if Bernie Sanders puts everyone on Medicare), until Trump fulfills another promise, to stop insurance FRAUD, including an audit of government administrative and infrastructure costs, this is simply an imaginary and extortionary shakedown of American citizens.
FOURTH, have a national formulary requirement for all insurance plans so that if one person is denied life-saving drugs if they can't afford them out of pocket we all are, including Congress…that will get them moving.
Then there's the actual work of dealing with big pharma and its price-gouging that Obama wouldn't do, but that is necessary for Americans' health. The midterm elections are an opportunity for consumers to look for meaningful change in the health industrial complex of America, and we should take that opportunity.
