WASHINGTON — Last week, Rep. Terri Sewell (AL-07) joined Reps. Haley Stevens (MI-11), Jahana Hayes (CT-05) and Annie Kuster (NH-02) to introduce the Maximizing Drug Coverage for Low-Income Seniors Act (H.R. 4669). The legislation would improve the Medicare enrollment process and lower out-of-pocket costs by ensuring that beneficiaries are enrolled in a Part D plan that best meets their needs. By establishing an “intelligent assignment” process for low-income beneficiaries, rather than the current random assignment, beneficiaries will be matched with a plan that is better suited to cover their specific medical needs.

Medicare’s Low-Income Subsidy program (also called “Extra Help”) assists low-income individuals by fully or partially covering their out-of-pocket costs under the Medicare Part D prescription drug program. These subsidies reduce or cover Medicare Part D premiums, deductibles, and coinsurance. However, the current random assignment process for low-income seniors can lead to considerable differences in out-of-pocket costs. Under this bill, the Secretary of the Department of Health and Human Services (HHS) would design a system that intelligently assigns beneficiaries to a plan in their geographic area that is based on their individual prescription drug needs. It would do this by taking into consideration factors like prior medication use and pharmacy preferences. This enhanced assignment process has the potential to save seniors thousands of dollars on out-of-pocket costs for the prescription drugs they need to stay healthy, while also generating savings in overall Medicare spending.

“In the richest nation in the world, every American should be able to afford the highest quality lifesaving medications and, yet, I have heard from too many Alabamians who struggle to afford their prescription drugs due to skyrocketing costs,” said Rep. Sewell. “The Maximizing Drug Coverage for Low-Income Seniors Act is smart and innovative legislation to ensure seniors are enrolled in the best Medicare Part D program for their individual needs, saving them money on out-of-pocket costs and improving access to their needed medication."

“The exorbitant cost of prescription drugs is forcing countless families in my district to make the impossible choice between taking care of their health and putting food on the table,” said Rep. Stevens. “We cannot tolerate a system that is causing three in ten adults to not take their medication as prescribed due to high costs. There is much innovation that can be done in our great Medicare program to ease the burden of the high cost of prescription drugs, which tends to fall hardest on older adults. This legislation takes a step in that direction, by ensuring beneficiaries’ Part D coverage is actually working for them to keep them healthy at the lowest possible cost.”

“For too many Americans, the rising cost of prescription drugs has resulted in serious concerns about the ability to afford life-saving medication, something particularly acute for older Americans with limited incomes” said Rep. Hayes. “The Maximizing Drug Coverage for Low-Income Seniors Act would help relieve that burden by deliberately assigning enrollees to Medicare plans catered to their individual needs, in contrast to the current system of random assignment. I thank Representatives Stevens, Sewell, and Kuster for their important work in protecting the health of our older Americans.”

“I continue to hear from Granite Staters who struggle to pay for their prescription drugs, often being forced to choose between necessities like groceries and the medications they need,” said Rep. Kuster. “This problem requires a multifaceted solution, and this legislation is a step in the right direction. The Maximizing Drug Coverage for Low-Income Seniors Act is a commonsense approach that will ensure our most vulnerable Americans are matched with the prescription drug plan that’s best for them, saving senior and taxpayer dollars.”

This legislation is supported by the National Council on Aging and Justice in Aging.