Before leaving office, the Trump administration had one last target in its final hours: people living with HIV.
A last minute change to the policies of Part D, the section of Medicare that covers most prescription drugs, will allow private insurance companies to stop offering prescriptions for certain “protected class” drugs such as insulin and antipsychotics as early as next year. The rule change would affect the prescription costs for people living with HIV for drugs such as antiretrovirals and immunosuppressants.
Related: People living with HIV in New York will soon be eligible for the COVID-19 vaccine
Medicare provides healthcare to 63 million seniors and disabled people. The “protected class” of prescription drugs are generally offered at a fair rate, but the rebate rule will allow companies to charge premiums on vital drugs that people need to manage their health — and taxpayers would foot the bill.
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The policy change was part of Trump’s efforts to implement what’s known as the “rebate rule” and could put premiums through the roof, increasing the cost of Medicare by billions to the government budget. The Department of Health and Human Services (HHS), which oversees Medicare, made the change under the Trump administration in November, and on Trump’s last day in office, set the rule changes to take place at the beginning of February.
The Biden administration pushed back implementation of the rule when they entered office and came to an agreement with the Pharmaceutical Care Management Association, a trade association representing pharmacy benefit managers that who filed a lawsuit against the rule. The agreement will continue recognizing the “protected class” of prescriptions until 2023.
Still, there are calls for the Biden administration to reverse the rule altogether before it’s too late.
“The rebate rule was haphazardly finalized and clearly circumvented the proper rulemaking process,” the President and CEO of the Pharmaceutical Care Management Association J.C. Scott said in a statement last month. “Evidence showing that the rebate rule will significantly increase beneficiary premiums and government costs was ignored by the previous Administration. The rebate rule should be promptly and permanently repealed.”
“We’re hopeful that the rule will not be put into effect,” America’s Health Insurance Plans (AHIP) CEO Matt Eyles stated. “There’s so much uncertainty around that. We have been communicating some of those challenges to the new administration.”
