The Trump administration is making good on its latest effort to lower out-of-pocket drug costs for Medicare recipients, but its approach could also limit drug options or even risk eliminating coverage of some prescriptions.
The Centers for Medicare and Medicaid Services proposed late Monday changes to Medicare Advantage and Medicare Part D. Among the changes, it would allow insurers to stop covering certain "protected" classes of drugs used to treat common ailments like depression, cancer and HIV.
When Congress added a prescription drug benefit to Medicare in 2003, it required insurers to cover at least two different drugs to treat any particular ailment. It also set aside six protected classes of medication where insurers were required to cover "all or substantially all" of the drugs offered to ensure seniors got whatever treatment they needed, like for cancer.
The Trump administration thinks that gives drug manufacturers greater negotiating power on prices. The proposal is meant to give insurers more leverage and drive prices down by allowing them to drop coverage of certain drugs in a protected class if it's too expensive.