Biden administration pulls last-minute Trump Medicare drug demo plan

Would Have Allowed Plans to Restrict Access to HIV & Other Drugs

Washington DC… In a victory for patients who depend on Medicare Part D for their medications, the Biden administration has pulled a demonstration project that would have allowed participating Medicare plans in 2022 to not cover all drugs in certain classes and only one drug per class in all others. The proposal that was pulled was announced literally in the final hours of the Trump administration.

“We are thankful to the Biden administration for quickly realizing the detrimental impact this proposal would have had on the elderly and the disabled who rely on critical medications to stay healthy. If not stopped, Medicare Part D plans would have been able to deny coverage of drugs to the most vulnerable Medicare beneficiaries,” stated Carl Schmid, executive director of the HIV+Hepatitis Policy Institute.

Under the proposed demonstration project key patient protections established in law would be waived. Medicare recipients in the plan’s area who rely on medications to treat HIV, cancer, epilepsy, organ transplants, and mental illness would lose their “protected status.” Additionally, the plans would only have to cover one drug in all classes, instead of the current two drug per class standard.

The proposed project has been met with widespread opposition from the patient community along with members of Congress. HIV+Hep is particularly grateful to the Congressional HIV and Mental Health Caucuses, who sent a bipartisan letter signed by 67 members to the leadership of the Department of Health and Human Services in opposition to the demo project. The letter was led by Reps. Barbara Lee (D-CA), Jenniffer González-Colón (R-Puerto Rico), Grace F. Napolitano (D-CA), and John Katko (R-NY).