Opinion: Threats to Medicare continue in 2019

Bob Blancato
This Wednesday, Aug. 29, 2018 photo shows an arrangement of Oxycodone pills in New York. A study in Tennessee released on Thursday, Aug 30, 2018, found learning disabilities and other special education needs are more common in young children who were born with symptoms from their mothers' prenatal opioid use. The results bolster evidence of long-term consequences for infants caught in the nation's opioid epidemic.

Medicare faces numerous threats in 2019. And now that the 116th Congress has convened, it's time for lawmakers and healthcare advocates to attack these challenges head-on.

One threat stems from the Trump administration, which has suggested weakening the so-called protected classes provision in Medicare "Part D."

Since its creation more than a decade ago, Medicare's Part D drug benefit has enabled seniors to purchase subsidized prescription coverage from private insurers. Part D regulations require every plan to cover all medications in six protected classes of therapies, including anticonvulsants, antidepressants, antineoplastics, antipsychotics, antiretrovirals, and immunosuppressants. This protection ensures that older adults who battle cancer, HIV/AIDS, depression, and other serious diseases have a full range of treatment options.

The administration's proposal would allow Medicare Part D plans to stop covering some of the most popular and needed medications in these classes. Key medical and patient advocacy groups have indicated their strong opposition, stating that the proposal should be withdrawn.

Another threat lurking for beneficiaries relates to the importation of prescription drugs. Some politicians argue certain drugs can be obtained cheaper if imported from other countries, assuming that price is the only factor that should motivate consumers.

However, consumers should also be concerned with the safety of imported drugs. Is the drug developed in a safe manner? Is it counterfeit? In other words, could it be a threat to the health of a person who uses the imported drug?

It is essential that the most stringent safety requirements be developed before there is any discussion of importation. All drugs that might be imported must pass this rigorous safety test.

In the highly-charged atmosphere around drug prices, importation will be a front and center issue. Different versions of bills permitting everything from unlimited importation to very limited importation will be presented in this session of Congress. Sens. Chuck Grassley and Amy Klobuchar already introduced one importation bill, the "Safe and Affordable Drugs from Canada Act of 2019." However, the rallying cry from advocates must be safety first.

Another concern relates to Medicare Part D's Low-Income Subsidy (LIS) program, which enables enrollees to obtain heavily discounted prescriptions. Some influential government advisors have proposed raising these enrollees' co-pays for certain necessary prescriptions. The program is a lifeline for low-income, older adults needing prescription drugs; the subsidy they receive makes the difference as to whether they obtain lifesaving treatments. All efforts to squeeze this vulnerable group of older Americans must be resisted.

Further, we need to do a better job of raising awareness about the LIS program to those older Americans from minority communities who are underutilizing this important benefit.

Medicare, as it enters its 54th year, has been an unqualified success. Many politicians, from the president to senators and representatives in Congress, have pledged to protect Medicare. Advocates should pressure them to fulfill that pledge.

Bob Blancato is executive director of the National Association of Nutrition and Aging Services Programs.