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Morning Briefing

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Tuesday, May 31 2022

Full Issue

HHS: Higher Medicare Premiums Stay In Place This Year, Will Drop In 2023

Medicare's highest-ever price increase in 2022 was driven by estimated costs for the controversial Alzheimer's drug Aduhelm. But even with severely limited coverage, the Centers for Medicare and Medicaid Services determined that a mid-year premium adjustment is not operationally feasible. HHS Secretary Xavier Becerra announced though that they would go down next year.

Medicare recipients will get a premium reduction 鈥 but not until next year 鈥 reflecting what Health and Human Services Secretary Xavier Becerra said Friday was an overestimate in costs of covering an expensive and controversial new Alzheimer鈥檚 drug. Becerra鈥檚 statement said the 2022 premium should be adjusted downward but legal and operational hurdles prevented officials from doing that in the middle of the year. He did not say how much the premium would be adjusted. (5/27)

Health and Human Services Secretary Xavier Becerra in January publicly announced he was ordering Medicare to consider dropping older adults鈥 premiums in the middle of this year, which would have been an unprecedented move. But the administration decided against a change due to 鈥渓egal and operational hurdles,鈥 the department said Friday afternoon. The overpayments will instead be factored into next year鈥檚 premiums. (Cohrs, 5/27)

Projections for how much Aduhelm, also known as aducanumab, would cost the government in 2022 were the primary reason for a 14.5% Medicare Part B premium hike that brought the monthly cost to $170.10 this year, CMS disclosed in November. Circumstances have changed since then. CMS has limited Aduhelm coverage to beneficiaries enrolled in clinical trials. And Biogen, the drug's manufacturer, halved the original $56,000 yearly price. ... CMS concluded that delaying the adjustment until next year is the only practical method, the agency wrote in a notice. The agency expects Part B premiums to be lower in 2023 because Adulhelm spending won't meet projections this year. (Goldman, 5/27)

In related news about CMS and the Affordable Care Act 鈥

Cathy Kornman is a nurse in Atlanta who cares for patients recovering from surgery. She is unvaccinated against Covid-19 despite a federal requirement for health workers. Opting out was easy: With the click of a button, Kornman said she lied to her employer, claiming on a one-sentence administrative form that her religion prohibited vaccination. 鈥淚 don鈥檛 really truly have a religious exemption,鈥 Kornman, 62, told POLITICO. 鈥淭aking the vaccine, for all intents and purposes, has been optional.鈥 (Levy, 5/30)

The scene seems straight out of a movie: A young couple stands solemnly before the judge. They鈥檝e been married just a year, and they're here 鈥 for the second time 鈥 to ask for a divorce. A month ago, the same judge gave them a hard time, then said no. He still thinks there is something fishy about their request. And he鈥檚 right. The young people want to be together. But the only way they can afford that is to legally split up. It isn鈥檛 about love. It鈥檚 not about employment or family pressure. It鈥檚 about health care. (Gorenstein and Levi, 5/28)

This is part of the Morning Briefing, a summary of health policy coverage from major news organizations. Sign up for an email subscription.
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