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Increase Access and Affordability

Cap consumer costs, keep pharmacy programs, allow importation and preserve donut hole deal

En español | Millions of Americans rely every day on prescription drugs to maintain their health. AARP believes it’s unfair that we pay the highest prices in the world and that many older adults have to choose between filling their prescriptions and buying food. AARP says the president, Congress and state governments must Stop Rx Greed and Cut Drug Prices Now.

Cap out-of-pocket costs

The Medicare Part D prescription drug program makes medications more affordable for millions of seniors. But 1 in 10 Part D enrollees with high out-of-pocket costs spend at least $5,200 a year on their medicines. Many of these seniors have chronic conditions — meaning they are facing these high costs for the rest of their lives. This forces many to choose between food or other necessities and medicine. 

AARP urges Congress and state governments to pass legislation that would help seniors with high drug costs by capping their out-of-pocket costs.

Protect state pharmacy assistance programs

Some states offer pharmacy assistance programs to help residents pay for prescription drugs. These programs differ in each state, often helping to pay Medicare Part D premiums, deductibles and copays.

AARP urges states to maintain these vital programs and more states to pass laws creating them.

Allow state importation

A number of states have proposed legislation to allow or explore the feasibility of importing prescription drugs from Canada. For example, under a 2018 Vermont law, the state must submit a drug importation implementation proposal to the federal government for approval by July.

AARP urges states to pass such laws and the Department of Health and Human Services to approve drug importation proposals that ensure imported drugs are safe and effective. 

Maintain donut hole provision

Congress last year helped millions of Medicare beneficiaries with high prescription costs by requiring drugmakers to absorb more of the cost of brand-name medicines for beneficiaries in the Medicare Part D donut hole. The donut hole is the coverage gap enrollees find themselves in when their total spending reaches a certain level. The law increased the share drugmakers must pay for brand-name drugs for enrollees in the gap, from 50 percent to 70 percent. Those higher payments cut what seniors have to pay out of pocket to reach the catastrophic stage — where Medicare picks up more of their costs. The drug industry has been aggressively lobbying lawmakers in both parties, trying to overturn this law.

 AARP urges Congress to maintain the donut hole provision.