WASHINGTON — The budget deal announced in the Senate on Wednesday contained a provision surprising to drug companies and Medicare beneficiaries alike: a sooner-than-expected change to the program’s “donut hole” coverage gap.
The provision included in the budget plan would mean a sizable hit to the pharmaceutical industry. It would move from 2020 to 2019 a requirement that drug makers pick up a larger portion of costs for their medicines for Part D beneficiaries who reach the so-called “donut hole” — a gap in Medicare coverage where beneficiaries often have to pay eye-watering drug prices out of pocket up to a certain dollar amount.
The elimination of that gap could save some Part D beneficiaries thousands of dollars per year. Democrats also hailed the provision as a political win that will save the Medicare program as much as $9 billion in total and transfer billions in cost obligations from patients to drug companies over the next decade.
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