Building on Success: Regulatory Reforms that Fulfill Medicare Part D’s Promise to Beneficiaries

Medicare Part D’s optional, affordable coverage for prescription drugs has changed lives.  Today, more than 43 million older Americans and people with disabilities have enrolled in Part D.1  From its inception, policymakers included safeguards that protect access to medicines and promote affordability.   As the program marks its 15th anniversary since passage, the Centers for Medicare and Medicaid Services (CMS) has signaled interest in sweeping regulatory changes to Part D benefits with significant implications for access and affordability for beneficiaries.   
Surveys indicate that the majority of beneficiaries enrolled in Part D are satisfied with the program.2  Yet even with the success of Part D, some beneficiaries experience challenges accessing prescription drugs. Although premiums have remained stable recently and the overall costs of the program are well below the Congressional Budget Office’s (CBO) original estimates, out-of-pocket costs for many beneficiaries have risen significantly, particularly for those living with serious, chronic illnesses.  
By putting beneficiaries first, CMS can build upon the success of the program, facilitate access to meaningful and affordable coverage options, and preserve existing protections relating to medication access.