Seniors Strongly Concerned That Proposed Medicare Part D Changes Result in Higher Premiums, Government Costs

Senior voters with Part D plans have largely not heard about proposed changes to Part D, however, and will punish supporters of these changes at the polls if they result in increased premiums. By double-digit margins, these voters say it is a bad idea to eliminate rebates and say the rebates reduce, rather than increase, costs.

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Key findings from the survey: 

1. Senior voters with Part D prescription drug plans are overwhelmingly satisfied with their plan. These voters say they are satisfied with their plan by an 83 to 14 percent margin. Further, they say the plans cover the drugs they need by an 82 to 12 percent margin, are convenient to use by a 92 to 5 percent margin, have a satisfactory number of pharmacies by a 90 to 6 percent margin, and they are satisfied with their out-of-pocket costs by a 67 to 30 percent margin.

2. Only a quarter of seniors say they have seen, read, or heard something recently about proposed changes to Part D. Just 25 percent of these seniors have heard about proposed changes,
while 73 percent have not heard anything.

3. By a 20-point margin, senior voters with Part D plans say it is a bad idea to eliminate drug rebates in negotiations between health plans and drug manufacturers. These voters say it is a bad idea to eliminate rebates by a 45 to 25 percent margin, even though they approach a split in the more general question of whether it is a good or bad idea for the federal government to
regulate negotiations between private companies (43 percent bad idea to 40 percent good idea).

4. Given competing arguments on the effect of drug rebates on costs, senior voters say the rebates reduce costs. When presented with these arguments:
a) Rebates drive up the cost of prescription drugs because they force the drug manufacturers to increase their list prices so they can then give rebates to health insurance plans that provide drug benefits to consumers.

b) Rebates reduce the cost of prescription drugs because they force the drug manufacturers to compete with other manufacturers to keep costs low and be included in the list of covered drugs for consumers by health insurance plans that provide drug benefits for consumers.

Senior voters say the rebates reduce costs by a 41 to 31 percent margin.

5. Two statements regarding the proposed elimination of rebates are particularly compelling. Senior voters are less likely to support the elimination of rebates by a 44 to 26 percent margin when they hear that, “The Department of Health and Human Services admits that this plan will increase premiums for seniors by 25 percent,” and are less likely to support the elimination of rebates by a 37 to 23 percent margin when they hear that, “Eliminating rebates in Part D negotiations will increase the cost to taxpayers by $196 billion.”

6. These senior voters will be less likely to support the reelection of their senators and representatives and of President Trump if those elected officials support eliminating rebates and their premiums increase. Despite a 40 to 39 percent Republican to Democrat split on the generic ballot, seniors would be less likely to support their senator or representative by a 44 to 6 percent margin if they support this plan to eliminate rebates and their premiums increase. Similarly, the seniors would be less likely to support President Trump’s reelection by a 32 to 11 percent margin if he supports the change and their premiums increase.