The Congress should make the following changes to the Part D prescription drug benefit:
- Below the out-of-pocket threshold:
- Eliminate the initial coverage limit.
- Eliminate the coverage-gap discount program.
- Above the out-of-pocket threshold:
- Eliminate enrollee cost sharing.
- Transition Medicare’s reinsurance subsidy from 80 percent to 20 percent.
- Require pharmaceutical manufacturers to provide a discount equal to no less than 30 percent of the negotiated price for brand drugs, biologics, biosimilars, and high-cost generic drugs.