Radar on Drug Benefits

‘Not a Good Look’: Premiums Could Jump If Trump’s CMS Drops Part D Demo

  • Dec 12
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    Dec 12, 2024

    If the Senate confirms them as the next leaders of CMS and HHS, Mehmet Oz, M.D., and Robert F. Kennedy Jr. will quickly be faced with a Catch-22 concerning the Medicare Part D program. Namely, they and their staffs must decide whether to extend a Biden administration-created program that has both garnered withering criticism from Republicans and helped ensure that 2025 premiums for stand-alone Prescription Drug Plans (PDPs) wouldn’t leave seniors with sticker shock. 

    The program in question is the Part D Premium Stabilization Demonstration, which CMS under President Joe Biden debuted in July. For PDPs opting into the program, CMS applied a $15 reduction to the Part D base beneficiary premium, which helps calculate plan-specific basic premiums. It also placed a $35 limit on participating PDPs’ plan-specific year-over-year premium increases, and it adjusted risk corridors to allow greater government risk sharing for potential losses experienced by PDPs.  

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    • Leslie Small

    Leslie has been working in journalism since 2009 and reporting on the health care industry since 2014. She has covered the many ups and downs of the Affordable Care Act exchanges, the failed health insurer mega-mergers, and hundreds of other storylines spanning subjects such as Medicaid managed care, Medicare Advantage, employer-sponsored insurance, and prescription drug coverage. As the managing editor of Health Plan Weekly and Radar on Drug Benefits, she writes and edits for both publications while overseeing a small team of reporters who also focus on the managed care sector. Before joining AIS Health, she was a senior editor for the e-newsletter Fierce Health Payer, and she started her career as a copy editor at multiple local newspapers. She graduated with a dual degree in journalism and political science from Penn State University.

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Managing Editor, Health Plan Weekly and Radar on Drug Benefits

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Reporter, Radar on Medicare Advantage and Spotlight on Market Access

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