Lower Health Care Costs for Working Families

WASHINGTON — U.S. Senator Martin Heinrich (D-N.M.) cosponsored the Choose Medicare Act, legislation that gives every American who is not already eligible for Medicaid or Medicare the opportunity to enroll in Medicare.

The Choose Medicare Act opens up Medicare to all Americans with a new 'Part E' and builds on the Affordable Care Act. By allowing Medicare to compete with private health insurance, Medicare Part E puts consumers and businesses in the driver's seat on the road to universal health care.

"New Mexico's working families deserve affordable and accessible health care. Period," said Heinrich. "I'm proud to cosponsor legislation that gives every New Mexican the opportunity to enroll in Medicare if they want it — putting power back into the hands of working families to choose the health care coverage that works best for them and their pocketbooks."

The Part E plan would leverage the existing exchange networks and low administrative costs of the Medicare program, while saving Americans even more money by allowing Medicare to negotiate drug prices thanks to the Inflation Reduction Act. The new plan will cover the same benefits as traditional Medicare, as well as additional benefits to meet the needs of the nonelderly.

The Choose Medicare Act is led by U.S. Senators Jeff Merkley (D-Ore.) and Chris Murphy (D-Conn.).

Alongside Heinrich, the legislation is cosponsored by U.S. Senators Tammy Baldwin (D-Wis.), Richard Blumenthal (D-Conn.), Cory Booker (D-N.J.), Tammy Duckworth (D-Ill.), Dick Durbin (D-Ill.), Kirsten Gillibrand (D-N.Y.), Jack Reed (D-R.I.), Brian Schatz (D-Hawaii), Tina Smith (D-Minn.), and Chris Van Hollen (D-Md.)

The bill is supported by Families USA, MoveOn, American Federation of Teachers, and the Center for Medicare Advocacy.

The text of the bill is here.

Background

Heinrich fought hard to pass the Inflation Reduction Act, historic legislation that lowershealth care and prescription drug costs for working families.

This year, the Inflation Reduction Act began capping out-of-pocket costs for prescription drugs at an estimated $3,300, providing substantial relief for individuals facing high medication expenses. This new Medicare drug cap comes in tandem with several other major healthcare provisions Heinrich helped secure, including free vaccines for seniors and a $35 insulin cap for those on Medicare.

Last year, the White House announced 48 Medicare Part B drugs that raised their prices faster than inflation, and some drug companies raised prices of certain medications faster than inflation for every quarter in 2023. The IRA provisions Heinrich helped deliver will now require these companies to pay rebates back to Medicare, saving seniors who take these drugs between $1 and $2,786 per dose, depending on their medication.

The IRA also reduced the cost of marketplace health insurance premiums by an average of hundreds of dollars per person, for roughly 40,000 New Mexicans.

A longer list of provisions Heinrich helped to secure in the Inflation Reduction Act can be found here.

Heinrich introduced the Strengthening Medicare and Reducing Taxpayer (SMART) Prices Act, legislation that builds on a provision that was included in the Inflation Reduction Act to empower Medicare to negotiate prescription drug prices for the first time. Specifically, the bill would allow prescription drugs and biologics to be eligible for negotiation five years after approval by the Food and Drug Administration (FDA) — increasing the overall amount by which Medicare can lower prices through negotiation. Additionally, the SMART Prices Act would lower Medicare Part B drug prices through negotiation two years earlier than under current law, and increase the overall number of drugs that the Department of Health & Human Services (HHS) can negotiate starting in 2026.

Heinrich is also a cosponsor of the Pharmacy Benefit Manager Transparency Act,legislation that bans deceptive unfair pricing schemes, prohibits arbitrary claw backs of payments made to pharmacies and requires Pharmacy Benefit Managers (PBMs) to report to the Federal Trade Commission (FTC) how much money they make through spread pricing and pharmacy fees.