The Honorable Frank Pallone
Chairman
Committee on Energy and Commerce
2125 Rayburn House Office Building Washington, DC 20515
The Honorable Cathy McMorris Rodgers
Ranking Member
Committee on Energy and Commerce
2125 Rayburn House Office Building Washington, DC 20515
Dear Chairman Pallone and Ranking Member McMorris Rodgers:
We write to you in support of H.R. 1978, Protecting Seniors Through Immunization Act of 2021. As you know this is a bi-partisan initiative sponsored by Reps. Ann Kuster (D-NH) and Larry Bucshon (R-IN), quickly gaining some 40 bipartisan cosponsors.
On behalf of the undersigned signatories, we support this initiative aimed at encouraging seniors to get vaccinated and not shy away because of costs.
The Part D program has been enormously successful over the years in providing medicines to seniors and creating a robust system of choice and competition. The leading plans participating in the Part D program are also leaders in the commercial marketplace and use their vast purchasing power representing tens of millions of Americans to obtain good deals for seniors. In addition, savings are generated by rapidly moving to generic medicines once available.
Unfortunately, there is a concerning gap between the commercial market and in Part D plans when it comes to vaccines. In the commercial market, most Americans receive vaccines without cost-sharing.1 However, in Part D, America’s seniors are often subjected to very high cost-sharing, leading them not to be vaccinated. We know that the higher the cost-share, the less likely seniors are to be vaccinated.2
Vaccines represent an exceptional value and circumstance in medicine. Vaccines are a preventive measure that deliver excellent economic value – historically among the most cost-effective of public health measures — they help stop the spread of disease, not just treat individual instances of disease, and because of the unique analysis conducted by the CDC’s Advisory Committee on Immunization Practices (ACIP) they come with a more defined recommendation for their use than most medicines. Further, there is no risk of abuse, inappropriate prescribing or diversion of these medicines. There is no reason to attempt to discourage or moderate their use; in fact, the goal of increasing vaccination rates is included in both HP2020 and HP2030.
In addition, there is an illogic in Medicare that must be rectified. Medicare covers some vaccines under Part B, including the COVID-19 vaccines, where they are not subject to cost-sharing. Others, including future vaccines, are covered under Part D where they may be subject to very high cost-sharing. There is little if any rationale for these distinctions.
We are all hopeful that the technology deployed by American companies to fight COVID-19 will result in future vaccine innovations and that those innovations will be available to America’s seniors. The changes suggested by H.R. 1978 are fiscally responsible3 and common-sense – something we need more of in health care. The Part D program is highly valued by seniors – this modest but important change to the program will help ensure its continued success.
1 Schwartz, Freed, Cubanski, et al. “Vaccine Coverage, Pricing, and Reimbursement in the U.S.” Kaiser Family Foundation, November 18, 2020, kff.org/coronavirus-covid-19/issue-brief/vaccine-coverage-pricing-and-reimbursement-in-the-u-s/
2 Becker, Loren, et al. “Fewer Seniors Get Vaccinated as Their out-of-Pocket Costs Increase.” Avalere Health, 19 July 2018, avalere.com/insights/fewer-seniors-get-vaccinated-as-their-out-of-pocket-costs-increase.
3 Liow, Christine, et al. “Impact of Removing Part d Vaccine Cost-Sharing on the Federal Budget.” Avalere Health, 10 Sept. 2021, avalere.com/insights/impact-of-removing-part-d-vaccine-cost-sharing-on-the-federal-budget.
Sincerely,
James L. Martin
Founder/Chairman
60 Plus Association
Saulius “Saul” Anuzis
President
60 Plus Association
David Balat
Free2Care
Executive Director
Ryan Ellis
President
Center for Free Economy
Karen Kerrigan
President & CEO
Small Business & Entrepreneurship Council
Tom Kilgannon
President
Freedom Alliance
CC: Full Committee on Energy and Commerce
Organizations are listed for identification purposes only
