Bipartisan, Bicameral PACE Part D Choice Act Would Reduce Part D Costs and Increase Access for Medicare Beneficiaries to Innovative Programs of All Inclusive Care for the Elderly

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May 19, 2023, 07:11 ET

WASHINGTON, May 19, 2023 /PRNewswire/ -- This week, U.S. Representatives Brad Wenstrup, MD (R-OH) and Earl Blumenauer (D-OR3) and U.S. Senators Tom Carper (D-DE) and Bill Cassidy, MD (R-LA) introduced The PACE Part D Choice Act, which would eliminate a significant financial disincentive for Medicare-only beneficiaries to enroll in Programs of All-Inclusive Care for the Elderly or PACE.

"Everyone deserves a fair choice when it comes to health care and we must ensure that access to this choice is affordable," said Senator Tom Carper (D-Del.). "The PACE Part D Choice Act would give seniors the option to choose a cost-efficient plan that will provide them with the care they need."

Although many PACE participants are eligible for Medicare and Medicaid, for those who do not qualify for Medicaid, their average monthly Part D plan premium costs of $983.66 in 2023 are considerably higher—more than 20 times higher, than the $43 average monthly cost of a marketplace plan. The PACE Part D Choice Act would increase access to PACE for Medicare-only beneficiaries by enabling them to choose between the PACE Part D plan or a marketplace Part D plan, which is likely to have fewer total costs such as lower premiums and related deductible and coinsurance amounts. The policy solution in the legislation has been cited by non-partisan think tanks, including in a Bipartisan Policy Center report, highlighted as a notable way to address the lack of care options outside of nursing homes for our nation's fast-growing older population.

"PACE patients should have the same access to lower premiums and affordable prescription drugs as those in other Medicare programs," said Dr. Cassidy. "This will lead to better health outcomes for seniors with chronic illness."

"PACE is a proven model of care for older adults, and it has continued to demonstrate its benefits even more profoundly during and after the pandemic," said Shawn Bloom, President and CEO of the National PACE Association. "But widespread enrollment in PACE for the millions of Medicare-only beneficiaries who could benefit faces a significant financial obstacle --the high Part D premium cost. NPA strongly urges Congress to pass this bill quickly so that many more older adults and their families can be served by PACE and receive the care they need in their homes and communities."

Currently, 150 PACE programs operate at least 309 PACE centers in 32 states and the District of Columbia, serving more than 64,000 participants. However, if barriers to joining PACE were eliminated, including the high Part D premium, many millions more eligible seniors could be taking advantage of the benefits that PACE offers.

SOURCE National PACE Association