美国医疗保险和医疗补助服务中心（CMS）现任及前任领导人周三建议联邦医疗保险（Medicare）受益人在今年重新参保时密切关注自己的选择，因为近年来的重大变化只会让情况变得更加复杂。在《国会山报》与老龄化研究联盟合作举办的“物有所值：充分利用你2027年的联邦医疗保险福利”活动上，CMS副局长约翰·布鲁克斯和前CMS首席运营官乔纳森·布鲁姆都指出，《通胀削减法案》（IRA）中的条款，例如联邦医疗保险药品价格谈判计划，已经改变了联邦医疗保险福利的处理方式。
Current and former leaders at the Centers for Medicare and Medicaid Services (CMS) on Wednesday advised Medicare beneficiaries to pay close attention to their options this year upon re-enrolling in plans, as major changes in recent years have made only made the landscape more complex. Speaking at The Hill's "Bang for Your Buck: Get the Most from Your 2027 Medicare Benefits" event in partnership with the Alliance for Aging Research, CMS Deputy Administrator John Brooks and former CMS chief operating officer Jonathan Blum both noted how provisions in the Inflation Reduction Act (IRA), such as the Medicare Drug Price Negotiation Program, had changed how Medicare benefits are handled.
布鲁克斯建议，即使人们对自己目前的计划感到满意，也应该在参保期内多方比较。“平均而言，受益人可以在联邦医疗保险优势计划中从大约28个计划中做选择，97%的受益人将能够获得10个或更多计划，”布鲁克斯指出。“但平均值可能掩盖了医疗保健具有本地性这一事实，因此在不同医疗市场以及具体计划中，每年都可能发生很多变化。”
Brooks advised that even if people are satisfied with their current plans, they should still shop around during the enrollment period. "On average, beneficiaries will be able to choose among 28 or so plans in Medicare Advantage, and 97 percent of beneficiaries will have access to 10 or more plans," Brooks noted. "But the averages can conceal the fact that healthcare is local, and so in different healthcare markets and in and with specific plans, there can be a lot of changes from year to year."
《国会山报》特约编辑凯瑟琳·科赫指出，2026年也是谈判达成的联邦医疗保险药品价格生效的第一年，一些受益人实际上看到首批10种药品的自付额上涨了。“药品计划本身会与药品制造商谈判，以获得它支付的价格，但受益人通常支付的价格要低得多，”布鲁克斯说。
The Hill's contributing editor Kathleen Koch noted that 2026 also marked the first year that negotiated Medicare drug prices went into effect, and some beneficiaries have actually seen their co-pays for the first 10 drugs go up. "The drug plan itself negotiates with the drug manufacturer to get the price that it's paying, but the beneficiary is usually paying a much lower price than that," said Brooks.
因此，计划支付额与受益人支付额之间的差额可能会逐年发生变化，即使药物计划本身支付的金额较低，其中一些变化对患者自付费用的影响也可能同样重大。在奥巴马和拜登政府时期任职的布鲁姆表示，计划和患者都仍需时间来适应《通胀削减法案》带来的变化，国会在促进这一过渡方面发挥着作用。
"And so you can have these changes in how the difference between what the plan is paying and what the beneficiary is paying that shift over a year over year, and so some of those changes could be just as significant in terms of patient out of pocket, even if the drug plan itself is is paying a lower amount." Blum, who served during the Obama and Biden administrations, said that plans and patients all still need time to adjust to the changes brought about by the IRA, and Congress has a role in facilitating this transition.
《通胀削减法案》包含重组医疗保险D部分处方药福利的条款，其中包括设定自付费用上限——2026年为2100美元——以及建立医疗保险处方药付款计划，该计划允许受益人将处方药费用均匀分摊到全年，而不是预先支付较高的一次性费用。
The IRA included provisions that restructured Medicare Part D prescription drug benefits, including setting a cap on out-of-pocket spending — $2,100 for 2026 — and establishing the Medicare Prescription Payment Plan, which allows beneficiaries to evenly spread out the cost of the prescriptions across the year instead of paying a higher one-time cost up front.
布鲁姆说：“《通胀削减法案》——无论你是支持还是不支持《通胀削减法案》——我们都必须同意，它对D部分计划进行了根本性改变。它改变了福利结构，首次为药物福利提供了灾难性保障。这些变化实施得非常、非常快……这意味着计划必须调整保费；它们必须适应这些新福利。”
"The IRA — whether that you support the IRA, don't support the IRA — we all have to agree that it made fundamental changes to the Part D program. It changed the benefit structure, gave catastrophic coverage for the first time for for for drug benefits. Those changes were put in place very, very quickly ... meaning that plans have to adjust their premiums; they have to get used to these new benefits," said Blum.
他补充道：“我们必须考虑该计划真正适应我们所处的新世界。因此，我认为国会未来必须考虑的关键问题之一是，我们如何为该计划提供资金？”
"We have to think about the program really adjusting to the new world that we're in. And so that I think is going to be one of the key questions that Congress has to consider going forward is, how do we finance the program?" he added.