Our nation is growing older, a change that is reshaping the healthcare needs of our communities. In 2020, nearly 17 percent of the population was age 65 and older. This age group grew five times faster than the general population between 1920 and 2020 and is continuing its exponential trajectory, with the share of U.S. adults aged 65 or older projected to account for almost a quarter of the country’s population by 2060.
That shift is not abstract. It means more people managing heart disease, diabetes, cancer, and other chronic and complex conditions that require consistent access to prescription medications.
For older adults on fixed incomes, the price of filling a prescription is not just another line item in their budget. That cost can determine whether someone stays healthy enough to remain independent or ends up in a hospital bed.
More than 90 percent of Americans age 65 and over live with at least one chronic condition, and many rely on multiple medications daily. When out-of-pocket costs rise unexpectedly, seniors are often forced to make difficult tradeoffs between prescriptions and other essentials such as groceries. Even modest increases can strain retirement savings and Social Security benefits that were never designed to absorb unpredictable spikes in healthcare spending.
For seniors nationwide, TrumpRx represents a promising step toward addressing these concerns. By negotiating directly with pharmaceutical manufacturers and creating a direct-to-consumer purchasing pathway, the administration is connecting Americans to the lowest prices for treatments they need by cutting out the supply-chain middlemen that drive up costs. For seniors who have long felt squeezed between rising out-of-pocket costs and burdensome insurance barriers, the launch of TrumpRx offers hope.
Greater transparency and direct purchasing options give patients more control over their care and lead to lower upfront costs. It is a meaningful development for older Americans who depend on predictable healthcare expenses to manage their budgets.
However, Congress must act to ensure as many seniors as possible can fully benefit from these lower prices. Under current insurance rules, purchases made outside of traditional plan structures often do not count toward a patient’s annual deductible or out-of-pocket maximum. That means an American senior could obtain a medication at the lowest cost through TrumpRx, but make no progress toward meeting their full insurance deductible before coverage begins. Dollars spent securing a better price for their medication would not necessarily bring them any closer to reaching their plan’s cost-sharing threshold.
That disconnect undermines the very goal of improving patient affordability.
Seniors should not be penalized for pursuing lower prices. If a patient pays for a medication through TrumpRx, those payments should count toward their deductible and annual out-of-pocket cost cap.
Without this fix, older adults may face an unfair choice. They can seek a lower upfront price but delay progress toward meeting their deductible, or they can remain within their plan’s structure and potentially pay more at the pharmacy counter. Neither outcome reflects a patient-centered system.
This issue becomes more urgent annually. Projections estimate that the number of Medicare beneficiaries in the United States will increase to 77 million in the next four years. As our population continues to age, the number of Americans navigating these financial and administrative barriers will grow.
Congress has an opportunity to ensure that innovation translates into meaningful savings. By requiring that purchases made through TrumpRx count toward deductibles and annual out-of-pocket limits, federal lawmakers can align incentives with common sense to benefit patients. Such a change would not dismantle existing insurance coverage but ensure that savings follow the patient.
Seniors have worked for decades, contributed to their communities, and paid into Medicare. They deserve a healthcare system that supports their independence and rewards responsible efforts to manage costs.
With Congress supporting its goals, TrumpRx gets the job done, lowering costs for patients and putting Americans back in control of their health. What our legislators must not do is codify overly broad price controls, such as a most-favored nation pricing approach, that go far beyond the scope of meaningful out-of-pocket cost reform. These foreign price controls only threaten the availability of current and future treatments.
TrumpRx is a game-changing option for patients. Now, federal policymakers must take the right next step to ensure that older Americans can fully benefit from it. As our great nation grows older, our policies must evolve as well.
Saul Anuzis is president of 60 Plus, the American Association of Senior Citizens.
Reprinted with Permission from DC Journal – By Saul Anuzis
The opinions expressed by columnists are their own and do not necessarily represent the views of AMAC or AMAC Action.