Impact of Historic Medicare Rx Out-of-Pocket Spending Cap on Ohio Seniors

Savings Possible Thanks to the Prescription Drug Law Championed by AARP

A new AARP report that shows an estimated 127,193 of Ohioans on Medicare prescription drug plans will see savings thanks to a new out-of-pocket cap that starts Jan. 1, 2025. The savings are made possible by a provision in the 2022 prescription drug law that AARP championed, which caps out-of-pocket prescription drug costs every year, beginning at $2,000 next year, for America’s 56 million Medicare drug plan enrollees.

The AARP report analyzes the number of enrollees who will benefit from the cap by state, age, gender and race between 2025 and 2029. The findings indicate that Medicare drug plan enrollees nationwide who reach the new out-of-pocket cap will see average savings of roughly $1,500, or 56%, in 2025 for their prescription drugs.

“AARP fought hard for the 2022 prescription drug law because we knew lowering drug prices and out of pocket costs would provide critical relief for Medicare enrollees here in Ohio and across the country,” said Jenny Carlson, state director of AARP Ohio, which serves more than 1.5 million members age 50 and older in the state. “Knowing they won’t pay a dime over $2,000 next year at the pharmacy counter for their prescriptions gives Ohio seniors on Medicare drug plans some peace of mind especially as they face higher costs for things like groceries and utilities.”

Other findings from the report include:

• Between 3 and 4 million Part D plan enrollees nationwide are estimated to benefit from the new out-of-pocket cap every year between 2025 and 2029, including up to 163,000 here in Ohio.
• By 2029, the share of enrollees benefiting from the new out-of-pocket cap is estimated to be 10 percent or higher in 19 states, plus the District of Columbia.
• More than three-quarters of Medicare drug plan enrollees who will benefit in 2025 are between the ages of 65 and 84.

The full report and a fact sheet on the findings can be found on aarp.org.

Carlson said, “Capping yearly out-of-pocket prescription drug costs for Ohio’s Medicare enrollees builds on other new and important common sense measures of the legislation, such as capping insulin co-pays at $35 a month and making many vaccines, such as shingles and pneumonia, free.

“In Ohio, where 67% of voters 50 and older consider the cost of prescription drugs a critical issue, and an estimated 127,193 Ohioans on Medicare prescription drug plans expected to benefit from this cap starting in 2025, the financial relief is both timely and necessary.”

To learn more about AARP’s work to lower prescription drug prices, visit How High Rx Prices Hurt.