Well, the bill is going to make it. The dissidents in the Senate led by Kennedy could only muster 29 votes in favor of a filibuster (they need 40). So the bill will pass tonight. Drug stocks and PBM stocks rallied yet further on the news–here’s Caremark’s performance–note the bump in price and volume around 2pm EST.
So I was wrong about this one. I thought that it would get past the House easily and die in the Senate. But in fact it was (almost) the other way around.
This is immediate very good news for a smallish subset of poor sick seniors, rural hospitals, pharma companies and (probably) PBMs. It’s good-ish news for doctors who got a 1.5% hike as opposed to a 4% cut in Medicare payments for their support, and employers who will now start to get subsidized for something they were doing anyway. It’s not such good news for Medicare recipients who already have drug coverage and now will probably be pushed by employers into the Medicare system. And, as for the taxpayer, as the conservative Republicans who voted against it claimed, we’re witnessing the birth of another, potentially out-of-control, Federal spending program.
The longer term implications for Medicare depend on the details of the bills that will amend this bill in years to come–and there will be several. The shorter term implications are about how this will play out for seniors in next year’s elections. Is it "Drug coverage" or "The end of Medicare"?