Current, former CMS leaders offer advice on Medicare changes ahead

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 reenrolling in plans, as major changes in recent years have 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.

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.”

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,” Brooks said. “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 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.

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.

“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 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,” Blum said.

“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.