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CMS Administrator Seema Verma rolled out a new Medicare proposal. Photo: Evan Vucci / AP

The federal government unveiled a new proposal late Thursday that would make some rather large changes to Medicare Advantage and the Part D drug program in 2019. The 713-page rule covers a lot, but there are two nuggets worth highlighting.

Part D: Health insurers and pharmacy benefit managers "rarely" pass along to consumers the discounts they extract from drugmakers, the Centers for Medicare & Medicaid Services said. Now, the agency is asking for help to design a policy that would require Medicare drug plans to pass some of those savings onto consumers when they are actually buying their medicine.

  • Why it matters: This would potentially lower what people pay at the pharmacy counter, but it wouldn't change how drugs are priced in the first place. Insurers and pharmacy benefit managers likely will argue against it.

Medicare Advantage: By law, Medicare Advantage insurers have to spend at least 85% of premiums on health care. Money they spend trying to combat fraud is not counted toward that 85%. CMS' proposal would change that.

  • Why it matters: It's a big win for insurers. They've wanted this for a long time, and it could immediately boost their profits because an administrative expense could be lumped into what they have to spend on health care services.

Go deeper

Biden embarks on a consequential presidency

Photo illustration: Sarah Grillo/Axios. Photo: Joe Raedle/Getty Images

Donald Trump tried everything to delegitimize the rival who vanquished him. In reality, he's set Joe Biden on course to be a far more consequential U.S. president than he might otherwise have become.

The big picture: President Biden now confronts not just a pandemic, but massive political divisions and an assault on truth — and the aftermath of the assault on the Capitol two weeks ago that threatened democracy itself.

Updated 24 mins ago - Politics & Policy

Inauguration Day dashboard

U.S. Capitol and stage are lit at sunrise ahead of the inauguration of Joe Biden. Photo: Patrick Semansky - Pool/Getty Images

President Biden has delivered his inaugural address at the Capitol, calling for an end to the politics as total war but warning that "we have far to go" to heal the country.

What's next: Representatives from all branches of the military escort the 46th president to the White House.

Inaugural address: Biden vows to be "a president for all Americans"

Moments after taking the oath of office, President Biden sought to soothe a nation riven by political divisions and a global pandemic, while warning that "we have far to go" to heal the country and defeat a "virus that silently stalks the the country."

Why it matters: From the same steps that a pro-Trump mob launched an assault on Congress two weeks earlier, the new president paid deference to the endurance of American political institutions.