Medicare Part B Premiums to Rise 9.7% in 2026 as CMS Negotiates Cancer Drug Price Reductions
Key Insights
Medicare Part B premiums will increase to $202.09 per month in 2026, representing a 9.7% rise from the current $185 monthly cost for individuals earning $109,000 or less annually.
The Centers for Medicare and Medicaid Services (search) successfully negotiated price reductions for 15 drugs, including significant discounts on four costly cancer treatment medications.
The American Hospital Association (search) has filed a lawsuit against HHS challenging a new pilot program that changes how safety net hospitals receive 340B drug cost reimbursements from upfront discounts to rebates.
Centers for Medicare and Medicaid Services (search) has announced that monthly premiums for Medicare Part B will begin costing patients $202.09 per month next year—a 9.7% rise up from $185 in 2025—for individuals making an annual income of $109,000 or less. The premium increase comes as CMS simultaneously achieved significant cost reductions through drug price negotiations.
CMS Secures Cancer Drug Price Reductions
The Center for Medicare and Medicaid Services said it has negotiated down the price of 15 drugs, including significant discounts to four costly cancer treatment drugs, according to an announcement from Nov. 25. These negotiations represent part of ongoing federal efforts to reduce prescription drug costs for Medicare beneficiaries.
Hospital Association Challenges 340B Program Changes
The American Hospital Association (search), joined by four community-based hospitals, has sued HHS over a pilot program to reimburse drug costs to safety net hospitals enrolled in the 340B program through a rebate—a departure of the status quo of up-front discounts. This legal challenge highlights tensions over changes to the federal drug discount program that serves vulnerable patient populations.
New Medicaid Drug Payment Model Announced
CMS announced a new drug payment model called the GENErating cost Reductions for U.S. Medicaid (GENEROUS) Model that the agency plans to pilot next year. The initiative represents another approach by federal health officials to control rising pharmaceutical costs within government healthcare programs.
Obesity Drug Coverage Expansion
The White House Nov. 6 announced a deal with drugmakers Eli Lilly and Co. (search) and Novo Nordisk to expand coverage and reduce prices for their obesity treatments, Zepbound and Wegovy. This agreement addresses access concerns for weight management medications that have shown significant clinical benefits but carry high costs.
ACA Marketplace Insurance Costs at Risk
Millions of Americans with Affordable Care Act marketplace health insurance will face higher costs next year if Congress doesn't extend enhanced premium tax credits that have made the plans more affordable for low- and middle-income enrollees. The potential expiration of these subsidies could significantly impact healthcare affordability for marketplace participants.