WASHINGTON – President Joe Biden on Monday pledged that his social agenda legislation would deliver tangible savings on prescription drugs for all Americans. The relief consumers have been craving is now in sight, he said.

But the bill must pass Congress first, where many obstacles remain in its way.

Biden has tried to focus on portfolio provisions overlooked in political machinations over his $ 2 trillion legislation, which deals with issues ranging from climate to family life and taxes. Even before concerns about rising inflation, polls consistently showed Americans’ support from all walks of life for government action to reduce drug costs.

“It’s safe to say we can all agree that prescription drugs are shockingly expensive in this country,” Biden told the White House.

“I am committed to using all the tools at my disposal to reduce prescription drug costs for Americans, while allowing pharmaceutical companies to get a fair return on their investment,” he added.

But even if Biden and his fellow Democrats succeed in their latest push to push through the legislation, a major political difficulty awaits them: The dividends of their prescription drug provisions won’t emerge right away, as the pain of the increase in costs is real and present. Democrats will need to highlight the savings promised, not real, in next year’s midterm elections.

The biggest policy change – a system for Medicare to negotiate the prices of prescription drugs – will not start cutting costs until 2025, and only for a selected set of 10 drugs, as well as products made from it. insulin. The number of drugs under negotiation would increase over time, reaching 100 in six years and continuing to grow by 20 per year.

Other provisions would come into force sooner.

– The co-payment for insulin would be capped at $ 35 per month, starting in 2023. Biden called the high cost of insulin “one of the most egregious examples” of overpriced drugs. He was introduced to the White House by a young woman, Iesha Meza, who could not afford insulin for her type 1 diabetes and was hospitalized in a coma.

– Drug manufacturers would be required to pay Medicare rebates if they increase prices faster than inflation, starting in the same year. This provision would also benefit private policyholders.

– Medicare beneficiaries with high drug costs would finally get a cap on their annual financial exposure, $ 2,000 from 2024.

– Shingles vaccines and other injections covered by Medicare’s “Part D” pharmaceutical benefit would be free for consumers from 2024.

Social legislation has been passed by the House and is pending before the Senate, where it could be submitted as early as next week.

Some of the main prescription drug provisions are subject to parliamentary challenges under Senate rules. The powerful pharmaceutical industry is maneuvering to strip as much as possible. Pharmaceutical companies oppose the entire bill, arguing that limits on their ability to set prices would stifle investments that fuel innovation.

But Biden said the industry has lost the debate with the American people.

“It’s not a partisan issue,” Biden said. “Diabetes, Alzheimer’s disease, cancer – so many other diseases. It doesn’t matter if you are a Democrat or a Republican.

“We need Congress to finish the job,” he said.

The main provisions of the Biden Bill are modeled on earlier legislation that was supported by then-President Donald Trump, but failed to progress. These include the cap on out-of-pocket expenses for the elderly and penalties imposed on drug companies that raise prices faster than inflation.

Monthly co-payments of $ 35 were also introduced under Trump by regulation and are now available in a limited but growing number of Medicare prescription plans. Biden would significantly expand access and benefits.

Meanwhile, Medicare beneficiaries are poised to have an unfortunate illustration of the impact of high drug costs.

About half of next year’s increase of $ 21.60 in Medicare’s monthly “Part B” outpatient care premium next year is due to the program’s need to prepare financially for a pending coverage decision for a health care provider. $ 56,000 a year Alzheimer’s drug called Aduhelm. Notices have already been sent to millions of seniors telling them their cost in January will rise to $ 170.10.

Senator Bernie Sanders, the Vermont Independent, is calling on the Biden administration to hold back this increase, a painful blow over any advantage of prescription drug legislation. But Biden did not address the issue in his speech on Monday, and the Democrats’ bill is currently silent on that as well.