The Center for American Principles submitted a formal public comment to the Centers for Medicare & Medicaid Services (CMS) opposing the proposed “Guarding U.S. Medicare Against Rising Drug Costs” (GUARD) Model.
In the comment, CAP argues that the GUARD proposal would unlawfully restructure Medicare Part D by importing foreign price-control mechanisms into the United States healthcare system. The model would tie certain Medicare drug prices to benchmarks set by government authorities in 19 foreign countries, replacing the competitive, market-based structure Congress designed for Part D with centralized price administration.
CAP warns that the GUARD model exceeds the statutory authority granted to the Center for Medicare and Medicaid Innovation (CMMI) by imposing a mandatory, multi-year price control framework affecting approximately 25% of Part D beneficiaries. The comment further explains that benchmarking U.S. prices to foreign government-set rates would undermine patient access, discourage pharmaceutical innovation, and weaken America’s global leadership in biotechnology at a time of increasing international competition.
Additionally, CMS itself acknowledges that the proposal would do little to reduce out-of-pocket costs for seniors and could increase Part D premiums and beneficiary cost sharing by an estimated $3.6 billion. Rather than addressing supply chain distortions and intermediary practices that inflate costs, the GUARD model shifts toward government-imposed pricing backed by substantial financial penalties.
CAP concludes that the GUARD model is an unlawful restructuring of Medicare Part D that replaces market disciplines with foreign price controls, undermines patient-centered care, and fails to deliver meaningful savings to beneficiaries. For these reasons, CAP strongly urges CMS to withdraw the proposed rule.