Medicare is another story. Medicare Part D is what sent Medicare over the hill, is my understanding. It cost $1 Trillion Dollars and wasn't funded, to provide Rx coverage. Additionally, there is STILL that provision in Part D that prohibits the govt from negotiating with Big Pharma over prescription prices (shameful....it makes no sense not to be able to negotiate a discount when your group has millions of people in it!). The ACA adds to Part D, filling in the donut hole partially, I believe...but that is funded by the ACA.
If the U S does something about the outrageous cost of prescription medication in the country, then Part D could at least be modified to decrease coverage. And take out that provision prohibiting negotiating with Big Pharma for discount pricing. The US pays more for medicines than any other country. And Big Pharma loves it. They use some of their enormous profits to run all those ads pushing medications for everything imaginable, while there are no ads recommending yoga, daily exercise, eating vegetables, and the like, which would cure a lot of illnesses.