WASHINGTON (AP) — Congressional advisers say the rising cost of drugs is unsustainable, and they’re recommending major changes to Medicare’s popular outpatient prescription program.

The proposal Wednesday from the nonpartisan Medicare Payment Advisory Commission, or MedPAC, steers clear of calling for the government to directly negotiate drug prices, an option both major presidential candidates advocate.

Instead, it would put more pressure on insurers to bargain for lower prices on the most expensive drugs.

The plan is a mixed bag for beneficiaries. All seniors would get better protection from extremely high costs, but some may have to spend more.

The recommendations are unlikely to gain traction in Congress during an election year, but they will get a serious look from staff experts on key House and Senate committees overseeing Medicare.

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