No big deal? Maybe not for you but one less year of paying less is a big deal for some people who are financially living on the edge and don’t qualify for medicaid or SNAP. The subsidy was $16 mo which is  $192/year is a big deal for some. Wellcare had the biggest national zero premium plan presence in most states (some had a nominal fee of, typically, $3-5/mo). The Medicare D’s will have to make that up “missing” money somehow and fee shifting is about their only choice.

And premiums are only part of the picture. The rest of the picture is which tier the drug is in, what the copay is - fixed dollar amount or a percentage of the cost of the drug (typically drives the cost of the copay up), what is on the formulary and at what tier, etc. 

Let me give you an example. I chose the Wellcare Value Plan, straight Medicare D as I have original Medicare with suppliment G,  because I was only taking a couple of generics and it was by far the cheapest. I paid NOTHING for anything I was taking. Then, past the point you could change I was prescribed a drug (and all it’s equivalents were not on the formulary). I had to wait over a month to get it approved (which did bring the cost down somewhat) when I should have started it far earlier and it took 3 weeks for the doctor to get free samples for me. People on medicare can’t use the pharmaceutical company program (had I been able to do that I would have paid $5 a month) and I was paying $504/mo. Sure I’d hit the max out of pocket in just over 4 months BUT had I known in advance I could have chosen a different D and my total cost - drug and premium would have been far less than the max out of pocket. And to me $2100 is a BIG deal. Very big - although again, maybe not for you.

That $192 is going to be buried in there somewhere as these companies are not charities and need to meet their costs and make a profit for their shareholders. 

Again you may be far more wealthy than the median social security a month (which is LESS than 200% of the poverty line but too much to get Medicaid - the same with the average. And the median amount of money people have in retirement accounts (and a fair number have none) added to social security still keeps them below 200% of the poverty line. It is well documented that that those who live below 400% below the poverty line have trouble paying their bills, cut back on medical care and medications. But, of course, that isn’t a problem according to you. Right? And people care what THEY pay because that affects what money they have left to pay other bills like rent, food, car insurance, gas…

AND 42.2% of retirees live below 200% of the poverty line.58% at or below 300% and 71% at or below 400%.  If, at the  200% poverty line you subtract out those who get Medicare you stlil have around 20% of the retired population who live at or below 200% of the poverty line. But no big deal for them. Right? As you state, there  isn’t many of them. Right?  So as you say it doesn’t matter. Right? Only 21% of the retired population are bailed by being dual eligible. but of that 21% around 29% of those don’t get full Medicaid. But hey, they’ll have enough money to deal with higher expenses. Right?
 

This will affect mostly the 25 million on traditional Medicare with a separate free standing Part D  drug plan.  Not so much  MA plans.