Following the U.S. House passing the Inflation Reduction Act on Friday, August 12, President Biden signed the bill into law today. Along with being the largest investment ever in addressing climate change, this law contains features to help individuals and seniors with healthcare costs.
Continued financial assistance and coverage for Individuals and Families
A large portion of America benefit from the raised tax credits put in place during the pandemic under the American Rescue Plan Act (ARPA). The IRA extends this assistance through 2025 as well as solidifying the year ‘round SEP for Marketplace consumers whose income is under 150% of the Federal Poverty Level. This extension is critical to helping the millions of people who are expected to lose Medicaid coverage at the end of the declared public health emergency transition to marketplace coverage once states begin conducting eligibility redeterminations.
Big steps to help our Seniors
The IRA includes comprehensive reforms to Medicare Drug pricing policies including Medicare drug price negotiation, Medicare inflationary rebates, and Medicare Part D redesign.
First, requires the Secretary of Health & Human Services (HHS) to negotiate prescription drug prices for Medicare, although it is limited.
Second, a policy which has worked effectively in Medicaid programs by limiting the rate at which companies increase the prices of existing prescription drugs.
Third, restructuring Medicare Part D to limit total out-of-pocket costs to $2000 per year and monthly insulin expense cap of $35. This restructure also helps protect seniors on fixed incomes by smoothing patients’ costs over a year.
Bad news for Insulin dependent individuals under 65
Individuals under 65 with Diabetes may feel a hit on insulin costs. The current cap of $35 monthly cost on insulin was not included to be kept in this law. Although there is no longer a Federal Cap, some states have places their own legislations to keep costs down on insulin. See here what your state has in place for state-level legislation.