3 Ways the Inflation Reduction Act Could Save You Money on Health Care

3 Ways the Inflation Reduction Act Could Save You Money on Health Care
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After a marathon session that stretched from Saturday night into late Sunday afternoon — and included 39 roll call votes on proposed changes to the bill — the Senate passed the Inflation Reduction Act, a sweeping health care, climate and tax reform bill that could cut the price you pay for prescription drugs.

The 755-page bill would invest $369 billion in clean-energy initiatives, set a corporate minimum tax rate and boost funding for the Internal Revenue Service. According to the nonpartisan Congressional Budget Officeit could also reduce the federal budget deficit by $102 billion over 10 years.

On the health care front, the Inflation Reduction Act would extend expiring subsidies for Affordable Care Act health insurance through 2025 and give Medicare the power to negotiate prescription drug prices for the first time ever. That could lower the price of medications for the millions of Americans on the plan, according to the White Houseand reduce federal spending on prescriptions.

The Democrat-controlled House of Representatives is expected to take up the bill on Friday, and President Joe Biden has signaled he intends to sign it into law.

Here’s how the Inflation Reduction Act could save you money on your health care costs.

1. Allows Medicare to negotiate prescription drug prices

To address the cost of prescription drugs, the bill would let Medicare annually negotiate prices with pharmaceutical companies on 10 pricey medications, starting in 2026.

Fifteen more high-cost and high-use drugs would be added the following year, another 15 in 2028, and 20 more drugs would make the list in 2029.

“Currently, our drug pricing system works for corporations and middlemen, not patients,” Senate Democrats said in a statement On Sunday. “The new negotiation policy will ensure that patients with Medicare get the best deal possible on high-priced drugs and pay cost-sharing for those drugs based on the Medicare negotiated price.”

The $740 billion bill includes $288 billion for prescription drug pricing reform for the more than 63 million seniors and others who use Medicare.

It also closes a “rogue Secretary” loophole that could allow a future administration to refuse to try to get the best prices “or negotiate fewer than the maximum number of drugs,” according to Senate Democrats.

Read more: How to Sign Up for the Healthcare Marketplace Under the Affordable Care Act

A senior looking at a bottle of pills

Prescription costs would be capped at $2,000 a year for seniors on Medicare Part D drug plans.

Jose Luis Pelaez/Getty Images

2. Caps annual drug costs for Medicare Part D enrollments

In addition to negotiated drug prices, the bill would cap out-of-pocket prescription drug costs at $2,000, starting in 2025, for those with Medicare Part D drug plans.

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The cap on prescription drug expenses would come with an option to break that into monthly payments. The bill also covers free vaccines and sets a $35 cap on insulin for Medicare recipients, starting in 2023.

3. Subsidizes health insurance bought on the Affordable Care Act marketplace

Notably, the bill enhances and extends subsidies to private health insurance bought through the public marketplace that were introduced in 2020 under the American Rescue Plan Act.

Before then, the assistance was generally available only to households with income from 100% to 400% of the poverty level. Now that income cap will be (temporarily) lifted, so no one pays a premium that’s more than 8.5% of their income.

In 2022, nearly 13 million of the 14.5 million Americans buying health care on the marketplace were receiving subsidies, saving an average of $800 a year, according to the White House.

In the 33 states that use HealthCare.gov, the federal insurance exchange site, premiums would be 53% higher on average this year if not for the extra ARPA subsidies, according to the Kaiser Family Foundation.

The same would be true in states operating their own exchanges, the foundation said.

What health care benefits does the Inflation Reduction Act leave out?

Senate Democrats didn’t get everything they wanted: The prescription drug provisions were weakened after Senate Parliamentarian Elizabeth MacDonough ruled that efforts to limit price increases on drugs to inflation rates went against the reconciliation process being used to pass the bill with a simple majority, The washington post reported.

It also isn’t clear yet which prescriptions the Secretary of Health and Human Services will be able to negotiate on.

“The battle over which therapies should be chosen will also be a regulatory lobbying frenzy,” Stat reported“and drugmakers have until 2026 to bend the policy to their will.”

And while an insulin price cap for Medicare users cleared the Senate, Republicans stripped one for people with private insurance.

What have been criticisms of the Inflation Reduction Act’s health care provisions?

A group of Republican physicians in Congress say they’re “deeply concerned” about the prescription drug caps in the Senate bill.

In a letter Monday to Senate Majority Leader Charles Schumer and House Speaker Nancy Pelosi, the GOP Doctors Caucus wrote that pricing controls could limit resources, stymie research and cause a significant drop in provider reimbursement.

Read more: How Mark Cuban’s Cost Plus Drugs Program Can Save You Hundreds on Prescriptions

Warning that “government price controls have consequences,” the caucus called for a bipartisan plan to lower drug costs “without sacrificing the cures and treatments that will provide for a healthier future.”

The letter was signed by Republican lawmakers including Sens. Bill Cassidy of Louisiana, a hepatologist; John Barrasso of Wyoming, a former orthopedic surgeon; and Rand Paul of Kentucky, a former ophthalmologist; as well as Reps. Scott DesJarlais of Tennessee, a general practitioner; Andy Harris of Maryland, an anesthesiologist; and Mariannette Miller-Meeks of Iowa, a former ophthalmologist.

What’s next for the Inflation Reduction Act?

Having passed the Senate, the bill now moves to the House, where it’s expected to pass without much trouble. Representatives are expected to return from their August recess on Friday for a vote.

It’ll then head to Biden, who’s already supported the measure, for signing.

“I ran for President promising to make government work for working families again, and that is what this bill does — period,” Biden said in a statement Sunday.

The information contained in this article is for educational and informational purposes only and is not intended as health or medical advice. Always consult a physician or other qualified health provider regarding any questions you may have about a medical condition or health objectives.

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