The Senate and the House passed the Inflation Reduction Act (IRA) and President Biden signed it into law six days ago. As I’ve said before (in this blog) it has some good things and some bad things. It was passed on a purely partisan vote, with the 50 Democrat Senators voting yes and the 50 Republican Senators voting no, and Vice President Harris voting yes to break the tie. It was a party line vote in the House with 220 Democrats voting yes and 207 Republicans voting no. Once again, our government chose to pass a purely partisan piece of legislation that will have a huge impact on seniors in this nation. I’ve written previously about the evils of partisan governing here. It’s not good when a small majority can pass such important legislation.
So, before we get into the new law, I’m going to rant a little. Maybe some math will highlight the reason for my displeasure. The vote was 50 for and 50 against the bill in the Senate so, from the Senate perspective 50% of us had Senators that were against the IRA. There were 13 more House members (all Democrats) that voted for the IRA than voted against it. The average size of a House district is 761,000 so the difference in citizens represented by the 13 yes votes was 9,893,000. With the population of the United States at 329.5 million the ratio of those 9,893,000 yes votes to no votes of citizens represented was 3%. That 3% made the difference and they were all in districts of Democrats. A bill of this magnitude should not pass on such a slim majority. Somehow, our country needs to figure out how to work together to develop laws that are bipartisan.
Ok, let’s talk about this new law. I’m only going to talk about the healthcare portions of the law and only those that affect older Americans. I’ll go year by year since many of the changes won’t go into effect for a few years. I’ll try to keep it short and to the point.
- The price of some drugs may not increase as fast since the manufacturer must pay a rebate if they raise prices above inflation. I wonder how much a benefit this will be if inflation stays high.
- Out-of-pocket costs for insulin is capped at $35 a month.
- Reduces the cost for adult vaccines.
- If you reached the catastrophic phase of your Medicare Part D coverage, which means you spent $7,050 on drugs, that’s all you’ll have to pay. Eliminates the 5% coinsurance that you used to pay.
- Expands the eligibility for the Part D low-income subsidy.
- Starting in 2024 and continuing through 2030 Part D premium growth is capped at a maximum of 6% per year.
- Part D 0ut-of-pocket costs are capped at $2,000 per year.
- The payment of drug costs can be smoothed out over the entire year.
- Government price controls will be implemented on 10 selected drugs. This may affect what you pay depending on the drugs you take.
- Government price controls will be implemented for 15 more drugs, for a total of 25.
- The Trump Administration’s drug rebate rule, which had been delayed until 2027, will be further delayed until 2032.
- Government price controls will be implemented for 15 more drugs, for a total of 40.
- Government price controls will be implemented for 20 more drugs, for a total of 60.
The amount of savings generated by government price controls for any one individual will depend on a lot of variables. The Kaiser Family Foundation, a non-partisan information source on healthcare, said the following about possible savings.
“The number of Medicare beneficiaries who will see lower out-of-pocket drug costs in any given year under this provision will depend on how many beneficiaries use drugs whose prices increase more slowly than would otherwise occur and the magnitude of price reductions relative to baseline prices.”
These are the pocketbook impacts of this new law for seniors. What hasn’t been discussed much since this bill was signed into law is the other impacts of this new legislation, like the constraint to the development of new drugs. This will be especially felt by the small bio firms which produce many of the new scientific break throughs. This law doesn’t do anything to add more transparency and efficiency to the drug supply line. There were many improvements that could have been done that would have saved money and improved access that were not considered.
As with all big changes to our healthcare system, the real impact will depend on how the law is implemented and how the providers, drug manufacturers and insurance companies react to the changes. There is much more to understand about this bill, and we must still stay involved as it is implemented. The devil is in the details and the details will reveal the real impact these big changes will have on each of us. We’ll stay involved through the process and we hope that you will stay involved also.