Biden-Harris administration urges lower commercial insurance drug prices

Changes to the Inflation Reduction Act

The Biden administration’s Inflation Reduction Act prescription drug law, effective since August 16, 2022, aims to reduce prices for commercial insurance in addition to its impact on prescription medications.

Relief for Medicare Enrollees

The law lowers prescription drug costs for individuals with Medicare, enhancing the program for current and future users. This reduction in drug costs has expanded access to medications for many Medicare enrollees.

Biden-Harris Administration Initiatives

President Biden’s Fiscal Year 2025 budget aims to further the Inflation Reduction Act‘s impact by lowering prescription drug costs for millions more Americans, including the 189 million under-65 individuals with private commercial insurance.

Proposed Changes for Commercial Insurance

The proposed new component of the law includes:

Medicare Negotiating Additional Drug Prices

Expanding Medicare’s negotiations beyond the current limit of 20 drugs per year to include medications commonly used by individuals with disabilities and seniors, such as those for heart disease, diabetes, and cancer treatment.

Increased Out-of-Pocket Cost Cap

Proposed changes would extend the out-of-pocket prescription drug cost cap to cover all private commercial insurance market plans.

Trial Medicare Reduced Cost Sharing

The Center for Medicare & Medicaid Innovation is exploring a model to reduce cost-sharing for high-value generic drugs, potentially setting a $2 limit for a month’s supply, impacting cost-sharing across all Medicare commercial insurance plans.

Expanded Insurer Rebate Payments

President Biden is pushing for Congress to broaden the Inflation Reduction Act‘s insurer rebate payment requirements to include commercial drug sales, similar to existing rebates for Medicare.