Fact Sheet: Biden-Harris Administration Calls on Congress to Reduce Drug Prices for Americans with Private Insurance

The Inflation Reduction Act: A Game-Changer for Medicare Enrollees

The landscape of healthcare in the United States is undergoing a transformation with President Biden’s recent signing of the Inflation Reduction Act on August 16, 2022. This groundbreaking legislation is set to provide significant financial relief to millions of Medicare beneficiaries by expanding benefits, reducing drug costs, and fortifying the Medicare program for the future.

Key Benefits for Medicare Enrollees

  • $35/month Cap on Medicare-Covered Insulin: Under the new law, the cost of each Medicare-covered insulin product is capped at $35 per month.
  • Free Recommended Adult Vaccines: Medicare Part D enrollees now have access to free recommended adult vaccines, such as shingles and RSV.
  • Enhanced Marketplace Plan Subsidies: Eligible individuals can benefit from continued enhanced subsidies for Marketplace plans, reducing premium costs.
  • Rebates on Drug Price Increases: Drug manufacturers are required to pay rebates to Medicare if they raise prices for certain drugs above the inflation rate, leading to reduced costs.
  • $2,000 Annual Cap on Medicare Part D Costs: Starting in 2025, there will be a $2,000 annual cap on out-of-pocket costs for Medicare Part D.
  • Medicare Negotiating Drug Prices: Medicare will now directly negotiate drug prices with manufacturers, ensuring fair pricing for beneficiaries.

Expanding Benefits Beyond Medicare

President Biden’s FY 2025 budget seeks to expand the benefits of the Inflation Reduction Act to a broader population, including the 189 million Americans under 65 with private insurance coverage. The proposed measures include:

  • Medicare Negotiating More Drug Prices: The President advocates for Medicare to negotiate prices for a wider range of drugs, including those crucial for treating conditions like heart disease, cancer, and diabetes.
  • Expanded Out-of-Pocket Cap: A call to extend the $2,000 out-of-pocket cap in Medicare Part D to all private insurance market plans, providing greater financial security for millions of Americans.
  • Cost-Sharing Reduction for Generic Drugs: Proposing a new model to reduce cost-sharing for high-value generic drugs in Medicare to $2 for a month’s supply, with the aim of implementing this across all Medicare plans.
  • Requirement for Drug Companies to Pay Rebates: The legislation mandates drug manufacturers to pay rebates to Medicare for price increases exceeding the inflation rate, a measure that could lead to reduced prescription drug prices and lower health insurance premiums.

Read More of this Story at www.einnews.com – 2024-03-11 13:48:00

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