How Does the Inflation Reduction Act of 2022 Affect You?

A dollar sign sits next to an arrow points downward, representing the effect of the Inflation Reduction Act

11 Aug How Does the Inflation Reduction Act of 2022 Affect You?

Posted at 16:57h in Health Insurance, Medicare by Triage Cancer

Tomorrow (August 12, 2022), the U.S. House of Representatives will vote to pass the Inflation Reduction Act, which was passed by the Senate on Saturday. If it passes, as expected, the President has stated that he will quickly sign it. Why does a bill called the Inflation Reduction Act impact the cancer community? Keep reading to find out!

What is the Inflation Reduction Act of 2022?

The Inflation Reduction Act is a federal bill that invests in domestic energy production and manufacturing, reduces carbon emissions that have a significant impact on our climate, and allows Medicare to negotiate with pharmaceutical companies on the price of prescription drugs.

But, the bill also does three very important things that lower the cost of health insurance and prescription drugs, and increase access to care. The bill:

Improves Medicare coverage;
Improves Medicaid coverage; and
Improves access to health insurance for individuals and families.

How does the bill improve Medicare?

Prescription drugs

Beginning 2025, the out-of-pocket expenses for prescription drugs will be capped at $2,000 for the year. This applies to people with Medicare who have prescription drug coverage through a Part D plan, or through a Part C Medicare Advantage Plan.

It also allows people to spread out their out-of-pocket costs throughout the year, in monthly payments, rather than having to pay a large amount up front to get care.

For example, if you take a prescription drug that now costs you $3,000 a month out-of-pocket, you only have a pay $2,000 for that drug for the whole year. And, you don’t have to pay that $2,000 all at once, in January, when you go to get your prescription. Instead, the cost can be spread out monthly.

This is a huge benefit for people with Medicare, and the impact on people’s finances will be substantial. The only downside is that this new benefit will not begin until 2025.

Insulin

The bills also caps what people on Medicare have to pay for insulin to $35 a month.

Vaccines

Beginning in 2023, people with Medicare Part D will not have to pay out-of-pocket costs for certain vaccines.

Medicare Financial Help

Beginning in 2024, more people will be eligible for the low-income subsidy, which provides financial help for people with lower incomes, to pay their out-of-pocket costs for Medicare. The eligibility threshold will be expanded to people who have incomes below 150% of the federal poverty level.

How does the bill improve Medicaid?

The bill improves access to certain adult vaccinations under Medicaid and CHIP and eliminates some out-of-pocket costs.

How does the bill expand access to health insurance for individuals and families?

Under the Affordable Care Act, individuals and families can purchase health insurance coverage through state Health Insurance Marketplaces. The Marketplaces offer health insurance plans from private insurance companies.

But there are some benefits to buying a plan through the Marketplace, including getting access to financial assistance to lower your monthly premium. The amount of financial assistance is based on your income level.

Due to COVID, the federal government increased the amount of financial assistance to help people buy plans in the Marketplace. On average, 4 out of 5 people get financial help, with some people getting access to plans that are $10 or less per month.

But, that increased financial assistance was going to end on December 31, 2022.

This new bill extends the increased financial help through 2025, which will help millions of people stay insured.

For more information about health insurance, see our Health Insurance Materials & Resources.

About Triage Cancer

Triage Cancer is a national, nonprofit providing free education to people diagnosed with cancer, caregivers, and health care professionals on cancer-related legal and practical issues. Through events, materials, and resources, Triage Cancer is dedicated to helping people move beyond diagnosis.

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