The Inflation Reduction Act and Healthcare

Portions of the “Inflation Reduction Act” benefit Medicare recipients and those insured through the Affordable Care Act Marketplace.

The impacts include the following:

  • Enhanced federal tax credits to save millions of people an average of $800 a year on health insurance premiums on the Affordable Care Act Marketplaces.
  • Limits the amount of money people with Medicare Part D pay out-of-pocket for prescription drugs at $2,000 a year.
  • And, after years of debate since Part D was passed, Medicare will finally have the ability to negotiate the price of prescription drugs to help seniors, people with disabilities, and taxpayers pay less. 

This is also in light of a recent Kaiser Foundation study that found that:

  • Price increases outpaced inflation for half of all drugs covered by Medicare in 2020.
  • In terms of drugs with the highest total spending, 23 of the top 25 Part D drugs and 16 of the top 25 Part B drugs had price increases above inflation between 2019 and 2020.

What drugs are all of us and particularly seniors seeing rise faster than inflation? The list eerily includes drugs we see in national marketing campaigns like:

  • Eliquis (Blood thinner)
  • Xarelto (Blood thinner)
  • Trulicity (Diabetes)
  • Biktarvy (HIV)
  • Symbacort (COPD)

Even worse when we look at the list, we can note that all these medications have something in common, they are used to treat long-term diseases and the profits on these drugs go on for years. Recently, the manufacturers of both Eliquis and Xarelto were granted extensions to their patents, these are not new drugs.

If Medicare can negotiate with drug companies, we would hope that the cost of these high-priced drugs could drop to the amounts patients in other countries pay for them. Let’s hope so.   

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Timothy Powell, CPA, CHCP

Timothy Powell is a nationally recognized expert on regulatory matters, including the False Claims Act, Zone Program Integrity Contractor (ZPIC) audits, and U.S. Department of Health and Human Services (HHS) Office of Inspector General (OIG) compliance. He is a member of the RACmonitor editorial board and a national correspondent for Monitor Mondays.

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