Impact of Inflation Reduction Act on Health Benefits

The Inflation Reduction Act, signed into law on August 16, 2022, contains many healthcare provisions, some of which will take effect in the beginning of 2023:

• The enhanced subsidies for purchasing a Qualified Health Plan, put in place by the American Rescue Plan Act (ARPA) of 2021, will continue for an additional three years, through 2025. Meaning those with incomes above 400% FPL can continue to claim the premium tax credit if otherwise eligible.
• Medicare changes:
  • Copays for insulin will be capped at $35/month for those with Medicare Pard D, as well as for insulin covered through Part B, with no deductible.
  • Drug companies are required to provide rebates to the government if the price of their drugs rise faster than the rate of inflation.
  • Vaccines covered under Part D, such as the shingles vaccine, will be covered at 100%, not subject to the deductible or cost-sharing.

Future provisions include:

• Beginning in 2024, eligibility for full Extra Help for Part D cost sharing will be expanded from 135% FPL to 150% FPL.
• 2024: $0 cost sharing once one reaches Part D catastrophic coverage.
• 2024-2029: Limits Part D premium increases to 6% annually.
• 2025: Out-of-pocket costs for Part D for beneficiaries will be limited to $2,000.
• Beginning in 2026, Medicare can start to negotiate drug prices for a limited number of drugs.

For more information go to https://www.whitehouse.gov/wp-content/uploads/2022/08/New-York-Health-Care.pdf.