Good news! (In a few years, anyway.)
The reconciliation bill, which passed Aug. 12 in the House and now goes to President Joe Biden, would lower at least some Medicare beneficiaries’ prescription costs on Part D, Medicare’s prescription drug program, and on Part B, which covers drugs administered in a doctor’s office, by:
- Requiring the federal government to negotiate prices for some Medicare drugs, 10 medications to start in 2026, rising to 20 in 2029.
- Capping seniors’ out-of-pocket costs at $2,000 a year for Medicare’s prescription drugs.
- Requiring rebates from drug companies if their prices increase faster than inflation.
- Expanding eligibility for prescription drug benefits in the Part D low-income subsidy program.
- Capping monthly insulin copays at $35.
- Making vaccines free, with no out-of-pocket costs.
- Limiting Part D premium increases.
Impact on Beneficiaries
Seniors who spend more than $2,000 a year on prescriptions would clearly benefit. That provision would launch in 2025, and could affect more than 1.4 million beneficiaries, according to Kaiser Family Foundation estimates based on 2020 enrollee data.
Right now, out-of-pocket costs of more than $7,050 for Part D drugs bumps seniors into what’s called the “catastrophic” phase — they pay 5% of their drug costs after that threshold. The reconciliation bill — called the Inflation Reduction Act — would eliminate the 5% copay in 2024, benefiting more than 1.3 million seniors, KFF estimates, as a precursor to implementing the $2,000 out-of-pocket cap the following year.
NEXT will provide more information on this new legislation, as well as a presentation as more information becomes available. In the meantime, learn more at: https://www.aarp.org/politics-…