Prescription drug changes included in the Inflation Reduction Act signed into law in August could reliably be characterized by adjusting Neil Armstrong’s famous quote when he stepped out onto the moon – that’s one small step for prescription cost changes; one giant leap for seniors on Medicare.
The good news is that provisions included in the act will help thousands of older adults with Medicare better afford their prescriptions, with some relief happening as early as 2023.
The not-so-good news is that there might have been more done to help a broader group of people and that even some of the positive changes won’t begin until 2026 or later, doing little to help struggling seniors in the short term.
In a live Facebook conversation, Congresswoman Lori Trahan and AARP Massachusetts Director Mike Festa discussed the positives and negatives behind the changes, how the law came together, and what older adults in Massachusetts can expect going forward.
Based on their conversation and interpretation, here are some of the benefits of the new law:
- Medicare Part D beneficiaries will have their share of prescription expenses capped at $2,000 a year, as of 2025.
- Premiums for Part D cannot increase more than six percent a year through at least 2029.
- Income levels for qualifying for Medicare Part D expand from 135 percent of the federal poverty level to 150 percent of the federal poverty level.
- A list of 10 drugs will be open to price negotiations with negotiations to begin in 2023 and price changes to happen in 2026. More drugs will be added to the negotiation list in subsequent years, with as many as 60 to be included by 2029.
- The cost of insulin for Medicare beneficiaries is capped at $35 a month.
In their discussion, both Trahan and Festa noted that many seniors will see their prescription expenses dramatically reduced from the decision to cap Medicare Part D costs to $2,000.
“For the 1.3 million Medicare Part D recipients who exceed the cap, we’re talking about thousands and thousands of dollars they’re paying out of pocket,” said Festa. “The certainty of knowing that once you get to a $2,000 cap there’s not going to be another bill, that certainty will impact lots of seniors in Massachusetts.”
They also praised the list of 10 drugs whose prices can be negotiated beginning in 2023 but recognized that the delay for when those prices take effect will be painful for older adults who are already forced to choose between daily necessities and expensive prescription medications.
“(Prices are) not going to kick in essentially until 2026, and that’s a challenge because it doesn’t give us the instant solution to the problem,” said Festa.
Festa also criticized the decision to limit insulin price cuts to those on Medicare instead of everyone who relies on the drug, saying AARP will continue to work to expand that price limit to more people.
“This was a compromise and it was not right,” he said. “There’s more to be done…We’re going to keep that fight going and extend it to everyone who is getting that insulin and that means the private markets.”
See the entire Facebook conversation on Rep. Trahan’s page at Facebook.com/RepLoriTrahan. For more information on these changes and more prescription drug information, visit aarp.org/prescriptiondrugs.