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The Inflation Reduction Act of 2022 (IRA) was signed into law by President Biden on August 16, 2022. While group health benefits are not directly impacted, health insurance professionals will want to be aware of several healthcare and health insurance provisions in the bill.
Increased premium tax credits for low-income individuals, which were implemented in the 2021 American Rescue Plan Act, were set to expire at the end of 2022. IRA extends the increased premium subsidies through 2025.
Prescription Drug Price Negotiation by Medicare
IRA allows for the first time the Centers for Medicare & Medicaid Services (CMS) to negotiate drug prices under Medicare Parts B & D.
$2,000 Annual Cap on Medicare Part D
IRA places a $2,000 annual cap on out-of-pocket costs for prescription drugs under Medicare Part D, starting in 2025.
Penalties if Drug Companies Increase Prices Faster Than Inflation
IRA places inflation caps in Medicare Part D that limit price increases for drugs year over year. Tax penalties will be levied on drugmakers that increase the prices of their products more than the rate of inflation.
$35 Out-of-Pocket Cost Limit on Insulin
IRA places a $35 out-of-pocket cost limit on insulin for individuals under Medicare.
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