After more than a year of debate and negotiations, sweeping legislation was signed into law today related to health care, climate and tax policy. Dubbed the Inflation Reduction Act (IRA), the measure includes provisions long supported by Susan G. Komen’s Center for Public Policy that will benefit the breast cancer community:
- Millions of Americans, including breast cancer patients and survivors, will continue to receive financial support for private health insurance premiums. The IRA extends these enhanced subsidies for middle-income Americans, called advance premium tax credits, which were enacted in 2021 as part of the American Rescue Plan, a COVID-19- related relief package. These subsidies were set to expire by the end of the year, but now have been extended for 3 years.
- The IRA also includes reforms to drug benefits under the Medicare program. Beginning in 2024, the IRA eliminates the current 5 percent patient coinsurance cost for Part D catastrophic coverage and expands eligibility for Part D low-income subsidies. In 2025, the law lowers Medicare patients’ out-of-pocket costs, capping them at $2,000 per year, with the critical new option to break that amount into affordable monthly payments.
Komen’s Center for Public Policy has long pushed policymakers to make health insurance more affordable and lower patients’ out-of-pocket costs. Komen was disappointed the legislation did not extend the provision to close the Medicaid gap to ensure continued coverage for Americans living in the 12 states that have not expanded the program. However, the health provisions in the IRA are welcomed changes that will benefit Americans and is an important step in the right direction.
Congress is paying for these essential patient support programs and protections using reforms to tax and drug reimbursement systems. Regarding prescription drug policy, the IRA requires manufacturers to pay a rebate back to the government if they raise prices higher than inflation starting in 2023. The IRA also will allow Medicare to negotiate prices for certain high-cost, single-source drugs with large expenditures, starting in 2026.
Komen will be monitoring implementation closely to ensure the breast cancer community is not negatively impacted by these reforms.
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