Inflation Reduction Act: The Real Healthcare Agenda
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- Опубликовано: 2 июн 2024
- The Inflation Reduction Act was recently passed by Congress and Signed by President Biden.
This new law has several healthcare changes:
1) ACA Marketplace Plans (aka Obamacare Plans) will have continued increased subsidies for 3 more years through 2025
2) Medicare will be able to negotiate drug prices for 10 drugs starting in 2026
3) Medicare Part D prescription coverage will have many changes to limit price increases, out-of-pocket costs and premium increases.
4) The Removal of the Anti-Kickback Statute Safe Harbor for Pharmacy Benefit Managers has been further delayed from 2027 to 2032.
All of these changes make Traditional Medicare more attractive, which is part of an overall strategy of many politicians to expand Medicare coverage to more Americans.
President Biden has previously said that he would like Medicare coverage to start at age 60 instead of the current age of 65.
Sources:
www.kff.org/medicare/issue-br...
www.commonwealthfund.org/blog...
www.npr.org/sections/health-s...
www.pbgh.org/historic-drug-le...
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When we talk about provisions that apply to "Part D" (I'm interested in the $35 insulin copay cap in particular), should we consider this to include Medicare standalone PDP plans AND Medicare Advantage plans that include Part D coverage (MAPD)? I'm thinking about the implications this will have on how health plans will rank on Medicare's plan finder and if MAO's will have time to account for this in formularies posted ahead of the 2023 Annual Election Period. Thanks for your videos btw, I share them with my health plan colleagues often!
It does apply to BOTH MAPD and Part D plans (we do Medicare). His videos are the BEST.
Thank you for your kind words.
Dr. Bricker, on negotiating drug prices could you please clarify a point for me? I believe that Medicare Part A covers drugs that you receive while in the hospital; Medicare Part B covers a few outpatient prescription drugs; and Medicare Part D is the prescription drug plan that someone on Medicare can purchase from an insurance company. So when everyone says that Medicare isn't permitted to negotiate drug prices with pharma companies it only relates to the limited circumstances of the drugs covered under Parts A & B, not Part D as the insurance companies sponsoring the Part D plans are already negotiating with the pharma companies. Is that correct?
Thank you for watching and for your question.
I think the point is Medicare would negotiate a better price than the Part D insurance company and then that lower price would be used instead.
Dr. Bricker, you have no idea how your videos are impacting folks - a TREMENDOUS VALUE ADD to both the health care delivery AND health insurance industries. And I agree 100% this is the beginning of universal healthcare. Boom.
Super! Great to hear. Thank you for watching!!
With Medicare expansion by lowering age eligibility, doesn’t that go against how the Medicare Part A HI trust fund is expected to deplete by 2026-2030? One of the strategies to help the HI fund is by increasing eligibility age, not decreasing. I’m assuming there is an offset somewhere on increasing member cost sharing , payroll taxes, etc
Oh yes, the money will be ‘found.’
Thank you for watching and for your comment.
Also, doesn’t the affordable insulin now act cap prices not only for Medicare part d but also private insurance plans?
I believe it is only Medicare. Thank you for watching and for your question.
Many states now mandate a cap on insulin for commercial plans as well. Like $100 cap in CO, $75 in LA, or $30 in KY, etc.
Hi Doctor! Have you made any videos on drug pricing and the pros and cons for price controls in this area?
I have not. Thank you for the suggestion.
I disagree with mandating cost free preventive care, all it does it shifts the cost into premia and deductible. There should be a nominal cost share for things like vaccines etc.
Thank you for sharing your opinion. Appreciate you leaving a comment.
As a PCP caring for the indigent, I couldn't disagree more. This makes it much easier for me to keep my patients safe when they come in for visits.
Yes the cost will be past on.
Thank you for sharing your thoughts.
Interesting thank you
Thank you for watching and for your comment, Sanad.
inflation reduction act make insurance companies non profit stop price gouging problem solved
Thank you for sharing your thoughts.