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Medicare Rights Supports Legislation Extending Inflation Reduction Act Affordability Reforms to the Commercial Market

September 16, 2024  
•  Press Releases

New York, NY—Today, Medicare Rights Center President Fred Riccardi spoke in support of the Capping Prescription Costs Act (S. 4671/H.R. 6347), legislation to extend key Inflation Reduction Act reforms to people with group health and marketplace plans. Mr. Riccardi issued the following statement.  

“The Inflation Reduction Act (IRA) took vital steps to lower beneficiary and Medicare costs. It limited monthly insulin co-pays to $35, made necessary vaccines free of charge, and expanded eligibility for critical Medicare cost assistance, the Part D Low Income Subsidy. The Medicare negotiation program is expected to further reduce cost and access barriers. 

“Importantly, the IRA also created a hard cap on annual out-of-pocket spending for Part D enrollees. Starting next year, the most a Medicare beneficiary will pay for covered prescription drugs is $2,000. This maximum amount will update annually for inflation, and the law is already shielding beneficiaries from potentially unlimited drug costs. In January, the IRA eliminated cost-sharing in the Part D catastrophic coverage phase, effectively holding enrollee spending at roughly $3,300 in 2024. 

“These are watershed moments. For the first time in Medicare’s history, people with Part D have certainty about their cost obligations, allowing them to plan more and worry less. 

“For too many years, our national helpline callers have reported problems with prescription drug affordability. The IRA’s cost protections chart a new course forward. They are making a transformative difference in the lives of people with Medicare, especially for beneficiaries with high health needs and fixed or limited incomes. 

“However, financial challenges persist. We still hear from older adults and people with disabilities who are trying to make ends meet, as well as from people who are not yet Medicare-eligible and are similarly struggling to pay for care. 

“They need swift, meaningful action. This means making Medicare low-income assistance more available, lowering and limiting costs program-wide, and filling harmful coverage gaps, like Medicare’s lack of comprehensive vision, dental, and hearing care. It also means shoring up non-Medicare coverage so that all Americans can get the care they need when they need it. 

“Ensuring timely access to high-quality, affordable health care is not only the right thing to do but is also cost-effective. Independent analysis finds the IRA will generate significant savings. By increasing prescription drug affordability, the law will improve adherence rates and health outcomes. This will reduce dangerous care delays and expensive acute interventions, ultimately lowering costs for beneficiaries, taxpayers, and the program.  

“Cost savings are already accruing. In 2025, the IRA’s Part D reforms are projected to lower enrollee out-of-pocket expenses by nearly $400 per person, on average, and enrollees in New York are expected to save over $446 million, in addition to $196 million in 2024

“The Medicare Rights Center strongly supports building on these successes within Medicare and extending them to people with other types of coverage.  

“That’s why we are pleased to endorse the Capping Prescription Costs Act. This commonsense bill would limit prescription drug costs for people with commercial insurance—promoting economic security, access to care, and peace of mind. 

“Thank you, Senator Gillibrand, for championing this legislation, as well as the IRA consumer protections that underpin it. 

“And thank you to Senators Bob Casey (D-PA), Raphael Warnock (D-GA), Amy Klobuchar (D-MN), John Fetterman (D-PA), Richard Blumenthal (D-CT), Chris Van Hollen (D-MD), Martin Heinrich (D-NM), Tammy Baldwin (D-WI), Peter Welch (D-VT), and Patty Murray (D-WA) for cosponsoring this bill in the Senate, and to Representatives Kathy Manning (D-NC) and Steven Horsford (D-NV) for leading the House companion bill. We look forward to working together towards passage.”

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The Medicare Rights Center, a national nonprofit consumer service organization that works to ensure access to affordable health care for older adults and people with disabilities.

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