From the At-Least-It's-Something Dept.

The House of Representatives passed the "Inflation Reduction Act" the other day. It's the climate, health care, tax, and kitchen-sink "budget reconciliation" bill that the Democrats have been struggling for months to get through Congress. The Senate had already passed it, and the President will be signing it soon.

I remain skeptical of most of what's in there. It isn't going to "reduce inflation" – that was slapped on the title page to help get Emperor Manchin's vote. The tax part of the law is almost laughably weak. And the concessions that were made to the fossil fuel industry to get Manchin to go along are all big steps backward, while the other climate provisions seem like tentative steps forward.

But looking more closely at the health care provisions, I have to admit that some good stuff is included. Having the federal government negotiate drug prices with Big Pharma gets all the headlines, but not many drugs are going to be on that bargaining table, at least not at first.

No, to me the most significant features of the soon-to-be-law have to do with capping the co-pays that patients have to fork over to get their prescription drugs:

New vaccine and insulin cost caps would... take effect in 2023. Under the bill, all vaccines recommended by the federal Advisory Committee on Immunization Practices will be fully covered by Medicare, as well as by Medicaid and the Children’s Health Insurance Program. For Medicare beneficiaries who need insulin, out-of-pocket costs would be capped at $35, and starting in 2026, the cap would be $35 or 25% of the negotiated price if that is lower.

Another big saver for Americans enrolled in Medicare would be a $2,000 cap on out-of-pocket drug costs, which would begin in 2025. According to KFF [Kaiser Family Foundation], 1.5 million Medicare beneficiaries paid more than $2,000 for their drugs in 2019. According to an analysis by the Council for Informed Drug Spending Analysis based on data from 2012, about 3.5 million beneficiaries would likely save more than $1,500 a year.

Starting sooner, in 2024, people whose out-of-pocket drug costs reach the “catastrophic” threshold of $7,050 won’t have to pay any additional money on drugs that year. Currently, there is no cap, and people must pay 5% of the cost of extremely expensive drugs after hitting the threshold.

I like the sound of all of that. Like so much of this bill, it falls short of the ideal and therefore must be viewed as "just a start." Straightening out private medical insurance practices must be left to another day, and I doubt that day will be soon. But they are starting somewhere now, with no major steps backward that I can see on the health care front, and that is worth some loud applause. 


  1. Just imagine what could be done if a few Republican't senators were interested in making the country a better place.

    1. Yeah look how Portland makes the world a better place with Republicans fully purged for decades.


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