What changes are coming for Medicare users?

Published 8:02 am Thursday, December 22, 2022

The Inflation Reduction Act was signed into law in August and caught the attention of many due to its sections on clean energy and climate change. However, the bill also contains changes regarding health care that will go into effect next month. 

Starting Jan. 1, Virginians under Medicare and the Affordable Care Act will see some relief in their medical costs. Here is what to know about the new law. 

For those under the Affordable Care Act, the enhanced subsidies placed by Congress due to the pandemic will extend for three years through 2025. This will keep health care premiums low for the 300,000 Virginians under the Affordable Care Act. If this had not been extended, the Center for Medicare & Medicaid Services predicted that Virginias under the Affordable Care Act would have seen a $71 increase in their premiums next year. 

“I am very happy about expanding the enhanced subsidies for the Affordable Care Act,” said Sen. Tim Kaine. “I’ve always been a strong supporter of the Affordable Care Act. Back in August 2017, I cast my vote and it was decided by one. We didn’t know a pandemic was right around the corner and Covid could have been worse than it already was if so many people had lost their health coverage. We never know what’s right around the corner.” 

The Inflation Reduction Act also provides numerous benefits for seniors on Medicare. One of the most notable is that this will cap insulin prices at $35 a month. As Kaine’s fellow Virginia senator Mark Warner points out, in past years seniors have paid thousands of dollars out of pocket just for insulin. 

“The cost of diabetes is huge,” said Warner. “I see this in my personal life as my daughter has type 1 diabetes and the price has gone up four times in the past 20 years. Luckily we are able to afford it but many can’t. This only helps those on Medicare, but it’s a step in the right direction.”

Even though this is a highly debated topic, those on Medicare will receive free coverage for vaccines. This includes the shingles vaccine along with others in hopes to prevent serious illnesses. 

Prescription drug costs

The Inflation Reduction Act also establishes a $2,000 cap on out-of-pocket costs for prescription drugs. Looking forward, the bill also allows Medicare to negotiate drug prices for seniors and people with disabilities. This won’t be something seniors will see right away, but will start seeing it in years to come.

“This is something I have fought for for years,” said Kaine. “There should be negotiations rather than just accepting the prices given to us. It’s taken a while to get here, but I feel it will be very beneficial.” 

Along with the $2,000 cap on out-of-pocket costs for prescription drugs, the bill expands the Low-Income Subsidy program that currently helps cover prescription drug costs for over 11,000 low-income Virginians with Medicare.

“Health care cost is still too high and with overall inflation, we need something to help Virginians,” said Warner. “There are too many people who have to choose between food and medicine and that should never be a problem.”