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To the Editor:

Two years ago this month, I wrote a column for this paper that highlighted the many benefits of the Inflation Reduction Act (IRA) for North Carolinians. This landmark legislation, approved by Congress with no Republican votes and signed into law by President Biden in August 2022, makes healthcare more accessible and affordable by granting Medicare the power to directly negotiate drug prices, extending subsidies for Affordable Care Act premiums, capping the cost of insulin for seniors at $35 a month, creating an annual cap on out-of-pocket drug costs for people with Medicare, and providing recommended vaccines for free to people with Medicare Part D.  On the two-year anniversary of this historic law, it is worth revisiting its status and exploring the positions of the two political parties as the November election draws near.

The IRA empowers Medicare to negotiate the price of certain prescription drugs with manufacturers. Earlier this month, the Biden Administration announced the results of its first round of price negotiations. These prices will be in effect starting January 1, 2026. According to the Centers for Medicare and Medicaid Services (CMS), if the new prices had been in effect last year, Medicare would have saved an estimated $6 billion, or approximately 22 percent, across the 10 selected drugs. Among the selected drugs are Eliquis, Jardiance, Xarelto, and Januvia. About nine million people with Medicare use at least one of the 10 drugs selected for negotiation, states CMS, which estimates that people with Medicare prescription drug coverage are expected to see aggregated estimated savings of $1.5 billion in their personal out-of-pocket costs in 2026. Additional drugs will be selected in future cycles of the drug negotiation program.

This provision, and the IRA as a whole, is not without its detractors. Republicans in Congress opposed the IRA and have decried the drug price negotiation program as price controls. The controversial Project 2025, a blueprint for reform created by the conservative Heritage Foundation and others, calls for repeal of the IRA and maintains that “these government price controls will limit access to medications and reduce patient access to new medication.”

Another provision of the IRA extended enhanced subsidies for those who get their health care coverage under the Affordable Care Act. Thanks to these subsidies, this year a record 21.4 million Americans, including thousands of North Carolinians, have signed up for coverage through ACA marketplaces. However, the enhanced subsidies are set to expire this year and must be made permanent by Congress so millions of Americans do not lose access to affordable health coverage.

In provisions effective last year, the IRA limited insulin copayments for Medicare enrollees to $35 a month. An estimated 1.5 million Medicare beneficiaries who use insulin would have saved $734 million in Part D and $27 million in Part B if these caps had been in effect in 2020. Some 116,000 North Carolina Medicare beneficiaries used insulin in 2020.

The IRA also provides free recommended vaccines for Medicare beneficiaries. In 2023, more than 10 million people received a free vaccine, according to CMS. Some 141,000 North Carolina Medicare beneficiaries received a Part D vaccine in 2020, and that number is expected to grow as those vaccines become more affordable.

Next year, everyone enrolled in Medicare prescription drug coverage will have their out-of-pocket costs capped at $2,000. That will provision will benefit about 51,000 North Carolina Medicare beneficiaries who would otherwise have out-of-pocket costs above the cap, according to estimates from the Kaiser Family Foundation.

Elections matter. The Inflation Reduction Act lowers health care and prescription drug costs for seniors and the Medicare program yet its future could depend on which party is in control of the White House. It passed on a close, partisan vote in Congress, with Vice President Kamala Harris, the Democratic presidential nominee, casting the deciding vote in the Senate in favor of the legislation.  Candidate Harris has pledged to build on these historic actions by working with Congress to cap the cost of insulin at $35 and out-of-pocket expenses for prescription drugs at $2,000 for everyone, not just seniors. Harris would also allow Medicare to accelerate the speed of negotiations so the prices of more drugs come down faster.

As someone who supports the policies in the Inflation Reduction Act that lower health care costs for America’s seniors as well as the Medicare program, I plan to vote for Democrats on November 5. I hope you will join me.

Laura Allendorf

Manteo

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