The Inflation Reduction Act (IRA) will make key changes to improve drug affordability for people who have Medicare. IRA Part D drug-related provisions include instituting a $35 out-of-pocket cap on a month’s supply of each covered insulin, eliminating out-of-pocket costs for Advisory Committee on Immunization Practices (ACIP)-recommended adult vaccines under Part D, imposing a maximum out-of-pocket cap of $2,000 starting in 2025, and eliminating the coverage gap phase. In 2025, the IRA Part D drug-related provisions will lead to an estimated $7.4 billion reduction in annual out-of-pocket spending for 18.7 million enrollees (LIS and non-LIS). This translates to about $400 per person among enrollees who have savings in out-of-pocket costs.
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- Insulin Affordability and the Inflation Reduction Act
- Report to Congress on the Affordability of Insulin
- IRA Elimination of Part D Covered Vaccine Cost-Sharing
**ALERT – ASPE is in the process of revising the race and ethnicity data in the Research Report. We caution users to wait for the revised data on race and ethnicity to be posted to the website. Note that the Research Report currently uses race and ethnicity information that CMS obtains from the Social Security Administration (SSA). This information has been shown to substantially undercount the number of Hispanic and Asian American/Pacific Islander beneficiaries. To address this undercount, CMS has developed the Research Triangle Institute (RTI) race and ethnicity recoding algorithm, commonly known as “RTI race.”
ASPE is in the process of revising the current results using the RTI race measure.
For further reading on race and ethnicity information in Medicare data, see: Filice, Clara E. MD, MPH, MHS; Joynt, Karen E. MD, MPH. Examining Race and Ethnicity Information in Medicare Administrative Data. Medical Care 55(12):p e170-e176, December 2017. DOI: 10.1097/MLR.0000000000000608. https://journals.lww.com/lww-medicalcare/abstract/2017/12000/examining_race_and_ethnicity_information_in.26.aspx