On the heels of a critically important vote in congress Rick Larsen was back in western Washington talking about the Inflation Reduction Act.
“It extends the premium subsidies for the Affordable Care Act (ACA) for 3 years to help folks who are otherwise struggling to pay for healthcare,” he told officials during a roundtable meeting at Compass Health, a leading provider of behavioral health services. President & CEO Tom Sebastian understands the urgency, “It allows us to be able to think about how we plan over the next 3 years to make sure we are as accessible as possible.”
Washington is a national leader in the recognition and treatment of a mental health crisis that exploded during the pandemic.
Affordable healthcare & lowering prescription drug costs for Medicare recipients is a key piece of this legislation.
For the first time since its creation in 2006, Medicare will be allowed to negotiate lower prescription drug prices for seniors in its Part D program. “It would save taxpayers and Medicare billions of dollars,” AARP’s Cathy MacCaul told reporters during a conference call, “this bill holds drug companies accountable when they increase drug prices faster than the rate of inflation.”
But the benefits won’t be available until 2026 and new drugs would not be subject to price limits.
“We don’t usually get a phone call until the Medicare beneficiary has gone to the pharmacy gets sticker shock on the medication” Robert Potts, principal broker at The Grace Agency, a Medicare insurance provider, says it’s hard to know how well these changes are going to work “each person is an individual case, they’re taking drugs specific to their needs so we have to look at it on a case by case basis and that’s what we do.”
It’s unclear how the most expensive “Top Tier” drugs are going to be treated, but one expert calls this: a modest start. “After years of discussion and negotiation congress is finally on the cusp of delivering real prescription drug price relief,” a $2000 yearly cap on out-of-pocket costs is a big win for Medicare seniors says AARP’s MacCaul “which is huge for people who are paying significantly more amounts of money on a monthly basis for their prescription drugs.”
48 million Americans get their drugs through Medicare Part D; and that accounts for one-third of all prescription drug spending. There may be leverage.
Back at Compass Health in Everett officials there likened the IRA to the passage of the Affordable Care Act, “that day, January 1st 2014 everything changed for us because we had so many thousands of community members that could not access care,” says an excited and emotional Tom Sebastian.
Compass supplies behavioral health services in Snohomish, Skagit, Island, San Juan and Whatcom counties. “Behavioral health is really part of overall health” Congressman Larsen sees an opportunity, “the stigma is I think decreasing and so we need to strike while the iron is hot and invest in behavioral health.”
The House of Representatives is expected to approve the Inflation Reduction Act during a vote on Friday.
