The budget reconciliation process was used by the Senate on October 7, 2022 to pass the Inflation Reduction Act. Vice President Kamala Harris cast the tie-breaking 51-50 party-line vote. The House followed suit five days later by passing this $437 billion tax, climate, and health package by a similar party-line vote of 220-207 vote. The legislation was signed into law by President Joseph Biden. A White House celebratory event is scheduled for September 6, 2022.
Apart from health-related provisions, enactment will result in new taxes on large, profitable corporations, increased spending over a decade on new workers and technology at the Internal Revenue Service, and tax subsidies aimed at combating climate change. Some major health features are as follows:
• The Medicare program is granted authority to set the price of certain high-expenditure prescription drugs, in both Part B and Part D. Prices on a narrow set of 10 drugs can be negotiated starting in 2026 with a potential expansion to 20 medicines in 2029.
• Out-of-pocket Part D spending by beneficiaries will be capped at $2,000 per year, beginning in 2025.
• Individuals who received Affordable Care Act subsidies through the 2021 American Rescue Plan will be able to depend on obtaining another three years of those benefits.
• Insulin costs will be capped at $35 per month for Medicare recipients.
• Along with Medicaid program participants, beginning in 2023 seniors will be eligible to receive certain vaccines free.
Apart from the Inflation Reduction Act, the House also approved legislation to extend further Medicare telehealth flexibilities first instituted in response to the COVID-19 pandemic. H.R. 4040, the Advancing Telehealth Beyond COVID-19 Act of 2022 was passed on July 27, 2022. This bill modifies the extension of certain Medicare telehealth flexibilities after the end of the COVID-19 public health emergency. It provides that certain flexibilities continue to apply until December 31, 2024, if the emergency period ends before that date. More specifically, this legislation allows:
• Beneficiaries to continue to receive telehealth services at any site, regardless of type or location (e.g., the beneficiary's home).
• Occupational therapists, physical therapists, speech-language pathologists, and audiologists to continue to furnish telehealth services.
• Federally qualified health centers and rural health clinics to continue to serve as the distant site (i.e., the location of the health care practitioner).