New HHS Report Finds Major Savings for Americans Who Use Insulin Thanks to President Biden’s Inflation Reduction Act

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AMERICA NEWS NOW

$35 monthly insulin cap in historic law, which went into effect January 1 for Medicare Part D, would have saved 1.5 million people with Medicare an average of $500 dollars on their insulin in 2020

Today, the U.S. Department of Health and Human Services (HHS) issued a new report showing the major savings coming to people with Medicare thanks to the $35 cap on a month’s supply of insulin. The report shows that if the Inflation Reduction Act’s provision capping the cost of insulin at $35 for a month’s supply for Medicare beneficiaries had been in place in 2020, 1.5 million seniors across the country would have saved an average of $500 on insulin for the year. Through the Inflation Reduction Act – the most consequential health care law since the Affordable Care Act – President Biden is delivering on his promise to lower prescription drug costs, make health insurance more affordable, and make the economy work for working families.

The insulin provisions of this historic law went into effect January 1, 2023, for Medicare Part D. Starting July 1, 2023, under Medicare Part B, beneficiary cost sharing will be limited to $35 for a month’s supply of insulin. Researchers estimate that 1.5 million people with Medicare would have benefited from the new Inflation Reduction Act insulin cost-sharing limits if they had been in effect in 2020, with total savings to beneficiaries of about $734 million in Part D and $27 million in Part B – an average savings of approximately $500 for those Medicare beneficiaries.

“The Biden-Harris Administration is committed to lowering health care costs and increasing access to high-quality, affordable health care, and the Inflation Reduction Act is helping us do just that,” said HHS Secretary Xavier Becerra. “Thanks to this historic law, people who get their insulin through Medicare won’t have to pay more than $35 for a month’s supply. No one should have to skip or ration their insulin because they can’t afford it.”

Produced by the HHS Office of the Assistant Secretary for Planning and Evaluation (ASPE), the report includes selected findings from a recent report to congress that examined the critical role that insulin plays in the treatment of diabetes, reviewed evidence on how insulin affordability affects adherence to insulin treatment and downstream health consequences, and described policy efforts to improve the affordability of insulin.

The new report also provides information on savings by state and by demographic characteristics, including gender, race and ethnicity, and age. The states with the most people with Medicare projected to benefit from the new Inflation Reduction Act insulin cost savings are Texas (114,000 beneficiaries), California (108,000), and Florida (90,000). North Dakota ($805), Iowa ($725), and South Dakota ($725) have the highest average annual out-of-pocket savings.

In 2019, about 37 percent of insulin fills for people with Medicare required cost-sharing exceeded $35 per fill, including 24 percent that exceeded $70 per fill.

Nationally, the average out-of-pocket cost was $58 per insulin fill in 2019, typically for a 30-day supply. Patients with private insurance or Medicare paid about $63 per fill on average.

The full HHS report, “Insulin Affordability and the Inflation Reduction Act: Medicare Beneficiary Savings by State and Demographics”, is available at https://aspe.hhs.gov/reports/insulin-affordability-data-point and the Report to Congress is available at: https://aspe.hhs.gov/reports/insulin-affordability-rtc

The state-by-state estimated savings and estimated number of Medicare individuals who would experience cost savings can be found below:

Estimated Out-of-Pocket Savings If Inflation Reduction Act $35 Out-of-Pocket Insulin Cap Had Been In Effect in 2020, by State

State Total Number of Enrollees in Part D and B Who Would Experience Savings Projected IRA Savings ($) Average Annual Out-of-Pocket Savings Per Enrollee ($) Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington Washington D.C. West Virginia Wisconsin Wyoming
29,127 $12,800,687 $439
1,026 $613,867 $598
28,124 $14,545,058 $517
15,559 $8,395,598 $540
108,164 $36,622,758 $339
16,085 $8,288,613 $515
11,444 $6,749,195 $590
6,066 $2,707,378 $446
90,181 $42,920,606 $476
45,625 $21,764,218 $477
3,703 $1,440,292 $389
7,927 $4,801,119 $606
59,718 $30,975,919 $519
42,310 $22,876,374 $541
18,834 $13,648,044 $725
15,657 $10,170,650 $650
27,797 $12,590,086 $453
22,071 $9,095,485 $412
5,976 $3,169,201 $530
21,052 $9,868,664 $469
26,287 $13,248,195 $504
66,726 $26,908,214 $403
27,128 $18,232,052 $672
15,366 $8,344,497 $543
34,881 $18,256,529 $523
4,835 $2,913,023 $602
9,716 $6,576,898 $677
10,769 $4,725,569 $439
6,586 $3,533,326 $536
39,641 $20,239,433 $511
8,716 $3,856,841 $443
75,601 $36,526,747 $483
56,921 $25,580,364 $449
4,527 $3,642,152 $805
72,854 $36,536,703 $502
19,556 $10,417,603 $533
17,915 $10,586,279 $591
80,197 $43,565,423 $543
4,678 $2,269,088 $485
31,235 $14,896,443 $477
4,568 $3,313,226 $725
39,562 $19,534,028 $494
114,242 $50,395,627 $441
11,393 $7,110,735 $624
3,118 $2,153,816 $691
36,461 $18,597,268 $510
28,063 $16,917,285 $603
650 $262,462 $404
12,656 $5,706,666 $451
31,935 $20,064,260 $628
2,469 $1,597,721 $647
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