A TRUSTED INDEPENDENT HEALTH INSURANCE GUIDE SINCE 1999.
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Featured

Featured
13 qualifying life events that trigger ACA special enrollment
Outside of open enrollment, a special enrollment period allows you to enroll in an ACA-compliant plan (on or off-exchange) if you experience a qualifying life event.

Latest News & Topics

Latest News & Topics

Featured

Featured
Finalized federal rule reduces total duration of short-term health plans to 4 months
A finalized federal rule will impose new nationwide duration limits on short-term limited duration insurance (STLDI) plans. The rule – which applies to plans sold or issued on or after September 1, 2024 – will limit STLDI plans to three-month terms, and to total duration – including renewals – of no more than four months.
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Inflation Reduction Act

What is the Inflation Reduction Act?

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The Inflation Reduction Act (IRA) was signed into law by President Biden in August 2022. Although the IRA’s most significant investments are related to climate change, the law also makes numerous important improvements to health coverage.

How does the Inflation Reduction Act help people who buy their own health coverage?

More than 14.5 million Americans purchased health coverage through the marketplace / exchange in 2022. Most of them were eligible for premium subsidies, and the IRA helps to ensure that their coverage options will remain affordable after the end of 2022.

Under the IRA, the enhanced subsidies that are in effect in 2022 (as a result of the American Rescue Plan) will continue to be in effect through 2025. Without the IRA, they would have expired at the end of 2022.

Read our overview of the IRA provisions that will affect ACA marketplace health plan buyers.

How does the Inflation Reduction Act help Americans with Medicare coverage?

The IRA includes numerous provisions that will improve Medicare’s prescription drug coverage, with changes phasing in over the next several years.

These changes will affect more than 50 million Americans are enrolled in Medicare Part D coverage, either as a stand-alone plan or as part of a Medicare Advantage plan – and will also affect pharmaceutical benefits Medicare enrollees receive under Medicare Part B.

These IRA provisions that impact Medicare coverage will take effect in 2023:

  • Recommended vaccines covered by Medicare Part D will no longer have any out-of-pocket costs.
  • Copays for all covered insulin products will be capped at $35/month
  • Drug manufacturers will have to pay rebates to Medicare if drug prices increase faster than inflation.

IRA provisions that will be phased in over the next several years include:

  • No out-of-pocket costs once an enrollee reaches the Medicare Part D catastrophic coverage phase.
  • Availability of full Part D Low-Income Subsidy (Extra Help) to more enrollees.
  • A 6% cap on annual Part D premium increases.
  • A cap on out-of-pocket costs under Part D.
  • CMS negotiations with drug manufacturers over the price of certain high-cost prescription drugs.

Read a full overview of the IRA provisions that will affect Medicare enrollees.

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