The Inflation Reduction Act (IRA) is helping people with Medicare, including nearly 30 million women enrolled in Part D. Our review shows that, in 2020, about 733,000 women enrolled in Part D and B would have benefited from the IRA’s $35 insulin cap and, in 2021, about 2 million women would not have had any out-of-pocket costs for recommended adult vaccines covered by Part D. Under the IRA’s Part D redesign, about 857,000 women enrollees who do not receive financial assistance are projected to save $1,000 or more in 2025. Additional benefits are expected for women from other IRA drug-related provisions.
KEY POINTS
- Among Medicare enrollees, women have disproportionately higher rates of certain health conditions relative to men, including Alzheimer’s disease, asthma, fibromyalgia, osteoporosis, and certain types of cancer.
- The IRA expanded the low-income subsidy (LIS) program in 2024 by expanding eligibility of the full LIS group so that enrollees who previously met the requirements for the partial LIS group are now eligible for the full LIS benefit. Women are disproportionately represented among Medicare enrollees receiving low-income subsidy (LIS) and among those whose out-of-pocket costs have gone down due to the expansion of LIS eligibility under the IRA.
- The IRA caps the out-of-pocket cost per covered insulin product to $35 for a month’s supply, which will result in greater affordability of insulin for women enrolled in Medicare. This provision went into effect in January 2023 for covered insulin products under Part D and in July 2023 for covered insulin products under Part B. About 733,000 women enrolled in Medicare were taking insulin and would have benefited from the insulin cap if it had been in effect in 2020.
- The IRA vaccine provision made certain Part D-covered adult vaccines available without enrollee cost-sharing starting in January 2023. Among the 3.4 million enrollees who received a vaccine under Medicare Part D in 2021, nearly 2 million were women. These enrollees would have had no out-of-pocket costs under the IRA vaccine provision if it had been in effect in 2021. Starting in 2025, enrollee out-of-pocket spending in Part D will be capped at $2,000 per year. This cap, which will be indexed to inflation, will help enrollees who take high-priced drugs, including women enrolled in Medicare who have higher rates of certain health conditions that require costly medications (e.g., cancer).
- Among female non-LIS enrollees projected to have out-of-pocket savings under the IRA’s Part D redesign provisions, a sizeable number (about 857,000 or 4 percent of female non-LIS enrollees) will have savings of $1,000 or more in out-of-pocket costs. This subset of women enrolled in Medicare is estimated to save an average of $2,444 on out-of-pocket prescription drug costs in 2025.
- Enbrel is one of the 10 Part D drugs selected for the first cycle of Medicare drug price negotiations. The share of enrollees using Enbrel that are women is about 72 percent, a proportion that is 16 percentage points greater than female representation in the Part D population (56 percent).
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Related Products:
- IRA Drug Negotiation Report
- ASPE IRA Drug Negotiation Fact Sheet
- Medicare Enrollees and the Part D Drug Benefit: Improving Financial Protection through the Low-Income Subsidy
- Inflation Reduction Act Research Series: Medicare Part B Inflation Rebates in 2023
- Insulin Affordability and the Inflation Reduction Act: Medicare Beneficiary Savings by State and Demographics
- Medicare Part D Enrollee Savings from Elimination of Vaccine Cost-Sharing
- Medicare Part D Enrollee Out-Of-Pocket Spending: Recent Trends and Projected Impacts of the Inflation Reduction Act
- Trends in Prescription Drug Spending, 2016 - 2021