Payers, Hospitals Rejoice As Biden Signs Full Health Bill Into Law

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On Tuesday, President Joe Biden signed into law a $740 billion bill that would enact some of the biggest changes to U.S. healthcare since the Affordable Care Act was passed more than a decade ago.

With the Inflation Reduction Act, Medicare will begin negotiating drug prices starting in 2026, limit Medicare Part D copayments, limit insulin copayments for Medicare beneficiaries to $35 a month, and reduce ACA health insurance plan copayments. Subsidies can be extended to low amounts. Income beneficiaries for another 3 years.

Patient advocacy groups have welcomed the new law, and Frederick Isasi, executive director of Families USA, has called it a David and Goliath moment for governments to take on the big challenge. Amid persistently high inflation, pharma companies ‘couldn’t have been a better time’ for patients.

Payers and hospital groups are also pleased with the continuation of enhanced ACA subsidies. This will increase financial assistance to those already eligible, as well as expand subsidies to middle-income earners who may have previously been priced outside coverage.

This subsidy should save approximately 13 million people $800 a year on health insurance, reduce payer roll surrenders in the ACA market, and provide more stable earnings for insurers over the next few years. Meanwhile, the hospital could benefit from more patients remaining on his ACA plan, which tends to be reimbursed at higher levels than other publicly sponsored coverage like Medicaid.

“In short, we are delighted that this bill has passed,” said Margaret Murray, CEO of the Association for Community Affiliated Plans, which represents more than 70 public plans, in a statement.

However, hospital groups are seeking additional financial aid from the government, citing labor shortages, rising labor costs and supply chain problems, indicating that this year’s industry lobbying is far from over.

Bruce Seigel, CEO of America’s Essential Hospitals, said: “I urge Congress to provide more funding to overcome these challenges.”

A major for-profit hospital operator reported lower second-quarter net income as patient admissions declined year-over-year and patient care costs rose.

Amid macro headwinds, the 2% Medicare quarantine cut that was suspended due to the COVID-19 pandemic took effect last month, with another 4% set to start at the end of the year unless Congress moves to delay it It is scheduled to be Providers are also asking the government that proposed payment rules for 2023 be too low to work in today’s tricky operating environment.

The IRA seemed dead in the Senate until late last month when Democrats announced a surprise deal with Sen. Joe Manchin (DW.Va.) to finally pass the bill.

It passed the Senate on August 7, 51-50, with Vice President Kamala Harris casting the tie-breaking vote, and the House of Representatives on August 12, 220-207.

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