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How the New Inflation Reduction Act Affects the Cost of Brain Tumor Treatment

Published on October 4, 2022 in Advocacy, Treatment, Legislative Issues, Take Action

Guest Author: David F. Arons, JD, President & CEO, National Brain Tumor Society

On August 16, President Joe Biden signed into law the Inflation Reduction Act, a sweeping set of policies that includes new provisions aimed at reducing the cost of health care for persons covered under the Medicare program.  

The policies that will impact patients with brain tumors include:

  • Capping patients’ out-of-pocket costs for drugs under Medicare Part D at $2,000 per year beginning in 2025, and limiting annual increases between 2024-30
  • Expanding premium and co-pay assistance on prescription drugs for low-income individuals covered under Medicare. Currently, the low-income subsidy program (LIS) under Medicare Part D is fully available to all seniors earning less than 135% of the federal poverty level, and is partially available to seniors earning less than 150% of the federal policy level. The bill eliminates the partial subsidy status, giving those seniors the full low-income subsidy under Medicare Part D
  • Helping patients covered under the Affordable Care Act (also known as Obamacare or marketplace plans) by extending health insurance premium subsidies through 2025
  • Capping the out-of-pocket cost of insulin at  $35 per month  

All of these new and additional benefits for patients covered under the Medicare program also underscores the importance of Congress passing the Stop the Wait Act (Sen. Casey-PA/Rep. Doggett-TX). This bill, which was a key legislative ask of NBTS advocates during this year’s Head to the Hill, would help brain tumor patients by:

  • Phasing out the 24-month waiting period for Medicare disability benefits
  • Requiring the Social Security Administration to begin payment to an individual eligible for Social Security Disability Insurance (SSDI) immediately after they are determined to be eligible for the program, rather than requiring the individual to wait five months to begin receiving benefits

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