Number:        117-11   
Date:             August 19, 2022

The President Signs H.R. 5376, the
“Inflation Reduction Act of 2022”

 

On August 16, 2022, the President signed the Inflation Reduction Act of 2022, which became Public Law 117-169. The House previously passed the bill on August 12, and the Senate passed it on August 8.

The new law extends health insurance subsidies under the Affordable Care Act, changes certain taxes, and authorizes the Centers for Medicare and Medicaid Services to negotiate the prices of certain drugs under Medicare. The law also expands the benefits and coverage of the Medicare Part D and Extra Help Programs by, for example:

  • capping out-of-pocket costs for prescription drugs for beneficiaries at $2,000 per year;
  • capping insulin costs for beneficiaries at $35 per month; and
  • eliminating beneficiary cost-sharing (“copays”) for certain vaccines.

This law contains the follow provision of interest to the Social Security Administration:

Section 11404––Expanding Eligibility for Low-Income Subsidies under Part D of the Medicare Program

  • This provision increases the income and resource limits on qualifying for the highest level of subsidy under the Medicare Part D Extra Help Program (“full subsidy”), and eliminates the other level of subsidy (“partial subsidy”). This means that all Medicare beneficiaries eligible for Extra Help will receive the full subsidy, which generally provides 100 percent premium subsidy (based on the service area’s benchmark base premium), eliminates the need to pay a deductible, and limits copays.1

  • The income limit for full subsidy will increase from 135 percent of the Federal Poverty Line (FPL) to 150 percent of the FPL (the current income limit for partial subsidy).

  • The resource limit for full subsidy will also increase. Currently, the Extra Help program has two resource limits––people must have resources below the lower limit to qualify for full subsidy, and they must have resources below the higher limit to qualify for partial subsidy. This provision eliminates the lower limit and makes the higher limit the only resource limit for determining subsidy eligibility.


    • The Extra Help resource limits are adjusted every year. The current higher limit is:2


  • These changes (under Section 11404) are effective January 1, 2024.

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1 As under current law, copay limits will continue to vary based on certain circumstances (e.g., whether the beneficiary also receives Medicaid).
2 Amounts shown in the table include the burial fund exclusion.