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affordable care act
What the Inflation Reduction Act Has Meant for Healthcare 2 Years Later
From the $35 insulin co-pay to capping insurance premium costs, the legislation has been health-changing and life-changing.
Aug 30, 2024
I was honored to be at the White House this month for the Inflation Reduction Act anniversary event, featuring Americans sharing their stories of saving money and saving lives.
Thank you to the millions of people fighting every day for lower drug prices, to Congress for passing the Inflation Reduction Act, U.S. Vice President Kamala Harris for casting the deciding vote in the Senate, and President Joe Biden for signing it into law.
Meet Bob Parant, from New York. He’s a 71-year-old man who has been living with type 1 diabetes for over fifty years. He lost his leg in 2010, and became eligible for Medicare. Before the Inflation Reduction Act, the last price Bob paid for a vial of insulin was $580, which was “horrendous.”
We have made so much progress on healthcare. But as everyone reading this knows, there is so much more to do.
Listen to Pam Parker, from Maryland: She’s a retired electrician, 62 years old, and has been diabetic since she was 30. “I had to decide, a lot of months, between mortgage, groceries, utilities, and other things… I would juggle my expenses, and really juggle my healthcare.. I would eat less, or ration my insulin to make it last.. I had high blood pressure, I fell into a coma, my kidneys failed… they told me I coded.”
Learn from Robin Craycroft, from Missouri: When she turned 65 and had access to Medicare, the pharmacist told her that one insulin for three months was $3,000. “Everything that we had planned, cancelled, and our life just changed. And I felt such guilt over that… We’re gonna spend $2,000 a month (two insulin vials) to keep me alive. You start going through, am I worth it? Should I do that to [my husband]?”
Hear Steven Hadfield, from North Carolina: “Before the $35 cap, sometimes you had to skip a dose, sometimes you had to not test yourself, watch what you eat because you couldn’t afford it…”
The $35 insulin co-pay cap for people on Medicare is just one of the health-changing and life-changing parts of the Inflation Reduction Act.
This year, people on Medicare have their out of pocket Part D drug costs capped at around $3,500. And next year, the maximum drops down to $2,000. This means seniors on a fixed income won’t have to choose medicine over food or housing or anything else. Also recommended adult vaccines such as the new shingles vaccine are now free for Medicare recipients.
Pharmaceutical companies that raise their prices higher than inflation are required to pay Medicare a rebate, to encourage them to stop price gouging patients. And in 2026, price negotiations for the first 10 drugs under Medicare go into effect: lowering the costs of those drugs for millions of Americans. The savings will continue for patients and taxpayers as more drug prices are negotiated each year.
But the Inflation Reduction Act doesn’t just help people on Medicare. Over 21 million Americans like me get their health insurance through the Affordable Care Act marketplaces. When I was diagnosed with stage 4 cancer in 2017, I did not qualify for financial help for insurance. Thankfully I was able to afford a plan anyway, and to pay the maximum deductible for that year. A bargain compared to the over half a million dollars it cost to save my life.
I am so grateful to still be here, and for the Affordable Care Act made truly more affordable to millions of working Americans like me.
The American Rescue Plan, and then the Inflation Reduction Act, provided financial help for health insurance to many more who needed it. This law caps the cost of premiums at no more than 8.5% of your income, meaning people—especially older folks who face higher premiums, or people in more expensive healthcare markets—don’t get penalized, and can still afford the care they need.
We have made so much progress on healthcare. But as everyone reading this knows, there is so much more to do.
First, we have to defend the advances in the Inflation Reduction Act. A new administration and a new Congress next year means everything we’ve gained could be on the chopping block.
Second, the health insurance tax credits piece expires in 2025. Without that renewal, millions of Americans would go back to being priced out of health insurance.
Third, the Medicare provisions such as the $35 insulin cap, the drug price negotiation, and more, need to be expanded to everyone.
We are grateful to still be here, and to keep fighting until every American can get the healthcare they need. We cannot go back.
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Medicare for All Advocates Welcome Obama DNC Remarks as 'New Opening for Reform'
The former president said Democratic nominee Kamala Harris "knows we can't stop" at the Affordable Care Act.
Aug 21, 2024
A brief aside in former President Barack Obama's 35-minute speech at the Democratic National Convention Tuesday night provided a glimmer of hope that a Kamala Harris victory in November could be a catalyst for transformational change to the United States' disastrous for-profit healthcare system.
Obama—who before becoming president described himself as a "proponent of a single-payer universal healthcare program"—told Democratic delegates, leaders, and activists gathered inside the United Center in Chicago that the party should be "proud of the enormous progress that we've made through the Affordable Care Act," the 2010 law commonly known as Obamacare.
"But," the former president added, "Kamala knows we can't stop there, which is why she'll keep working to limit out-of-pocket costs."
Obama's remarks were far from an explicit endorsement of Medicare for All, a longstanding progressive goal that Harris backed as a senator and continued to support—at least in name—as a 2020 presidential candidate.
But longtime single-payer advocate Michael Lighty told Common Dreams on Wednesday that Obama's acknowledgment that the ACA has not been nearly enough to rein in the nation's out-of-control healthcare costs and crack down on the rampant abuses of the for-profit insurance industry "signals a new opening for reform" if Harris defeats Republican nominee Donald Trump.
"I was struck by the juxtaposition of 'access to affordable coverage,' which is the usual centrist frame for healthcare reform, and this reference to going beyond the ACA," Lighty said in response to Obama's comments. "It recognizes that rising costs overall and out-of-pocket costs especially are unsustainable."
"The cost frame is good for Medicare for All advocates," he added, "if we 'prosecute' the argument for the savings generated by Medicare for All."
Research has repeatedly shown that a Medicare for All system of the kind envisioned by Sen. Bernie Sanders (I-Vt.) and Rep. Pramila Jayapal (D-Wash.)—the leading single-payer advocates in Congress—would cost less than the status quo while providing everyone in the U.S. with comprehensive insurance coverage for free at the point of service.
Under the nation's current for-profit system—which leaves tens of millions of Americans uninsured or underinsured and struggling to afford their out-of-pocket costs—annual healthcare spending is projected to rise to $7.7 trillion by 2032, according to federal estimates.
"It is clear that the North Star of a Harris-Walz administration is consistent with what Senator Bernie Sanders said from the DNC stage last night: guaranteeing healthcare to every person in this country."
Despite co-sponsoring Sanders' Medicare for All bill in the Senate in 2017 and campaigning on a proposal that donned the "Medicare for All" label during the 2020 Democratic primary, Harris has not made the popular progressive idea part of her 2024 platform.
A Harris campaign official toldPolitico earlier this week that Medicare for All is "no longer part of" the vice president's healthcare policy agenda, which has thus far focused largely on slashing prescription drug costs and relieving the burden of medical debt.
But Medicare for All advocates, who have seen support for the proposal surge at the state and local levels amid federal inaction, are not disheartened by the vice president's decision to sideline single-payer in her 2024 campaign.
Alex Lawson, executive director of Social Security Works, pointed to the newly unveiled Democratic platform's support for expanding Medicare benefits to include dental, vision, and hearing services as part of a viable "path forward."
"It is clear that the North Star of a Harris-Walz administration is consistent with what Senator Bernie Sanders said from the DNC stage last night: guaranteeing healthcare to every person in this country, so if you get sick you get the care you need," Lawson told Common Dreams. (The Democratic platform states that "healthcare should be a right in America, not a privilege"—a line popularized by Sanders.)
"As president," said Lawson, "it is clear that Kamala Harris would use every tool at her disposal to rein in the corporate greed, delays, and denials of the current system and continue building step by step towards a goal of universal guaranteed healthcare."
Rose Roach, national coordinator of the Labor Campaign for Single Payer, offered a similar assessment, telling Common Dreams in an email on Wednesday that while President Joe Biden "was clear that he did not support Medicare for All," he "supported important improvements to traditional Medicare that begins to build the public infrastructure we'll need for Medicare for All when it does pass"—specifically the drug price negotiation program and new constraints on corporate-run Medicare Advantage plans.
"The Labor Campaign for Single Payer believes VP Harris is equally committed to securing and protecting traditional Medicare and will work with the movement to continue the work of stabilizing our public Medicare program," said Roach. "Improving and expanding traditional Medicare, protecting it from the privatizers who are overbilling Medicare while inflicting obstacles for enrollees to access care via onerous prior authorizations and outright claims denials, is job one."
"Doing so not only offers the infrastructure building we need on the pathway to Medicare for All," Roach added, "but it also makes traditional Medicare affordable for enrollees, unions who negotiate retiree health benefits, and even for employers who offer retiree benefits. It's a win-win."
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Workers Who Help Americans Get Healthcare Benefits Deserve Fair Compensation
Companies like Maximus that are getting so much government money should have to create good jobs with liveable wages, decent benefits, and the right to unionize.
May 24, 2024
I love my job.
Every day I get to answer phone calls from some of the tens of millions of Americans who rely on the Affordable Care Act and help them get the healthcare benefits they need.
Even though I do an essential job, my employer—the federal call center run by Maximus in Tampa, Florida—does not pay me enough or provide me with the healthcare benefits needed to be able to treat my own health condition.
Maximus signed a 10-year deal worth $6.6 billion in 2022 to field calls about the federal healthcare marketplace and Medicare. The company has 10,000 employees across 12 call centers, mostly in the South and Southwest.
I’m supposed to visit the doctor every three months to treat a chronic health condition, but because our deductibles are so high, I haven’t been in two years.
Companies like Maximus that are getting so much government money should have to create good jobs with liveable wages, decent benefits, and the right to unionize—the same conditions that federal workers enjoy. President Joe Biden has taken some important steps, especially to set high standards for construction workers on new big infrastructure and clean energy projects. But more needs to be done to make sure service contract workers like me get a fair reward for our labor—instead of letting so much of public money go to rich executives and shareholders.
While many of us at Maximus who field calls all day make around $17 an hour, our CEO, Bruce Caswell, got a 17% raise last year to $7.3 million. Over the past four years combined, Maximus has awarded Caswell over $27 million and spent over half a billion dollars on stock buybacks and dividends to enrich shareholders.
This September will mark 10 years of working at Maximus for me. My only major raise in that time came when President Biden set the minimum wage for all federal contract workers at $15 dollars in 2022. While we appreciate the pay hike, for a single mother of two the minimum doesn’t cut it, I need a real living wage. Instead, my only raise in the last two years was 22 cents.
Our healthcare benefits aren’t much better. I’m supposed to visit the doctor every three months to treat a chronic health condition, but because our deductibles are so high, I haven’t been in two years.
Because of the issues with pay and healthcare, last year I joined the campaign to unionize Maximus workers with the Communication Workers of America. The process is long, and different locations are moving at different speeds, but we’ve already had some victories.
After we protested our high health costs, Maximus dropped our health insurance deductibles significantly.
We need more help, though. I’ve participated in several protests at my call center demanding $25 an hour and increased benefits from Maximus.
I’ve also gone to Washington, D.C., to call on the Biden administration to follow through on its promise to create “good jobs” with federal money. Last fall I even got to take my daughter with me to speak with lawmakers in Congress.
I’m not going to quit because I don’t feel properly valued or because the benefits are not good. I’m going to stay and fight within the company to make it better, because the ACA is a great program that is helping millions of Americans.
And even though I know that I can be fired at any time—Maximus laid off more than 700 employees in one month last year—I’m standing up for my rights. I’m standing up for a better company and for a better future for my children.
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