You At Your Best

bY KareN rice You at Your best Of the 300 million people in the United State with diabetes, nearly a quarter of them use insulin to prevent life- threatening complications. But the average price of insulin in this country—$98.70 per vial—is more than ten times higher than the average of all other countries put together, and a huge financial burden for those who depend on it to manage their disease. Fortunately, the Inflation Reduction Act signed by President Biden in August will limit the cost of insulin for seniors beginning in January. How does it work? The Inflation Reduction Act caps the out of pocket cost of insulin at $35 per month for seniors who have Medicare – including those who use insulin pumps – starting in 2023. The Inflation Reduction Act also makes changes to prescription drug pricing in Medicare Part D that mean seniors may pay even less than $35 per month for their insulin starting in 2026. To make sure seniors are getting these savings right away, people who are charged more than $35 per month for their insulin in the first few months after the new Medicare copay cap is enacted will be reimbursed. Unfortunately, a provision to extend that benefit to people with private insurance was struck down in the Senate. "While we have more work to do to expand this benefit to all people with diabetes who rely on insulin to survive, this first national copay cap is a significant step in the right direction and a potentially life-saving policy change for seniors," said Lisa Murdock, chief advocacy officer for the American Diabetes Association. What else does the Inflation Reduction Act do for people with diabetes? The bill also caps the out of pocket cost of all prescription drugs at $2,000 per year for seniors who have Medicare Part D. And, the Inflation Reduction Act allows Medicare to negotiate the price of some of the most expensive prescription drugs directly with drug manufacturers, reducing the cost of these often out-of- reach medications for seniors. $1 in every $3 spent on prescription drugs in the U.S. is spent on someone with diabetes, according to the American Diabetes Association, and these changes will benefit people with diabetes who rely on more than just insulin to survive. Insurance coverage expansion For individuals and families who have private insurance plans through the Affordable Care Act, the Inflation Reduction Act extends through 2025 premium subsidies that were expanded during the COVID-19 pandemic and were set to expire at the end of this year. Why is this important? "Having health insurance is the single strongest predictor of whether adults with diabetes have access to high-quality health care and are able to manage their diabetes," according to Dr. Robert Gabbay, the ADA's chief scientific and medical officer. "Uninsured Americans who are at risk for diabetes and its complications are much less likely to receive a diagnosis, and if they do get a diagnosis, they still average 60 percent fewer office visits with a physician and experience 168 percent more hospital visits than their insured counterparts. The expansion of these ACA health insurance subsidies will literally save lives of people with diabetes." How will the Inflation Reduction Act help people with diabetes? Legislation makes insulin, other prescription drugs more affordable for seniors and extends health insurance benefits suNDaY, october 30, 2022 | November - beatiNg the betes YouatYourbest.NwaoNliNe.com | You at Your best | 5

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