Inflation Reduction Act Toolkit

The U.S. Department of Health and Human Services has curated this Inflation Reduction Act Toolkit for anyone who wants to support and spread awareness about the new prescription drug law. In this toolkit, you'll find resources and materials that can serve as a foundation for your efforts to promote the Inflation Reduction Act. You're encouraged to make use of these resources as a starting point or a creative spark for your own initiatives aimed at sharing the benefits of this law with a wider audience.

Key Messaging

In this section, you'll find key messages that can serve as your compass through the new prescription drug law, highlighting the critical components and their real-world implications.

• The Inflation Reduction Act is one of the most consequential health care laws since the Affordable Care Act was signed into law, and the biggest improvement to Medicare since the passage of Medicare Part D in 2003. This new prescription drug law is delivering lower prescription drug costs, making health insurance more affordable, and making the economy work for working families.
• Thanks to the President’s new lower cost prescription drug law, the lives of Medicare enrollees are changing for the better. Seniors and people with disabilities on Medicare are benefiting from a $35/month cap on the cost of each Medicare-covered insulin product and free, certain recommended preventive adult vaccines.
• A historic part of the President’s landmark prescription drug law allows Medicare, for the first time, to negotiate directly with drug manufacturers to lower the price of some of the costliest drugs.

• As of January 1, 2023, cost-sharing for a month’s supply of each covered insulin product is capped at $35 per month for people with Medicare prescription drug coverage through a Part D plan or their Medicare Advantage plan.
• As of July 2023, people with Medicare who access their insulin through Part B and take insulin delivered through a pump also pay no more than $35 per month for each covered insulin product.
• A variety of Medicare prescription drug plans cover insulin. Help may be available for people with Medicare who take insulin, and we encourage them to call 1-800-MEDICARE if they need assistance in exploring options to find the plan that works best for them. Local State Health Insurance Assistance Program (SHIPs) can also help with insurance plan counseling. Find your local SHIP.

• Certain-recommended preventive adult vaccines are free of charge for people with Medicare prescription drug coverage as of January 1, 2023.
• Adult vaccines that are covered under Medicare Part D include: RSV, shingles; tetanus/diphtheria (Td); tetanus, diphtheria, and pertussis – also known as whopping cough (Tdap); hepatitis A; and hepatitis B.
• Medicare Part B already covers flu, pneumococcal, COVID-19, and certain other vaccines without cost-sharing for people with Medicare.
• State Medicaid programs are now required to cover certain recommended approved adult vaccinations, without cost-sharing, for many adults in Medicaid.

• The Extra Help or Low-Income Subsidy Program helps with drug costs for Part D enrollees with limited income and resources.
• Starting January 2024, the Inflation Reduction Act expanded the program to cover more drug costs for people with limited resources:
  • Nearly 300,000 low-income people with Medicare currently enrolled in the Extra Help program will be newly eligible for expanded benefits, including no deductible, no premiums, and fixed, lowered copayments for certain medications.
  • An additional 3 million people could benefit from the Extra Help program now but aren’t currently enrolled.
  • Visit Social Security online at SSA.gov/extrahelp or call Social Security at 1-800-772-1213 to see if you are eligible.
  • Contact your local State Health Insurance Assistance Program (SHIPs) at shiphelp.org or call 1-877-839-2675 for assistance with the Low-Income Subsidy application.
  Affordable Care Act (ACA) Subsidies
  • Because of the historic Inflation Reduction Act, quality health care coverage continues to be more affordable for the third year in a row. Last year, extended enhanced subsidies enabled 13 million Americans to save an average of $800 on their health insurance. In 2024, four out of five HealthCare.gov enrollees will continue to find a plan for $10 or less after financial help.
  • This year, plan selections for 2024 Marketplace coverage have already surpassed 20 million.
  Medicare Drug Price Negotiations
  • On August 15, 2024, the Biden-Harris Administration announced that it has reached agreements for new, lower prices for all 10 drugs selected for negotiations. These negotiated drugs are some of the most expensive and most frequently dispensed drugs in the Medicare program and are used to treat conditions such as heart disease, diabetes, and cancer. The new prices will go into effect for people with Medicare Part D prescription drug coverage beginning January 1, 2026.
  • If the new prices had been in effect last year, Medicare would have saved an estimated $6 billion, or approximately 22 percent, across the 10 selected drugs. These negotiated prices range from 38 to 79 percent discounts off of list prices. About nine million people with Medicare use at least one of the 10 drugs selected for negotiation. People with Medicare prescription drug coverage are expected to see aggregated estimated savings of $1.5 billion in their personal out-of-pocket costs in 2026. For more detailed information about the negotiated prices please see the Centers for Medicare & Medicaid Services (CMS) Negotiated Prices Fact Sheet.
  • The new drug law gives Medicare the authority to negotiate prescription drug prices directly for the first time in history.
  • In 2023, CMS through HHS began the negotiation process by announcing the first 10 drugs covered under Medicare Part D selected for the first cycle of negotiation.
  • The selected drug list for the first round of negotiation is:
    • Eliquis
    • Jardiance
    • Xarelto
    • Januvia
    • Farxiga
    • Entresto
    • Enbrel
    • Imbruvica
    • Stelara
    • NovoLog/Fiasp*
      *Includes Fiasp, Fiasp FlexTouch, Fiasp PenFill, NovoLog, NovoLog FlexPen, and NovoLog PenFill

    These drugs treat conditions such as blood clots, diabetes, heart disease, heart failure, autoimmune diseases, and chronic kidney disease.

    Drug Manufacturer Inflation Rebates
    • Manufacturers will need to pay rebates to Medicare if they increase their prices for certain drugs at a rate that exceeds the rate of inflation. The first rebate period began October 1, 2022 for drugs covered under Part D and January 1, 2023 for drugs covered under Part B.
    • Some people with Medicare may pay a lower coinsurance for some Part B drugs if the drugs’ prices increase faster than the rate of inflation. Since April 1, 2023, CMS has announced Part B drugs with reduced coinsurances on a quarterly basis.
    Capping Prescription Drug Out-of-Pocket Costs in Medicare
    • Starting January 1, 2024, for the first time ever, patients with high prescription drug costs are no longer required to pay out-of-pocket costs once they reach a certain level of spending known as the catastrophic phase of Medicare Part D.
    • In 2025, out-of-pocket costs will be lowered even more, with a $2,000 annual cap on those costs in Medicare Part D.
    • Beginning in 2025, the new drug law requires all Medicare prescription drug plans (Medicare Part D plans) — including both standalone Medicare prescription drug plans and Medicare Advantage plans with prescription drug coverage — to offer enrollees the option to pay out-of-pocket prescription drug costs in the form of capped monthly installment payments instead of all at once at the pharmacy.
    Where to Get Help
    • Call 1-800-MEDICARE to learn more about lowering drug costs.
    • Contact your local State Health Insurance Assistance Program (SHIP) at shiphelp.org or call 1-877-839-2675 to get free personalized health insurance counseling.

    Social Media Sharables

    This section features a collection of ready-to-use graphics and engaging social media posts crafted to help you spread awareness and amplify the benefits of the Inflation Reduction Act.

    Social Media Sharable: General Inflation Reduction Act

    

    Post Copy - Facebook/Instagram/X/LinkedIn: For decades, Americans have spent more on Rx drugs than people in other countries — paying two to three times more for the same drugs. The President’s new lower cost prescription drug law is making changes to #Medicare so that millions of people with Medicare will spend less!

    Graphic Alt-text: The Inflation Reduction Act is:
    Capping out-of-pocket costs for Rx drugs covered under Part D
    Improving coverage of certain drugs including insulin and vaccines
    Expanding eligibility for financial assistance
    Improving Part D benefits
    Allowing Medicare to negotiate with participating drug companies for certain drugs covered under Medicare

    Download & Share

    

    Post Copy - Facebook/Instagram/X/LinkedIn: The President’s new lower cost prescription drug law makes improvements to #Medicare that will expand benefits, lower drug costs, keep Rx drug plan premiums stable, & improve the sustainability of the Medicare program for future generations!

    Graphic Alt-text: The President’s new lower cost prescription drug law is bringing relief to seniors and people with disabilities
    $35 monthly cap per Medicare-covered insulin prescription
    Certain recommended preventive adult vaccines are free– includes shingles & Tdap, and RSV vaccines
    Lower prices through direct negotiations with drug companies for certain drugs covered under Medicare

    Download & Share