States can piggyback on Inflation Reduction Act to expand drug savings in commercial market
Workers and employers stand to save on health-insurance premiums in the coming years as Medicare drug-pricing reforms recently passed by Congress spill over into the commercial market, and states piggybacking on the federal rules may amplify the impact, health policy experts say.
States, meanwhile, may use the federal reforms as a springboard to rein in drug prices in state-regulated markets, such as individual insurance markets and health plans for state workers, according to the National Academy for State Health Policy, a nonpartisan policy group. Such reforms have been a topic of conversation at the group’s conference this week in Seattle, said Hemi Tewarson, the organization’s executive director.
Inflation-related penalties in the new law are based on the number of units of a drug sold in Medicare multiplied by any price increase exceeding inflation–and that price-change factor includes prices charged in the commercial market. The CBO projected that the inflation-rebate provision will generate about $7 billion in additional revenues from payroll and income taxes through 2031.
Business Group on Health, a nonprofit that represents large employers and criticized the new law’s drug-pricing reforms as creating “extraordinary risk for American employees and their families,” also said that concerns remain. The group acknowledges the possibility that inflation rebates could generate savings in the employer market, said Garrett Hohimer, the group’s vice president for policy and advocacy, “but from our perspective, it’s just a big maybe.
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