Democrats reach deal to give Medicare price negotiation powers, extend ACA subsidies

Senate Democrats reached a deal June 27 on a major healthcare and energy reform bill that will extend Affordable Care Act tax credits to 2025, empower Medicare to negotiate the cost of some drugs and put the U.S. on a path toward 40 percent lower carbon emissions by 2040, according to CNN.

Though voting on the legislation is expected to fall along party lines, Democrats are aiming to use a budget reconciliation process that allowed them to pass the $1.9 trillion American Rescue Plan Act last year. The reconciliation process avoids the Senate's 60-vote threshold and requires approval from the Senate parliamentarian. If approved, the legislation would need to pass a final vote in the House and Senate, which could happen as soon as August.

Six key takeaways:

  1. Medicare would be allowed to negotiate the cost of certain prescription drugs. HHS would choose 10 drugs eligible for negotiation in 2026, 15 drugs each in 2027 and 2028, and 20 drugs in 2029.

  2. There would be a $2,000 annual cap on cost-sharing amounts for prescription drugs under Medicare Part D plans.

  3. Drug manufacturers would have to pay rebates if their prices in the Medicare and commercial insurance markets rise faster than inflation.

  4. Affordable Care Act premium tax credits would be extended for three additional years after originally being set to expire at the end of 2022.

  5. The deal would invest $369 billion into renewable energy and climate change initiatives, with a goal of reducing the country's carbon emissions 40 percent by 2030. Electric vehicle tax credits will continue at up to $4,000 for a used vehicle and $7,500 for a new vehicle. 

  6. President Joe Biden said publicly he would sign the legislation if it reaches his desk.


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