A Ray of Hope After the Inflation Reduction Act
By Suganya Karuppana, MD, MS, Chief Medical Officer at Valle Del Sol
From Print Issue - Fall 2022
As physicians, we are taught to do no harm.
Healthcare providers go to school for years to learn pathophysiology clinical guidelines to help lead patients on a path to wellness.
However, soon after we begin to practice, we are faced with a brutal truth: we can often see that path to wellness, but the path is blocked by social determinants of health, barriers to accessing care, and costs of treatment, such as medication. As a result of these barriers, patients develop a distrust of their providers and the healthcare system, while healthcare providers experience burnout and moral injury.
If physicians make a recommendation that we know patients can’t access or can’t afford, we may not be doing harm, but we certainly aren’t doing good either. As patients return to us month after month, year after year, with no end in sight, both healthcare providers and patients remain frustrated, depressed, and hopeless.
Fortunately, help is on the way for providers like me and so many across the nation. President Biden signed the Inflation Reduction Act which lowers health care costs for the American people. Along with fighting inflation and making key investments in climate and energy, the bill will finally rein in prescription drug costs for millions of seniors and continue to make health insurance more affordable and accessible. This is a once-in-a-generation historic piece of legislation, and it infuses us all with a much-needed ray of hope.
We now have hope because the Inflation Reduction Act will lower health care premiums by extending Affordable Care Act (ACA) Advanced Premium Tax Credits (APTC) for three years, helping level the playing field for working families and deliver affordable care to Americans from all walks of life, including older adults, people with disabilities, people in rural communities, and people of color. The APTC allows Americans who get insurance coverage through the Health Insurance Marketplace® to use a tax credit to lower insurance premium based on estimated income for the year. Extending these tax credits is among the most efficient and direct ways to lower cost of living and deliver long-overdue relief to families, while ensuring they can continue to access the care they need.
WHAT COMES NEXT
Medication will become more affordable for seniors. Decades in the making, the Inflation Reduction Act finally gives Medicare the power to negotiate lower drug prices. This alone will drive down the prices of some of the most popular and expensive drugs for seniors on Medicare. Medicare beneficiaries will have more reasonable caps on out-of-pocket spending on medications, and my personal favorite, the Medicare $35 copay for insulin. This will make a world of a difference for the more than 3.2 million insulin users on Medicare Part D. Polling shows over 80 percent of Americans support giving Medicare the power to negotiate, making it among the most popular provisions in the entire bill. By 2030, more than 80 drugs will be eligible for Medicare price negotiation.
All of this will allow healthcare providers to confidently provide the treatment and care our patients actually need because these barriers will no longer stand in the way. Though much of this legislation only applies to patient with Medicare, there is hope that it will start the precedent for other private insurance plans and Medicaid to then follow with regard to helping medication be more affordable for patients and as well as improve access to care.
As a Family Physician who has been seeing patients for almost 20 years, I now have a ray of hope that soon, my patients will be able to seek out the care and treatment they need without worrying having to choose between their health and putting food on the table or keeping the lights on. I now have a ray of hope that I will be able to spend my time listening, assessing, diagnosing, educating, and guiding my patients rather than filling out prior authorization forms, patient assistance forms, and other piles of denial paperwork in order to advocate for needed treatment.
This legislation gives us hope that providers can guide patients back on that path to wellness by providing them with chronic and preventative care. Providers can develop deeper, more meaningful relationships with patients, leading them to regain trust that their provider and the healthcare system will allow them to access necessary treatment.
So, thank you to our members of Congress and the dedicated advocates for working tirelessly to pass the Inflation Reduction Act. This historic legislation is a huge step forward and it has restored a sense of hope that we can look ahead to a healthier community.
About the Author
Suganya Karuppana, MD, is a Board-Certified Family Physician with over 20 years of experience in healthcare and 10 years of physician leadership in community health in the Phoenix area. Dr. Karuppana recieved her medical degree from Albany Medical College. She would go on and complete her Family Medicine Residency and Fellowship at Harbor-UCLA Medical Center in Los Angeles, CA. She would go on to earn her Masters of Science of Health Care Delivery from Arizona State University. She is currently the Chief Medical Officer at Valle Del Sol.