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The provisions in the Inflation Reduction Act are designed to lower costs for Medicare patients and the uninsured drew sharply different reactions from the two men campaigning to represent Rim Country and the White Mountains in Congress.

The Act would sharply lower prescription drug costs for millions of Medicare patients and cap total prescription drug prices. It would also extend existing subsidies for insurance policies through the Affordable Care Act for middle-income people without insurance.

The bill also included a host of new subsidies for electric cars, solar cells and other green energy initiatives — as well as a new minimum corporate tax for corporations earning more than $1 billion annually.

Rep. Tom O’Halleran (D-Oak Creek) voted for the package, which passed both the Senate and the House on a straight party-line vote.

“Like the hardworking Arizonans I talk to, I too am concerned about inflation, extremely high prescription drug prices for seniors, and tangible issues like the Southwest’s sustained drought that leads to wildfires and devastating floods, especially in Arizona’s First District,” said O’Halleran. “That’s why I voted in favor of this legislation: it finally caps out-of-pocket costs for prescription drugs for seniors, invests in common-sense solutions that will provide relief in our changing climate, lowering energy costs and improving drought conditions, and sensibly pays down the national deficit, fighting inflationary costs of everyday goods in the process.”

He noted that in 2018 he introduced a bill that would have capped drug costs for Medicare, since the state has 1.35 million people on Medicare — many of them living on a fixed income of about $30,000. Older Americans take an average of 4.7 prescriptions every month.

Eli Crane, who won the Republican nomination to challenge O’Halleran in Congressional District 2, had not replied to an email request for comment as of press time.

However, Republican leaders in the House and Senate argued that the bill would harm the economy by increasing taxes, feed inflation by increasing government spending and prompt drug companies to cut back on research and development of new prescription drugs.

O’Halleran remains one of the most vulnerable Democratic incumbents in the House, due to redistricting that added several Republican strongholds to his already highly competitive district. Post-primary polls show Crane and O’Halleran in a dead heat.

Crane is a former Navy SEAL, who gained fame after retiring from the military by appearing on the TV show “Shark Tank” to launch his business making bottle openers from 50 caliber shell casings. He’s been endorsed by former President Donald Trump, which boosted him to the front of a crowded Republican field in the primary.

The provisions limiting prescription drug costs for Medicare patients would have a big impact in Gila County, with a median age of almost 50. The provisions providing cheaper insurance coverage generally would have a big impact in Navajo, Apache and Gila counties, with their high poverty rates.

Medical advocacy groups say the Inflation Reduction Act represents the biggest boost to the uninsured and Medicare recipients in a decade.

Here are some of the medical care provisions of the Inflation Reduction Act:

• Caps the cost of insulin for Medicare patients at $35 per month starting next year.

• Immediately caps co-payment for prescription drugs at 5% once a patient hits the current “catastrophic care” total of $7,000.

• Starting in 2026, caps out-of-pocket prescription drug prices for Medicare patients at $2,000.

• Requires drug companies to pay rebates to Medicare if the cost of existing drugs rises faster than inflation.

• Gives Medicare the ability to negotiate for lower prices from a list of 11 frequently prescribed drugs.

• Extends for another three years the insurance subsidies for Affordable Care Act plans added during the pandemic. The subsidies amount to about $8,500 annually for each person who qualifies based on income. The extension increases the income threshold for getting the subsidies. It would affect an estimated 13 million people.

U.S. patients pay the highest cost for prescription drugs in the world, since it’s the only industrialized nation without some form of universal health care and Congress has previously prohibited Medicare from negotiating for lower drug prices.

The average Medicare price for brand name drugs doubled between 2009 and 2018 and since then has substantially outpaced inflation, according to the Kaiser Family Foundation.

For instance, the cost of the insulin drug Humalog went from $21 in 1999 to $332 in 2019 — a 1,000% increase, according to a commentary in the medical journal Mayo Clinic Proceedings.

At any given moment, an estimated 10% of U.S. citizens have no medical insurance, according to the federal Centers for Disease Control and Prevention. The uninsured rate is significantly higher in rural, low-income areas — like Navajo, Apache and Gila counties.

The U.S. Commonwealth Fund recently ranked the U.S. dead last among 11 comparable industrialized countries when it comes to health care outcomes. The U.S. has twice the rate of preventable death as Switzerland — the top ranked country. However, the U.S. spends far more on medical care than any other nation — both on a per-capita basis and as a percentage of the gross domestic product. The U.S. has a lower life expectancy, a higher infant death rate and a higher burden of chronic disease than most other industrialized countries.

Some 49 million Americans get prescription drug coverage through Medicare. The median age in Gila County is 50 — compared to 35 in Apache County and 38 in Navajo County. The average age in Show Low is 41, compared to 60 in Payson.

Gila County’s poverty rate is 22%, compared to 28% in Navajo County and 36% in Apache County.

Some 28 million Americans without insurance face a higher risk of death and disability, according to a study published in the Annals of Internal Medicine.

A study by the Institute of Medicine found significantly higher death rates among uninsured patients with cancer, diabetes, heart disease, kidney failure, mental illness and HIV infection.

A pandemic study found that lower insurance rates increased COVID death rates. For each 10% increase in the share of county residents without health insurance, COVID cases increased by 70% and COVID deaths increased by 50%. The study concluded that universal health insurance would have reduced COVID cases by 2.6 million and COVID deaths by 58,000 between the start of the pandemic and Aug. 31 of 2020, according to a summary of the research published by FAMILIESUSA.org.

Millions of people have gotten insurance coverage due to the pandemic increase in Affordable Care Act subsidies. The Inflation Adjustment Act would continue subsidies for people making between $51,000 and $80,000. It would also reduce increases in cost for people with plans.

Contact the writer at paleshire@payson.com

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