THE BIDEN-HARRIS ADMINISTRATION has made expanding access to high-quality, affordable health care a top
priority in the United States. That includes working to bring down health care costs and strengthen health care
coverage so Americans can have peace of mind knowing that an emergency or a visit to the doctor’s office
won’t send them into bankruptcy.
According to projections from the U.S. Department of Health and Human Services, because of President
Biden’s Inflation Reduction Act (IRA) – his landmark law to lower prescription drug costs – about 1,323,000
Texans will save an average of $400 per year on prescription drug costs when new policies, including the
$2,000 annual out-of-pocket cap on Medicare prescription drug costs go into effect in 2025.
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This is in
addition to the hundreds of thousands of Texans who are already saving money on insulin and vaccines
because of President Biden’s prescription drug law.
The President’s new lower cost prescription drug law is helping to connect more Americans to quality care
while giving them some extra financial breathing room. This includes:
• Making recommended vaccines available at no cost – in 2023, more than 10.3 million Medicare Part D
enrollees received a recommended vaccine free of charge, which saved those enrollees more than $400
million in out-of-pocket costs;
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• Eliminating cost-sharing in the catastrophic phase of the Part D benefit, capping annual out-of-pocket
drug costs for prescription drugs, capping insulin costs at $35/month per covered insulin product, and
expanding the Low-Income Subsidy (LIS) program for people with Medicare Part D;
• Allowing Medicare to negotiate lower prescription drug prices directly;
• Requiring drug companies to pay a rebate to Medicare if they raise certain drug prices faster than the
rate of inflation; and
• Continuing enhanced premium tax credits that help millions of people covered under the Affordable
Care Act (ACA) save on their Marketplace health insurance.
Lowering Prescription Drug Costs for Hundreds of Thousands of Texans
Nearly 4.7 million residents of Texas were enrolled in Medicare as of February 2024.
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•
As of February 2024, nearly 3,727,000 residents of Texas were enrolled in Medicare Part D.
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• In 2025, the IRA changes are expected to save about 1,323,000 Medicare Part D enrollees in Texas an
average of $400 per year, for a total of nearly $529 million.
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Nearly 624,000 Medicare Part D enrollees in Texas take drugs selected for negotiation including:
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• Nearly 308,000 Medicare Part D enrollees who take Eliquis or Xarelto, drugs used to prevent and treat
blood clots.
• Over 226,000 Medicare Part D enrollees who take Jardiance, Januvia, or Farxiga for Type 2
Diabetes.
• Over 35,000 Medicare Part D enrollees who take Entresto to treat heart failure.
In 2023, nearly 720,000 Medicare Part D enrollees in Texas received a recommended Part D covered
vaccine with no cost sharing, which represents 20 percent of the state’s total Part D population.
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1
https://aspe.hhs.gov/sites/default/files/documents/93a68f3c5ca949dcf331aa0ec24dd046/aspe-part-d-oop.pdf
2
https://aspe.hhs.gov/reports/ira-elimination-vaccine-cost-sharing-2023
3
https://data.cms.gov/summary-statistics-on-beneficiary-enrollment/medicare-and-medicaid-reports/medicare-monthly-enrollment//data
4
https://aspe.hhs.gov/sites/default/files/documents/9a34d00483a47aee03703bfc565ffee9/ASPE-IRA-Drug-Negotiation-Fact-Sheet-9-13-2023.pdf
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https://aspe.hhs.gov/reports/ira-elimination-vaccine-cost-sharing-2023
The Biden-Harris Administration
is Lowering Health Care Costs for
Hundreds of Thousands of People Across
Texas
The IRA expanded eligibility for Medicare’s LIS Program. Nearly 41,000 Partial LIS enrollees in Texas
would have received full LIS benefits if the IRA’s LIS eligibility expansion had been in effect in 2020.
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Increasing Access to Affordable Health Care for Millions of Texans
The Biden-Harris Administration has a simple vision: “Health care is a right for all and not a privilege for the
lucky few.” That’s why the Biden-Harris Administration has made expanding access to high-quality,
affordable health care a top priority. More than 300 million people now have access to quality, affordable
health care, including over 21 million who enrolled through the Marketplaces, made possible because of the
ACA. Over 45 million people are currently enrolled in Marketplace or Medicaid expansion coverage under
provisions of the ACA, the highest total on record.
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This has contributed to the current historic low in the
uninsured rate, which in 2023 was less than 8 percent.
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Between 2020 and 2023, plan selections in
HealthCare.gov Marketplaces, which account for more than half of total Marketplace enrollment, grew by 103
percent among Latino individuals, 95 percent among Black individuals, 59 percent among American Indian
and Alaska Native individuals, 28 percent among Multiracial individuals, 25 percent among White individuals,
and 14 percent among Asian American, Native Hawaiian, and Pacific Islander individuals.
More people in Texas have health insurance coverage since the implementation of the ACA.
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Since the implementation of the ACA, the total uninsured rate in Texas decreased 5.5 percentage
points (22.1% in 2013 vs. 16.6% in 2022).
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In 2024, 3,485,000 residents of Texas selected a health plan through the ACA Marketplace.
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• In 2023, the average subsidy per month for consumers who received a subsidy in Texas was $540
and the average monthly premium after subsidies was $58.
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• In addition, 88 percent of Texas enrollees could find coverage for $10 or less.
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Strengthening Medicaid
More people in America are enrolled in Medicaid for comprehensive, quality health coverage than in any other
program. To date, 40 states and the District of Columbia have expanded Medicaid under the ACA, meaning
more people in those states will now have access to better health coverage and a pathway to a more prosperous
and healthy future. If the remaining ten states expanded Medicaid, an additional nearly 3.5 million would be
covered, including 1,378,000 in Texas. As of February 2024, approximately 83 million people were enrolled in
Medicaid or the Children’s Health Insurance Program (CHIP).
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In the last three years, the Biden-Harris
Administration has expanded access to uninterrupted postpartum coverage for a full year after birth, expanded
12-month continuous eligibility for Medicaid to all children in Medicaid and CHIP, and has urged states to
expand service delivery in schools, including for behavioral health care. In addition, under section 9817 of the
American Rescue Plan Act, states expect to spend nearly $37 billion in federal and state Medicaid funds on
activities to enhance, expand, or strengthen home and community-based services.
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• As of February 2024, over 4.1 million residents of Texas were enrolled in Medicaid or CHIP.
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• Texas has not expanded Medicaid under the ACA. If Texas were to expand Medicaid an estimated
1,378,000 people would be newly eligible for health coverage.
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6
https://aspe.hhs.gov/reports/expanded-financial-protections-under-low-income-subsidy-program
7
https://www.aspe.hhs.gov/reports/aca-related-enrollment-february-2024
8
https://www.aspe.hhs.gov/reports/national-uninsured-rate-remains-77-percent-q4-2023
9
https://www.cms.gov/files/document/early-2023-and-full-year-2022-effectuated-enrollment-report.pdf
10
https://www.cms.gov/CCIIO/Resources/Data-Resources/QHP-Choice-Premiums
11
https://www.medicaid.gov/medicaid/national-medicaid-chip-program-information/downloads/february-2024-medicaid-chip-enrollment-trend-
snapshot.pdf
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https://www.medicaid.gov/medicaid/home-community-based-services/downloads/arp-sec9817-overview-infographic.pdf
13
https://www.medicaid.gov/medicaid/national-medicaid-chip-program-information/medicaid-chip-enrollment-data/monthly-medicaid-chip-
application-eligibility-determination-and-enrollment-reports-data/index.html
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https://www.aspe.hhs.gov/reports/updated-estimates-medicaid-eligibility-non-expansion-states
