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United States: major measures to address health care and the climate crisis

(Washington) – The US government’s passage of the Inflation Reduction Act advances the right to health care for millions of people in the United States, Human Rights Watch said today. Despite some problematic provisions, the law, signed into law by President Joe Biden on August 16, 2022, is also the most significant action the government has taken to address the climate crisis.

The historic package of reforms addresses two crises that have profound human rights implications: health care affordability and climate change. However, future actions based on the law are necessary to fully meet the government’s obligations under international human rights law.

health reforms in the Inflation Reduction Act of 2022 are more modest than those of the defunct Build Back Better Act, but they will continue to be life-changing, reduce drug costs for millions of older people and make health insurance private more affordable for people with low or middle income.

“Medicine pricing reforms do not make essential medicines affordable for everyone, but they are a complete game-changer and set a framework for improvement,” said Matt McConnell, economic justice and rights researcher at Human RightsWatch. “Extending health insurance subsidies is also vital for millions of households already struggling with inflation and health care costs. insulin were removed from the bill.

Soaring drug prices and inadequate health insurance have created an unaffordable drug crisis in the United States, which undermines the right to health, drives people into financial distress and debt, and disproportionately affects socially and economically marginalized people, Human Rights Watch said.

The law includes major drug price reforms to address this crisis, but they do not reduce prices for everyone or adequately address the skyrocketing costs of some life-saving drugs, such as insulin. Yet they represent the most significant health reform in the United States since the Affordable Care Act of 2010.

Under the Inflation Reduction Act, the US government has taken a first step toward fulfilling its obligations under international human rights law to regulate drug prices and ensure that people have equal and affordable access to essential medicines, Human Rights Watch said. The act authorize health insurance, the US public health insurance program for the elderly and disabled, to begin negotiating prices for some of the most expensive prescription drugs it covers. It penalizes drugmakers who raise the prices of their products at rates faster than inflation and creates a cap on drug costs for Medicare beneficiaries.

The law also expands federal subsidies that help millions of people afford private health insurance purchased in a government-run marketplace. These enhanced subsidies were due to expire at the end of this year, potentially causing more three million people become uninsured and many more to move to less protective, high-deductible health plans.

Because of the Inflation Reduction Act, the federal government will continue to cover almost entirely the cost of health insurance for millions of people, including many workers whose wages are close to poverty, until 2025.

Despite the law’s many measures to make health care affordable, its potential impact was significantly weakened by the last-minute removal of two key insulin provisions. Republican Senators got enough votes in the Senate to remove language that would have included all insulin products in Medicare negotiations and capped copayments for insulin under all public health insurance plans and private at 35 USD per month.

While a co-pay cap on insulin for all Medicare beneficiaries was eventually included in law, removing these other provisions amounts to a lost opportunity to meaningfully address the affordability crisis. insulin in the country, Human Rights Watch said. Even if these provisions had been included, the law still would not have covered people without health insurance, who often have to bear the full costs of soaring insulin prices.

The act is the US government’s largest legislative package to address climate change. The United States is currently the first second biggest emitter of greenhouse gases and is responsible for the biggest share of global emissions historically. Climate change threatens a range of human rights around the world, including in the United States, and particularly affects low-income people as well as Black, Indigenous, and people of color as a whole, exacerbating existing structural inequalities.

“While the Cut Inflation Act takes much-needed steps to reduce greenhouse gas emissions and spur the development of a clean energy economy, it is also a gift to the fuel industry. fossil fuels,” said Felix Horne, senior environmental researcher at Human Rights Watch. “The United States should be doing more to support frontline communities instead of increasing support for an industry most responsible for fueling the climate crisis.”

The law will allocate $369 billion to reduce greenhouse gas emissions by investing in renewable energy, promoting energy efficiency and subsidizing electric vehicles. It is expected to reduce greenhouse gas emissions in the United States to 40 percent 2005 levels by 2030.

In a win for community public health, the law includes funding to reduce air pollution in schools and near major transportation corridors and ports in low-income communities, and provides financial assistance for improve access to drinking water. It is also providing $15 billion to provide rooftop solar power projects in low-income communities.

Despite these promising provisions, the act provides considerable support for the fossil fuel industry, allowing the auctioning of millions of acres of public land for oil and gas production and limiting leases on federal lands for renewables until oil and gas lease thresholds have been reached.

While these concessions to the fossil fuel industry may have been necessary to garner political support for the law, the potential impact of the billions of dollars spent to tackle the climate crisis is significantly limited by simultaneously encouraging greater production of fossil fuels, Human Rights Watch said. There is a growing consensus, including from the International Energy Agency, that for governments to meet global climate goals, there can be no new oil, gas or coal development. .

The Cut Inflation Act of 2022 is an important step, but the United States still has a long way to go to realize the right to health and meet its human rights obligation to fight climate change, said said Human Rights Watch.

The law takes essential steps to reduce U.S. greenhouse gas emissions, but it does not do enough to protect the rights of those on the front lines of fossil fuel production and those already impacted by climate change, nor will it allow the United States to fully meet its emissions reduction targets. The U.S. government should urgently put an end to all forms of support for new oil, gas and coal development to rapidly reduce emissions in line with its human rights obligations and limit the human rights impacts of climate change.

The US government is also obligated under international human rights law to ensure that essential medicines, including insulin, are affordable to everyone in the country who needs them. Congress should quickly enact legislation to meet this obligation, building on the Inflation Reduction Act’s drug pricing reforms. In particular, he should consider legislation to provide free insulin to all insulin-dependent people in the country and to impose caps on the list prices of certain drugs. Congress should also further improve theaffordabilityandavailablityquality health insurance for low- and middle-income people.

“The Cut Inflation Act is a major victory for organizers, activists and human rights defenders,” McConnell said. “But the concessions made only underscore how far the United States still has to go.”