Millions of older American could benefit from provisions in the new climate and healthcare spending package that lower prescription drug costs. For Black and Latino seniors, who disproportionately suffer from chronic diseases and struggle with high costs, the package, if passed and signed by Joe Biden, could be especially life-changing.

The Inflation Reduction Act, which the US House is expected to pass on Friday, would give Medicare the power to negotiate prices with pharmaceutical companies for up to 10 drugs starting in 2026. But other provisions could make the annual out-of-pocket costs for US seniors more affordable, which could disproportionately help low-income Americans and Black and Latino seniors on Medicare, who are up to twice as likely to struggle with paying for medication as white Americans.

“This is a population that’s more likely to live with certain diseases that are often treated with expensive medications. It’s also a population with relatively limited income and assets,” says Tricia Neuman, executive director of the Kaiser Family Foundation’s Program on Medicare Policy. “It’s a double whammy that makes Black and Latino beneficiaries more vulnerable but also puts them in a place where they’re likely to be helped by the provisions.”

The legislative package, lauded for its sweeping $369bn investment toward addressing climate change, would include a $2,000 annual cap on drug costs for seniors and a monthly cap of $35 for insulin. The spending bill would also eliminate the cost of vaccines for seniors and a three-year extension of federal subsidies for lower-income Americans who buy private insurance through the Affordable Care Act, helping up to 15 million Americans.

“When a patient has several different conditions that they come into the office to see us with, $2,000 can be what they pay for a month for their medications, $2,000 can be what some patients pay for for a single prescription,” Utibe Essien, an associate professor of medicine at the University of Pittsburgh who has studied prescription drug inequity, said. “To limit that to the annual cost of prescriptions is going to be life-changing for a lot of patients and their families.”

While the healthcare provisions will impact older Americans on Medicare nationwide, the reality is that the burden of high prescription drug costs falls unevenly on Black and Latino Americans, who are more likely to work in lower-paying jobs with fewer retirement benefits, earn less income and hold less savings than their white peers. At the same time, in a country where people pay more than twice as much for prescription drugs as other countries, Black and Latino Medicare beneficiaries “are more likely to report being in relatively poor health, have higher prevalence rates of some chronic conditions, such as hypertension and diabetes than white beneficiaries”, according to a Kaiser Family Foundation analysis in 2021.

The combination of disparate suffering and the struggle to afford the significant costs to address that suffering, in turn, forces Black and Latino seniors into a devastating dilemma.

KFF researchers found that the median income per capita for white seniors on Medicare was double that of Latinos and one and a half times that of Black Americans. What’s more, researchers found that white Medicare beneficiaries overall held a median savings per capita of more than $117,000, more than eight times that of Black beneficiaries and a staggering 12 times that of Latinos.

Under the bill, a $2,000 annual cap on out-of-pocket drug expenses would go into effect in 2025. Currently, in an environment where there is no limit on costs, 1.4 million seniors on Medicare spent more than $2,000 on prescription drug costs in 2020, according to the Kaiser Family Foundation.

What’s more, the monthly cap on insulin, which goes into effect next year, would aid the more than 3 million Medicare beneficiaries who use insulin. But the disparities go beyond: nearly half of Black and Latino seniors on Medicare reported having diabetes, compared to less than a third of white beneficiaries. And while more than 3 million seniors covered by Medicare struggled to afford medications in 2019, Black and Latino seniors were nearly twice as likely to report not getting their necessary prescriptions because of costs than white seniors.

Essien says that the bill will reduce the costs that drive health disparities among seniors. Yet, for some provisions, its true impact may not be felt for years: Medicare negotiation of drug prices, for instance, fully goes into effect in 2026 and will be limited to 10 drugs to start. What’s more, the cap on monthly insulin costs leaves out those who are covered by private insurance.

Though the bill focuses on reducing healthcare costs, it fails to address the underlying causes of racial health disparities such as people’s unequal access to pharmaceutical care and the biases Black and Latino patients face within the medical system. Essien hopes the savings from drug costs in the bill would “allow us to start to address some of these fundamental root causes of health inequities in our country”.

“We must applaud this bill because it is going to reduce costs of drugs for millions of Americans each year, specifically for older Americans,” he says. “Why these disparities exist is what we have to get to the bottom of. A bill that reduces medication costs isn’t necessarily alone going to address that.”