1
For additional information on the estimate for the 2022 Reconciliation Act, see Congressional Budget Office, Estimated Budgetary Effects of Public Law 117-169, to Provide for
Reconciliation Pursuant to Title II of S. Con. Res. 14 (September 7, 2022), www.cbo.gov/publication/58455. Overall, CBO estimated that the law would decrease the deficit by $58
billion over the 2022–2031 period, excluding any additional revenue resulting from an increased appropriation to the Internal Revenue Service. For additional information on the safe
harbor rule, see Congressional Budget Office, “Incorporating the Effects of the Proposed Rule on Safe Harbors for Pharmaceutical Rebates in CBO’s Budget Projections”
(supplemental material for Updated Budget Projections: 2019 to 2029, May 2019), www.cbo.gov/system/files/2019-05/55151-SupplementalMaterial.pdf.
The act, which became Public Law 117-169 in August 2022, contains roughly 150
provisions, including ones that:
§ Affect prescription drug prices and coverage under Medicare,
§ Expand health insurance subsidies established by the Affordable Care Act,
§ Establish a new alternative minimum tax on corporations,
§ Provide additional funding for the Internal Revenue Service, and
§ Create subsidies for renewable energy.
The Congressional Budget Office estimated that the provisions related to prescription
drugs would reduce the deficit by $237 billion from 2022 to 2031. Three key policies
discussed in this document are responsible for $129 billion of that reduction.
The rest of the deficit reduction largely results from delaying a rule (commonly known
as the safe harbor rule) to restrict the ability of manufacturers and insurers to negotiate
rebates for prescription drugs. The estimates in this document reflect that delay.
Prescription Drug Provisions Are Part of the
2022 Reconciliation Act