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Looking at the Act, there is no clear indication that it can’t go down. The inflation adjustment is based on the amount by which the index exceeds the index for the year ending August 2018. If we were to have a year of negative inflation, the 2021 index figure could exceed the 2018 figure by a smaller amount than the 2020 figure. To the best of my knowledge, there is little if any expectation of negative inflation (or deflation), and the Federal Reserve would act vigorously to counter that possibility if it appeared likely, but as far as I can tell there is at least a remote chance the IRMAA figure could decline.