You don't have to do anything. But I did think about it over the evening and the change doesn't sit right with me, so I've taken it back.
Viewing post in Crimson High v0.39.0 Now available in Early Access! comments
If I understand you correctly, then no. It never worked like that, either. Each update is 20 bucks, just like the respective tier on Patreon is - which btw is where the $23 came from, because I never realized that I went with $20 on itch.io but 20€ on Patreon, which converts to $23.
You might think it's greedy to ask for 20 bucks every update - and in some ways it probably is - but keep in mind that the game is free in general. You always have the choice of just waiting two weeks (or one week for 75% off).
The repeating 20 bucks every update are so that I can keep doing this as a full-time job, thus delivering full-time work. I.e. monthly updates of consistently increasing quality.
No one is required to ever pay anything for Crimson High. The early access is solely a way for me to fund the game.