Joe Biden’s presidency is mercifully over. However, his damaging policies are still with us — as a recent announcement from Medicare officials made clear.
In mid-January, they selected 15 drugs for the second round of the Medicare Drug Price Negotiation program, which was authorized by the Inflation Reduction Act, Biden’s signature legislative achievement.
The IRA is upending Medicare, even though price controls on the 10 drugs selected in the program’s first round haven’t gone into effect. Seniors are facing substantial premium increases, fewer drug coverage options, and more insurer red tape as a result of the IRA.
It’s up to President Trump and congressional Republicans to roll back the IRA’s worst provisions before they do any more damage.
The IRA’s redesign of Medicare has sent seniors’ monthly premiums soaring. From 2023 to 2024, monthly premiums for Medicare prescription drug plans jumped by 21 percent. They would have climbed more this year if the Biden administration hadn’t orchestrated a multibillion-dollar insurer bailout last summer.
That bailout is unsustainable, though, so seniors should brace for more pain in coming years.
Even as premiums have risen, many insurers have left the Medicare market. There are 35 percent fewer standalone Part D prescription drug insurance plans offered in 2025 than in 2024.
Seniors are feeling this corporate squeeze in the care they receive. This year’s Part D plans feature more “utilization management” constraints — a fancy term for putting up roadblocks to essential medications. Insurers notoriously impose “prior authorization” requirements and “step therapy,” which forces patients to “fail first” with less effective drugs before being able to access the treatments their doctors recommended.
And that is before we get to the IRA’s central feature — price controls on prescription drugs.
The IRA divides drugs into two classes — and gives injectable “biologics” four additional years of exemption from price controls compared to “small molecule” treatments that typically come in pill form.
The exemption periods are a tacit acknowledgment that price controls deter investment in new medication. The disparate treatment means drug developers have a massive incentive to work on new biologics.
Ever since the IRA became law, laboratories have shifted research and development funding away from potentially life-saving small molecule drugs. Life sciences companies have delayed the development of medicines and halted early stage cancer therapy trials.
A University of Chicago analysis estimates this disparity will prevent Food and Drug Administration approval of 188 small molecule treatments and indications, costing patients an astonishing 116 million life-years lost!
Seniors deserve better. And Congress can do better by passing the Ensuring Pathways to Innovative Cures Act, which would give small molecules the same 13-year exemption from price controls as biologics.
The Biden administration is over. While undoing its full damage may take years, passing the EPIC Act would be a good place to start.
