Weekly Column: The IRA's Health Care-Lessness

The Biden-Harris Administration’s Inflation Reduction Act (IRA) misdiagnosed the health care access and affordability problem and prescribed bureaucratic, big-government, misguided solutions.  Seniors deserve better.  Assessing the flaws of the IRA helps us chart a more productive path for congressional action to improve access to cost-effective, quality health care moving forward. 

The Senate Finance Committee has proven that bipartisan consensus and deliberative policymaking can yield real solutions, from driving down prices at the pharmacy counter to ensuring patients can confidently select a mental health provider who fits their needs.  Unfortunately, the IRA took the opposite approach, advancing top-down, problematic program overhauls through a rushed, partisan process that ignored constructive input. 

Two years ago, my Republican colleagues and I joined patient advocates, small businesses and frontline providers in warning of the destructive nature of price controls on domestic manufacturing, drug development and American leadership on the global stage.  The law’s results to date suggest we should have struck an even more cautionary tone.  From a national security standpoint, as China supercharges its biopharmaceutical sector, the IRA waves a white flag, treating American job creators like adversaries.  Bureaucratic price fixing, under the guise of negotiation, may sound appealing, but it comes at a massive cost--particularly as firms begin to look elsewhere to launch new life-saving treatments. 

The implications for the therapeutic R&D pipeline are already apparent, with at least 21 drugs and 36 research programs discontinued since the law’s enactment.  Even for approved drugs, delays and denials in care have started to skyrocket—and yet the Biden-Harris Administration inexplicably excluded medications from its prior authorization reforms. 

Further, for Americans with rare diseases, 95 percent of which lack an approved treatment, the IRA contains a rigid disincentive for finding new uses for existing orphan drugs.  By providing preferential treatment to injectables and infused medicines, the law also systematically disadvantages capsules and pills, including oral cancer drugs, Alzheimer’s therapies, mental health medications and other clinical breakthroughs.  For insulin, it was President Trump who took action to ensure that all seniors with diabetes had access to plan options with copays of $35 or less.  In contrast, the IRA has resulted in plans actually tightening access to diabetes drugs. 

The Administration’s reliance on heavy-handed government intervention has also triggered annual premium increases, which have been hidden from consumers by subsidies and legally dubious programs.  I have called on the Government Accountability Office and Congressional Budget Office to look into these initiatives.

Encouragingly, bipartisan Members of the Senate and House have begun efforts to address these devastating outcomes and other consensus-based improvements will undoubtedly follow.  After all, the strongest and most enduring Medicare enhancements have always attracted support from across the political spectrum.  To that end, virtually all Republicans have long favored an out-of-pocket cap for seniors’ medication spending. 

Over the course of the current Administration, Americans have experienced persistent economic headwinds, from slow job growth to consistently high inflation and dwindling consumer purchasing power.  We should continue taking steps to enact the Finance Committee’s bipartisan reforms.  Instead of perpetuating a tax-and-spend agenda, we can and should work together to improve health care choice, affordability and reliability for all Americans. 

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