Seniors’ costs for Medicare Part D are soaring. Joe Biden is to blame | Opinion
Seniors from coast to coast will soon be hit with notices of skyrocketing Medicare Part D premiums.
And there’s no mystery about who’s to blame. Seniors’ financial pain is a direct consequence of former President Joe Biden considers his crowning achievement — the Inflation Reduction Act — that was pushed through in 2022 under the banner of lowering drug costs.
The law has destabilized Medicare Part D, the prescription drug benefit that, for 20 years, has stood out as one of the rare bipartisan success stories in health care. Part D worked primarily because it wasn’t a traditional entitlement program. Instead, private insurance companies were free to design and market drug coverage to seniors, with the government merely helping subsidize the premiums.
By harnessing the power of market competition and consumer choice, Part D provided seniors with affordable access to medicines and stable premiums while consistently costing taxpayers far less than analysts had originally forecast.
But Biden’s handiwork has left millions of seniors paying more for less. Today, the average monthly Part D premium is 57% higher than it was in 2021, before the law took effect. And the pressure on seniors’ budgets is only mounting.
Just weeks ago, the Centers for Medicare and Medicaid Services announced that the national average bid — the amount insurers project it will cost to provide coverage — for 2026 jumped to $239.27, up from $179.45 this year, a 33% increase. The bids are used to calculate premiums, so seniors may soon be paying hundreds more dollars each year to maintain coverage. That’s a far cry from the savings Democrats promised.
At the same time, plan options are rapidly dwindling. Between 2024 and 2025, the number of stand-alone Part D plans offered nationwide fell from 709 to 464. That represents a 35% year-over-year drop and the smallest selection since the program began.
The trajectory is particularly troubling for low-income beneficiaries. The amount of zero-premium “benchmark” plans available to those who qualify for a low-income subsidy has fallen to 90, a 29% decline from 2024 and also the lowest level on record. With fewer benchmark options, vulnerable seniors who rely on the subsidy will face even more limited choices.
Seniors are also struggling to get the medicines that their doctors prescribe, as insurers increasingly limit access to certain medicines within the plans that do remain. One survey revealed that 96% of insurers are expanding the use of tools such as new prior authorization and fail-first requirements, meaning a patient may have to try the lowest-cost drug first before being allowed to have what the patient’s doctor preferred.
Even areas once left largely untouched, such as oncology and rare-disease treatments, are targets of these new restrictions. Seniors were promised straightforward coverage and are instead facing delays, denials and bureaucratic hoops before they can get their medicines.
The disruption stems from how the Biden law restructured Part D. Among other changes, the law capped seniors’ annual out-of-pocket costs, thus shifting billions of dollars in costs onto Part D insurers. The law also shifted catastrophic coverage costs, raising insurers’ share from 15% to 60% while reducing Medicare’s contribution, saddling plans with far greater financial risk.
Faced with billions in added costs, insurers responded predictably: raising premiums, dropping plans and limiting coverage.
The Biden administration tried to paper over the problem with subsidies. In 2024, it rolled out a “premium stabilization” demonstration that used taxpayer dollars to conceal the IRA’s fallout. And that temporary “fix” has carried a staggering price tag: Estimates range from $7 billion to as much as $20 billion in 2025.
The initiative was an election-year bandage, not a real solution. Once the subsidies run out, seniors will still be stuck with the same broken system, and premiums will keep climbing.
Put plainly: Democrats promised relief but delivered instability. They took a program that was working and turned it into one where seniors pay more, have fewer choices, and face more hurdles to care. And the damage will only mount until lawmakers re-embrace the market-oriented designs that originally made Part D so successful.
Merrill Matthews is a health policy analyst and co-author of “On the Edge: America Faces the Entitlements Cliff.”
