Health Affairs March 20, 2025
Fifty-three million Americans voluntarily choose to have prescription drug coverage provided through the Medicare Part D program. Medicare Part D is a managed competition market in which private insurers provide publicly funded services. This enables beneficiaries to select prescription drug coverage they believe best aligns with their health care needs and financial situation instead of relying on a single large government program.
In 2025, the Inflation Reduction Act (IRA) substantially changes how the prescription drug costs of Medicare Part D enrollees with high pharmacy spending are split between the federal government reinsurance program and private insurers. Historically, the government has borne a large share of prescription drug costs for beneficiaries with particularly high prescription drug costs through a program called...
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