IRA and MFN: Two Sides of the Same Coin

“Will Mr. Biden still be crowing when the price controls he and Sen. Joe Manchin made a cornerstone of their [2022] ‘Inflation Reduction Act’ don’t work as touted? Will he still praise government price controls on Medicare pharmaceuticals when Bidenomics meets economic reality, as this experiment in socialized medicine plays out?”

These are questions Locke’s Notebook asked in 2023. Back then, President Biden and Sen. Manchin were jubilant over having accomplished Bernie Sanders’ and Elizabeth Warren’s socialist dreams in the IRA.

Fast-forward to the present, and neither of those architects of U.S. socialized medicine remains on the political stage. Their IRA has now borne fruit that’s proving our clear foresight and their blindness by their political ambitions.

Word is that health insurers' 2026 premiums for ACA health plans have come in at a significant increase over 2025—driving up Americans' health care costs. The median rate hike is 15%, with some plans charging in excess of 20%--even 25%--more. Every beneficiary pays the premium, whether he or she needs a lot or very little medical care.

Medicare Advantage plans had been stable before the IRA, explaining enrollment in the MA program’s private insurance options now exceeding half of all Medicare beneficiaries. But the IRA is forcing unwelcome changes.

The IRA incentivizes Medicare Part D and Advantage-participating health plans to raise Medicare beneficiaries’ costs. A recent study by the University of Southern California’s Schaeffer Institute finds that Medicare health “plans have substantially increased beneficiary cost-sharing exposure” thanks to the IRA. The IRA has caused these health insurers to raise deductibles and replace copays with coinsurance (where a patient is liable for a percentage of the overall cost, in the case of prescriptions, based on the list price), the Schaeffer Institute reports.

Prior authorization has also become a barrier for more Medicare patients to receiving care promptly and efficiently. Fewer Part D plans are now available, posing access challenges to Medicare beneficiaries who live in rural areas.

Those who hold property rights, economic freedom and free enterprise dear should cry out for IRA repeal. Demand the bolstering of Medicare’s dynamic pre-IRA private-sector options.

Further, we all must insist on stopping the dangerous, unprincipled trend pushing government intervention in the free market. In particular, this includes opposing government price controls, such as “most favored nation” foreign reference pricing. Conservatives for Property Rights has cautioned about price controls’ dangers here, here, here and here, for example.

Reference pricing such as "most favored nation" price controls, just like IRA's Medicare drug price controls already, would further diminish drug sector R&D funds, reduce the number of viable biopharma projects, slow the rate of innovation and lower the number of new generic drugs available to patients.

CPR, a member of the Coalition Against Socialized Medicine, has consistently opposed price controls, regardless of the party in power. That’s because self-imposed price controls do nothing to end foreign freeloading by socialized medicine countries that set artificially low drug prices. Rather, such price controls only harm patients, dehumanize medical practitioners who must carry out inhumane consequences like rationing care and forcing un-QALY-fied patients to die, and ensure that medical innovation doesn’t happen in that country.

In short, adopting the very policies that have led to terrible consequences in other nations should not be an option in the United States of America. Rather, we must return to our principles and lean on our strengths. We’ll be a better nation for it.