Life Lessons

Thanks to Joe Biden, The Inflation Reduction Act Prescription Drug Cap Protects Seniors

I am grateful for a policy that helps seniors survive

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Filling and taking prescription drugs for chronic and deadly diseases is not optional, especially for seniors. Millions of Americans cannot live normal lives without medications for their physical and mental health issues. Without the 2026 $2,100 Medicare prescription drug cap, my family’s budget would be broken.

The lack of a routine daily drug can end a person’s life. Many Americans have died because of an inability to obtain medications. The lack of medications for cancer, chronic diseases, and mental health makes a person’s day-to-day life miserable.

Our 2026 Status

Biden is no longer president, but his $2,000 cap on out-of-pocket costs for prescription drugs was part of the Inflation Reduction Act (IRA) of 2022, which applies to Medicare Part D. The changes went into effect on January 01, 2025. The cap on out-of-pocket costs for prescription drugs was not the only change made in the cost of care for seniors in the IRA.

The cap is adjusted annually for inflation, with the 2026 adjustment to $2,100, up from $2,000 in 2025 when the program started. The $2,100 applies to all prescription drug costs: deductibles, copayments, and coinsurance.

As much as I would love to blame all the current drug cost increases on President Donald Trump, it is not true. Although a number of Trump's executive orders changed the prescription drug game, the big drug companies are greedy bitches, constantly raising the cost of custom drugs that have not been around long enough to have a generic counterpart.

“Generic drugs are prescription drugs that have the same active ingredients as their brand-name counterparts. Generics work like brand-name drugs in dosage, strength, and performance. They also meet the same quality and safety standards as brand-name drugs.

When patent protection for a brand-name drug expires, the U.S. Food and Drug Administration can approve a generic version of it for sale. The patent protection for a brand-name drug is usually 20 years from the date of the submission of the patent. Since generic drug manufacturers don’t develop a drug from scratch, the costs to bring the drug to market are lower.: hmsa.com,” What Are Generic Drugs and When does a Drug become Generic

Once a drug loses patent protection and becomes generic, anyone can make it, and it becomes less costly, but the drug must still be approved by the FDA before it goes on sale.

“In the United States, 9 out of 10 prescriptions filled are for generic drugs. Increasing the availability of generic drugs helps to create competition in the marketplace, which then helps to make treatment more affordable and increases access to healthcare for more patients.” Learn more about the FDA Drug Competition Action Plan. (Food and Drug Administration) from Frequently Asked Questions on Patents and Exclusivity

It turns out that the prescription drug cap has an outsized effect on those of us on a fixed income. That the drug cap does not help everyday Americans is one of my biggest complaints about the cap. It would have been better if everyone who needed medication got a break, not just seniors.

Why the Drug Price Cap Matters

My spouse had a daily drug that cost $20/per month in 2025; that same drug now costs $763 per month in 2026. I had a GLP-1 drug that I got directly from the pharmaceutical company for free on a medication assistance program through a hospital. Our other drugs have gone up $102 per month.

The GLP-1 cost is now $373 per month, with insurance, after Trump met with the GLP-1 companies to lower the cost for everyone. The original $1,200 to $1,700 cost for GLP-1 drugs will supposedly drop to $300 to $500 per month without insurance once the “deals” take effect.

The cost of our prescription drug premiums increased by $30 per month. We have a significant monthly increase in medication costs of $1,298. Multiply that by 12, and we are talking about a $15,576 per year increase.

Most people cannot tolerate a $1,298 monthly impact on their budget. We certainly cannot. To live comfortably (until we die), we tightly manage our expenses, earning the money we use for gifts and trips as we go. Our Boomer goal is never to have to ask our children for support.

Thanks to the prescription drug cap that limits seniors’ drug costs to $2,100 per year, the overall impact of our prescription drugs is reduced by about $11,000/year every year. $11,000 is nothing to sneeze at on a fixed income.

On the other hand, to obtain our needed drugs, we will spend a minimum of $4,200. The IRA drug cap turned an unmanageable expense into a manageable cost. We can stay healthy without going broke.

Gratitude with Every Refill

President Trump has launched several drug cost-reduction programs that will not take effect until later in 2026. To date, his plans have only hurt my wallet. Trump eliminated Biden's executive orders that affected drug costs as soon as he took office. Now, he is putting in his reductions.

The change in the GLP-1 price, negotiated by Trump and set to take effect in 2026, led to the cessation of many medication assistance programs. The TrumpRx website, where drugs, including GLP-1, are supposed to be at reduced cost, is not up and running yet.

Trump has multiple other programs that should come to fruition in 2026. These are driven by his Most-Favored-Nation (MFN) program, executive orders, and deals with pharmaceutical companies.

I fervently hope some of those programs will actually drop the price of drugs, but right now, I know seniors who are not buying their medications in January because of the increased costs. The cap alone isn’t enough, because you still need the money to pay the $2,000. Trump’s medication program changes are poorly executed.

The Biden cap on out-of-pocket prescription drugs for seniors means less fear, and every American deserves that. Nevertheless, I am hopeful the Trump changes will take effect soon.

We Needed a Break

I suspect my family is not the only one affected by the change in drug costs — all I can say is that I am deeply grateful to the Biden administration for figuring out a way to help older Americans.

It matters if our government cares about us. The IRA drug cap did not just save us money; it also allowed us to budget and provided peace of mind.

Thank you, President Joe Biden.

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