The IRA is unraveling the “Part D” drug benefit — and hitting seniors with bills that few can afford. It’s high time to review what went wrong.

The IRA’s most heralded reform gave Medicare officials the authority to set prices on a growing list of medicines covered by the program. Most thought the law would translate into savings at the pharmacy counter, but the IRA’s price-setting provision was designed to save the government — not patients — money. 

The IRA’s framers knew that the law wouldn’t reduce drug prices immediately, so they included other sweeteners. One, a cap on monthly insulin costs at $35, has taken effect and is rightly popular. Another, lowering the cap on out-of-pocket drug expenditures, could have been popular — except that it doesn’t take effect until next year, and was so poorly designed it’s already producing surprise premium increases.