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Opinion: The IRA Put Roadblocks Between Rural Americans and Their Medication

Patients across the nation rely on timely access to their life-saving medication. This is particularly true in rural communities, where geographic separations from pharmacies, doctor’s offices, and hospitals already present cumbersome barriers to healthcare access. Patients of all ages deserve an equal opportunity to access treatments that could change their lives for the better. Unfortunately, President Biden’s Inflation Reduction Act (IRA) has made this a lot more difficult and may worsen the care gap for Americans that can least afford it.  

More than 60 million Americans – about one out of every five – live in rural areas. On average, rural areas have a higher percentage of older American populations and a higher need for regular access to care than their urban counterparts. Despite this, these populations may also have greater difficulty accessing treatments and medicines.  

The growing number of hospital closures in rural America only compounds the access to care issue. With more than 100 rural hospitals closing between 2013 and 2020, residents in these areas are forced to travel upwards of 20 miles farther for standard services, such as vaccinations or annual examinations, and 40 miles for less common treatments, like chemotherapy. As it becomes increasingly difficult to get to a doctor or hospital, access to medication becomes paramount. 

And yet, the IRA directly works against the goal of providing reasonable access to care. From killing medical innovation and the creation of new therapies to causing insurance premium hikes that create unpredictability with patients’ monthly budgeting, the law has stifled many of the supposed benefits the President has touted during his campaign. While Biden has repeatedly proclaimed the law as a major win, the numbers tell a different story. 

Medicare Part D allows enrollees to access their much-needed prescription drugs by providing stable monthly costs and an array of treatment choices. This is no longer the case. Just this past year, premiums increased by over 21% and are expected to more than double in 2025. The value of the program hasn’t improved either or resulted in more choices. In fact, the number of plans available to patients today is less than half what it was when the program was introduced.  Additional insurers have recently stated that they will consider decreasing access in targeted counties to offset lost profits.  

More importantly, the plans that cover prescriptions are essentially useless if a healthy innovation pipeline does not bring new medications and cures to pharmacy shelves. The IRA served a massive blow to drug R&D by reducing revenue and removing innovation incentives. One study found that as many as 139 drugs over the next ten years are at risk of not being developed as a result of the law. The study also found that had the IRA been in place ten years ago, there would have been up to a 40% reduction in revenue on the impacted drugs, and anywhere from 24-49 therapies that exist today would not have come to market. 

Biden’s failed law did nothing to fix our healthcare system. Instead, it enacted policies that have stunted drug development, raised premiums, and siphoned $280 million away from Medicare — a program meant to help patients access their medication — toward funding liberal pet projects like green energy initiatives. 

The therapies and treatments that come from America’s flourishing innovation ecosystem are critical to the health and well-being of patients across the country. This is particularly true in our nation’s rural communities, where geographic separation and other barriers already make access to healthcare difficult. Rural America covers approximately 97% of the country and is filled with agriculture, mining, and forestry industries that provide natural resources to the country and the world. The hard workers who keep our nation’s heartland thriving deserve access to existing and potential treatments and cures. Biden’s IRA has decreased this access. Now, Congress must act to remedy the law’s most egregious policies and stand up for rural patients.