The Inflation Reduction Act Broke Medicare—and Montana’s Seniors and Veterans Are Paying the Price

In just a few weeks, seniors across Big Sky Country will start receiving notices of huge Medicare Part D premium increases.

Every single Democrat in Congress — including Montana’s then-senior senator Jon Tester — voted for the Inflation Reduction Act just over three years ago. Every single Republican voted against it, warning that it’d waste hundreds of billions of taxpayer dollars and wreck Medicare in the process.

And that’s exactly what has happened. Here in Montana, the average monthly premium for Part D drug coverage has jumped 28% since 2023 — from $47.78 to $60.98. That means the average enrollee is now paying over $150 more per year for coverage than just two years ago, a steep burden for families already living on fixed incomes.

There’s no relief in sight. The Centers for Medicare & Medicaid Services (CMS) recently confirmed that the national average Part D bid for 2026 — the benchmark used to set plan premiums — has spiked another 33%. When bids go up, premiums follow.

Seniors in Montana also have fewer choices in Part D than ever before. In 2023, there were 24 stand-alone Part D prescription drug plans available in the state. Today, there are just 16. And the most vulnerable seniors have been hit especially hard, with low-income subsidy Part D plans falling from six to only four. More plans are expected to disappear in the years ahead, leaving patients with even fewer alternatives.

Patients also increasingly struggle to get the medicines they need — when they need them. Insurers are layering on additional “prior authorization” and “step therapy” requirements that force patients to test out alternative drugs first before getting the treatments their doctors prescribe.

This was all entirely predictable.

The IRA handed Medicare officials sweeping new authority to dictate prices on certain medicines, a change that was always about reducing government spending, not lowering patients’ bills.

Lawmakers also changed Medicare benefit designs in ways that increased the financial burden on insurers. As a result, insurers have responded by raising premiums, dropping plans, and tightening access.

Put plainly: The law was sold as a way to save patients money, but in practice it just moved the tab around — leaving older Americans stuck with the bill.

Montanans deserve better. Medicare Part D was created two decades ago with strong bipartisan support. It was designed to foster competition, consumer choice, and affordability — and it worked. Before the IRA, seniors had numerous plans to choose from, and premiums remained remarkably stable. Now, that success story has been shattered.

Additionally, Montana Veterans have noted that Medicare Part B premiums increased 5.9% in 2025 to $185 — a $10.30 jump from 2024. These hikes are slamming America’s veterans, who grapple with service-related disabilities and fixed incomes. Millions of dual-eligible military retirees face steeper out-of-pocket costs for VA gaps like outpatient care and prescriptions, intensifying the financial pressures.

Today, the 262,000 Montanans on Medicare face higher premiums and have fewer choices than ever before. And the damage will only continue to mount, year by year, unless Congress repeals the IRA.