This article is part of a series from the Center for American Progress exposing how the sweeping Project 2025 policy agenda would harm all Americans. This new authoritarian playbook, published by the Heritage Foundation, would destroy the 250-year-old system of checks and balances upon which U.S. democracy has relied and give far-right politicians, judges, and corporations more control over Americans’ lives.



Over the past two years, seniors and other Medicare enrollees have begun to benefit from monumental prescription drug price reforms thanks to the Inflation Reduction Act of 2022. However, these lifesaving policies are now under threat.



The Heritage Foundation has outlined a sweeping, far-right policy vision to put power—and profits—back in pharmaceutical companies’ hands. Project 2025’s “Mandate for Leadership: A Conservative Promise” calls for repealing the Inflation Reduction Act. Similarly, the Republican Study Committee’s “Fiscal Sanity to Save America” fiscal year 2025 budget proposal calls for a full repeal of the law. If Project 2025 is implemented, millions of Medicare enrollees will see their out-of-pocket costs for prescription drugs rise, reversing much-needed savings generated by the Inflation Reduction Act’s Medicare Part D reforms and other provisions.



Across the United States, more than 1.5 million Medicare Part D enrollees—who are among the most vulnerable enrollees with significant health needs—could see their 2025 out-of-pocket costs rise if the $2,000 out-of-pocket cap is repealed. But beyond that, 18.5 million Medicare Part D enrollees could lose much-needed out-of-pocket savings from the Inflation Reduction Act’s full package of Medicare Part D redesign elements (as detailed in 1a–f under “What’s at stake in the Inflation Reduction Act”). Some seniors could see an average of nearly $400 in lost drug savings in 2025 alone. Overall, Medicare Part D enrollees across the nation could lose out on up to $7.4 billion in out-of-pocket savings next year.



Project 2025’s drug pricing agenda calls for repealing the Inflation Reduction Act, primarily to end the law’s Medicare drug price negotiation provision, which would significantly lower the prices Medicare pays for select drugs and finally counter Big Pharma’s unrestricted power to demand excessive Medicare drug prices. However, Project 2025 treats seniors’ access to affordable drugs as collateral damage. This dangerous agenda prioritizes Big Pharma’s bottom line at the expense of millions of Medicare Part D enrollees who, if Project 2025 is enacted, may once again have to pay more out-of-pocket for the medications they need, impeding both access and affordability.



Nicole Rapfogel is CAP Policy Analyst, Health





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