North Carolina seniors will soon be hit with higher health care bills.
Between 2023 and 2025, Medicare Part D drug plan premiums rose by 28% for North Carolina seniors. And some will see an even steeper jump this January. The blame falls squarely on the former Biden administration’s Inflation Reduction Act (IRA), which has effectively broken Medicare Part D and left seniors paying more while having fewer choices.
The Biden White House pitched the law as a way to lower health care costs, and promised that it’d be a “Godsend” for seniors.
But mostly, the law just played shell games. Several measures increased the financial burden on the private insurers that offer and administer Part D plans — and predictably, insurers just increased premiums, shifting the burden right back onto seniors. Since 2021, the average monthly premium has climbed by nearly 60%.
For many of the roughly 642,000 North Carolinians who rely on Part D plans, the hikes coming this January will be even more painful. Premiums for the popular SilverScript Choice plan, which has over 74,000 enrollees, will jump from $40.20 in 2025 to $90.20. The AARP Medicare RX Preferred from UHC plan will rise to $119.80 a month, up from $93.20 this year.
And those seniors have fewer choices than ever before. Nationwide, the number of drug plans fell by 35% between 2024 and 2025. In North Carolina, the decline was especially stark: seniors had 24 PDP options in 2023, but by 2025, that number had been cut to just 16. In 2026, they’ll have just 12 left to choose from.
The IRA has also damaged the low-income subsidy (LIS) program, which helps poorer seniors by covering their premiums entirely. In North Carolina, the number of LIS options fell from five in 2023 to four in 2025 — and starting January, only two will remain. Across the country, LIS plan availability has dropped to an all-time low.
Every time a plan disappears, seniors are forced to scramble for a new one. That means disruption in coverage and potential interruptions in access to medicines. For patients with chronic conditions, that disruption can be more than an inconvenience — it can threaten their health.
Even the remaining plans are scaling back the medicines they cover.
More than six in 10 Part D plans report they will put stricter controls on which diabetes drugs are covered, and many are also limiting access to certain cancer treatments, immunotherapies, heart medications, and rare disease treatments. One study found that across four chronic disease areas, over 70% of patients with Medicare Part D “were initially denied coverage when attempting to fill a new prescription.”
The combined result is devastating. Seniors are paying higher premiums and deductibles, losing plan options, and watching valuable benefits erode.
This is not the future that the 2.2 million North Carolina seniors enrolled in Medicare — and tens of millions more seniors nationwide — were promised. The IRA has failed in its most basic mission: instead of lowering costs and improving access, it has done exactly the opposite.
