If Congress Is Serious About Affordability, Drug Prices Can’t Be an Afterthought

By ALDP Co-Founders Michael Glassner and Jason Young

January 22, 2026

Today, Congress will hold a hearing on health care affordability. Insurance company executives will testify. Members will ask pointed questions. There will be soundbites for the evening news. 

And patients will still be facing drug prices two to four times what people in other countries pay. No wonder more than a third of Americans carry medical debt – over 40% in rural communities. 

To be clear, holding insurers accountable matters, and every industry deserves scrutiny. Rising premiums are challenging to families and small businesses alike. But if Congress is serious about affordability, it needs to ask a more basic question: What’s driving those premium increases in the first place? 

The answer, in significant part, is prescription drug prices. As STAT News reported recently, “For insurance plans that cover working-age populations, drugs now can easily represent 30% of their spending.” 

At the start of this year, drugmakers announced price increases on 350 medications. The median hike was 4% – nearly 50% higher than inflation. It’s like setting your thermostat for 72° at bedtime, waking up to a stifling 107°, and having your landlord tell you “Don’t sweat it.” 

These increases stack year after year, compounding on prices that are already the highest in the world. 

Here’s what makes this especially frustrating: Congress knows how to address drug prices. The Inflation Reduction Act gave Medicare limited authority to negotiate prices for a small number of drugs – and early results show it is working. Lawmakers need to expand that authority and take additional steps to hold manufacturers accountable. 

This inaction on drug prices comes at the worst possible time. Members of Congress clearly have differing views on the Affordable Care Act, but the fact is that the recently expired subsidies did help millions of Americans afford health insurance. Families who once had subsidized coverage are now experiencing high drug prices directly – at the pharmacy counter, often forced to choose between running up their credit card and going without. Unaffordable medicine has been the start of many patients’ road to medical bankruptcy. 

So today’s hearing matters, but let’s be clear about what it is and isn’t. A hearing creates pressure, generates coverage, and produces soundbites. But it isn’t legislating. So it isn’t actually lowering drug prices through expanded Medicare negotiation power, or changing policies to rein in the pharmaceutical industry’s monopoly pricing power. As pragmatists, we think talk is fine. Action is better. If Congress is serious about addressing voters’ concerns over affordability, drug prices can’t be an afterthought. 

Republicans and Democrats, rural and urban families, people in every corner of this country are struggling to afford their medications. We need Congress to do what some states are already doing: establishing accountability mechanisms like Prescription Drug Affordability Boards – independent bodies that review excessive price increases and can act when prices become unjustifiable. 

Affordability isn’t abstract – it’s families choosing between medications and groceries. If Congress wants to help, they know where to start: with the companies setting the prices in the first place.