Congress has a responsibility to fix policy mistakes when they become clear, especially when those mistakes could make it harder for patients to receive life-saving treatments in their local communities.
Beginning in 2028, the Inflation Reduction Act’s (IRA) Medicare Drug Price Negotiation Program will extend to certain Part B therapies the medicines physicians administer in their offices for conditions like cancer and other complex diseases. While the goal of lowering costs is understandable, the program as currently structured risks disrupting the very care it is meant to make more affordable.
I know what that disruption can mean for patients. Before my time in Congress, I spent nearly three decades practicing medicine in North Texas. And during my 22 years in the U.S. House of Representatives, including time as chairman of the House Energy and Commerce Health subcommittee, I worked on reforms to lower costs without compromising access to care, like the years-long effort to repeal Medicare’s flawed Sustainable Growth Rate (SGR) payment formula, replacing it with a more stable physician reimbursement system.
The issue we face today is a different policy, but a familiar problem: an effort to lower health costs that gets the implementation wrong.
In an effort to cut costs, the IRA’s Medicare Drug Price Negotiation Program’s short-sighted reimbursement formula will be devastating, particularly for oncology patients and providers. Estimates suggest that the resulting reimbursement cuts for selected oncology and complex therapies could reach as high as 60 percent.
That is not a marginal adjustment. It’s the kind of cut that forces practices to make hard choices. It is a straightforward math problem. If reimbursement drastically falls, community practices will either limit services, stop offering certain therapies, or close entirely. Of course inflation has compounded the problem.
But the real impact is on patients. When independent practices cannot sustain care, patients do not stop needing treatment. Patients could be pushed into hospital systems, where care is often more expensive and less convenient. For patients in rural or underserved communities, it may mean longer travel, delays in treatment, or going without care altogether.
As a physician, I have seen firsthand what it means when care moves farther from the patient. For many patients, the ability to receive treatment close to home from a trusted care team can be the difference between successfully completing treatment and falling through the cracks.
The good news is that the solution is straightforward.
While still in Congress, I introduced legislation alongside my colleague and fellow physician, Rep. Greg Murphy, M.D., to address this problem before it reached patients. On the Senate side, Sen. John Barrasso, M.D., led a companion effort. The approach is simple: preserve stable reimbursement for physicians administering these therapies, while requiring manufacturers to rebate Medicare the difference between that payment and the negotiated price. In other words, achieve savings without breaking the delivery system on which patients rely.
That legislation did not cross the finish line in the last Congress. But the need for it has only grown more urgent.
Earlier this year, Rep. Murphy reintroduced the bipartisan Protecting Patient Access to Cancer and Complex Therapies Act (H.R. 4299). Congress now has another opportunity to get this right.
But that window is closing.
Fixing this issue now, before these policies are fully implemented, is far easier than trying to rebuild access after it has been lost. This is preventative medicine at its best. Once community practices scale back or shut down, they are difficult, if not impossible, to replace.
Unlike the SGR of the past, Congress should not wait for that disruption to occur before acting. Lawmakers should take up and pass H.R. 4299 and ensure that efforts to lower costs do not come at the expense of patients getting care when and where they need it.
Michael Burgess, M.D., served from 2003 to 2025 as a Republican member of Congress from Texas and previously practiced medicine for more than 20 years.
