If you’ve had trouble paying for prescription medicine for yourself or family members — regardless if you are insured or not — you aren’t alone. Americans pay three times more for medications than people in other countries. As the cost of lifesaving medications like insulin skyrocket, Arizonans face impossible tradeoffs, like deciding whether to pay rent or to purchase the medications that keep them alive.

The COVID-19 pandemic has further laid bare the inequities in our health system, and now more than ever, we must be working together to lower health care costs for everyone. Particularly, we must focus on communities disproportionately impacted by the high cost of drugs: Seniors, women, communities of color, and even children are especially vulnerable to these skyrocketing costs.

It doesn’t always have to be this way. The US has historically emphasized patent exclusivity as an incentive to drug makers. This tilts the table heavily in the favor of drug companies, which essentially maintain monopolies on popular drugs for extended periods of time. While it is important to foster competition to promote innovation, the current system is having the opposite effect. Individual consumers often have no alternative drug choice, and even when multiple options are available, it may be the insurer rather than the patient and physician who make the ultimate decision about which medication is best for the patient.

It is not uncommon in my emergency medicine practice to see patients who are struggling to pay for medications. In some cases, they personally try and “prioritize” which medications they can afford to take and which they cannot. In the worst case, this might mean a patient taking no medications at all for extended periods of time.

The net effect is patients who are sicker than they have to be, with poorly controlled diseases. For a diabetic patient, this might mean the difference between manageable foot care and an amputation due to difficulties with blood sugar control. For a patient with heart or vascular disease, not “prioritizing” their anticoagulant (blood-thinning) medications can result in stent occlusion (blockage) and a recurring heart attack or loss of limb. And whether patients make better or worse guesses about which medications to prioritize, the reality is their doctors would not prescribe medications that are not necessary, so any trade-off is a gamble on future health.

Working to lower the cost of prescription drugs is more than just the right thing to do — it's overwhelmingly popular with voters across the political spectrum. A January 2021 Morning Consult poll found that 96% of voters said lowering drug prices is an important challenge facing Americans. Despite countless promises to take action, for four long years, former President Trump and his Republican allies in Congress blocked proposed Democratic reform addressing this very issue at every turn. Instead, they rewarded Big Pharma companies — and their CEOs — with record profits.

In his first address to the Joint Session of Congress, President Biden struck a markedly different tone: “Let’s give Medicare the power to save hundreds of billions of dollars by negotiating lower drug prescription prices,” he said. “Let’s do it now.” Democrats in the House of Representatives are following his lead.

In late April, House Democrats reintroduced H.R.3, the Elijah E. Cummings Lower Drug Costs Now Act. This bill would allow Medicare to negotiate lower prices on behalf of all Americans — not just those on Medicare — which is the single most effective way to reduce drug prices. It also establishes strong protections against price gouging and redirects more funding to the National Institutes of Health (NIH) for life-saving research and development. Finally, H.R.3 would also penalize drug companies that increase prices faster than the rate of inflation, a shockingly common practice.

Insights from a Gallup survey show the American public supports the provisions in H.R.3 meant to lower the cost of prescription drugs. Separate polling conveys that 93% of respondents — Democrats, Republicans, and independents alike — support giving Medicare the power to negotiate with drug companies for lower prices.

It’s horrifying to know there are Arizonans who ration their medications or delay care because the costs are too high. Legislation like H.R.3 would help change that reality for millions of people and reform is long overdue. With President Biden’s support, we can get this done. Now is the time for Congress to take bold action and pass this bill.