When the Medicare Part D prescription drug legislation was being developed, Congress and the Bush Administration decided to specifically prohibit the Medicare program from bargaining with pharmaceutical companies to secure lower drug prices. This controversial decision took the responsibility for moderating drug prices away from the Medicare program and, instead, placed it in the hands of private drug plans. One full year after the implementation of Part D, the unfortunate consequence of this decision is clear—private plans have failed to deliver low prices. The ability of private plans to secure low drug prices is critically important, both to America’s seniors and to taxpayers. Drug prices set by private Part D plans significantly affect premiums and how much beneficiaries end up paying out of pocket overall. These drug prices also have a direct effect on the burden borne by taxpayers, who pay approximately three-fourths of the costs of the Part D program.