Democrats have made affordability a central theme of their midterm campaign. In these closing weeks before the election, Republicans should hold them to account for the unsustainable costs of the Medicare prescription drug overhaul they passed in 2022 without a single Republican vote.

The Inflation Reduction Act promised lower prescription costs and savings for taxpayers. Its cap on seniors’ out-of-pocket spending helped patients with expensive medicines. But the remaining costs did not disappear. They landed elsewhere in the program, and the promised federal savings have turned into projected losses.

The Trump administration can correct flaws in how the law is being implemented. Congress must address the financing problems written into the statute. Democrats should not be left to campaign on affordability unopposed while refusing to address the higher costs their own law helped create.

The Congressional Budget Office (CBO) originally estimated that the law’s drug-price negotiations, inflation rebates and benefit redesign would reduce federal deficits by $129 billion between 2022 and 2031. It now projects that those same provisions will increase deficits over that period. The promised........

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