Democrats and Republicans in Congress are working together on a new effort to keep health insurers and pharmacy benefit managers from owning pharmacies.
The lawmakers are introducing a version of the Patients Before Monopolies Act bill for the 119th Congress.
The bill would force health insurers and PBMs to sell any pharmacies that they own.
Sens. Elizabeth Warren, D-Mass., and Josh Hawley, R-Mo., are returning as the lead sponsors of the bill in the Senate. The co-sponsors there are Sens. John Fetterman, D-Pa., and Roger Marshall, R-Kan.
Reps. Diana Harshbarger, R-Tenn., and Jack Auchincloss, D-Mass., are the lead sponsors in the House. They’ve lined up two Democrats and two Republicans as co-sponsors.
Warren said in a comment about the reintroduction of the PBM Act bill that she believes the bill is gaining momentum.
“People are realizing that you can’t lower healthcare costs without tackling corporate greed in the healthcare system,” Warren said.
Hawley said PBMs are driving up costs while pushing out independent pharmacies.
“Working Americans deserve better,” he said.
The Pharmaceutical Care Management Association, a national trade association representing America’s pharmacy benefit managers, contends that the players driving up drug costs are the manufacturers and the wholesalers, and that efforts to hobble PBMs will backfire by weakening the PBMs’ ability to bargain for the best possible deals for employers’ self-insured health plans, health insurers and other payers.
Forcing insurers and PBMs to sell pharmacies could also disrupt delicate, longstanding efforts to get specialty drugs to patients as quickly and as efficiently as possible and lead to realignments that could eliminate many jobs, the PBMs said.
Bill would give employers the opportunity for a prescription strategy
What it means: Employers and benefits advisors will have another chance to think about the best strategy for getting the best deals on prescription drugs.
The backdrop: Warren and Hawley introduced an earlier version of the PBM Act bill in 2024, as the 118th Congress was ending.
That bill died in committee, but it appeared to have broad, bipartisan support.
During the current Congress, Warren and Hawley have also teamed up to support a broader health care player breakup bill, the Break Up Big Medicine Act bill.
The Break Up Big Medicine Act bill will prohibit a wide range of health care organizations from owning their buyers or vendors.
Legislative mechanics: The new bill is now under the jurisdiction of the Senate Judiciary Committee in the Senate and the House Judiciary Committee in the House.
Two of the co-sponsors in the House, Reps. Jerry Nadler, D-N.Y., and Troy Nehls, R-Texas, are members of the House Judiciary Committee.
The bill backers predicted that the House Energy & Commerce Committee likely will share jurisdiction over the bill—the two other House co-sponsors, Reps. Greg Landsman, D-Ohio, and Buddy Carter, R-Ga., serve on the House Energy & Commerce Committee.
The lead sponsor in the House, Harshbarger, is a pharmacist herself.
Harshbarger said at a press conference on Capitol Hill in February that she has been so aggressive about lobbying against the PBMs that, when PBM lobbyists see her coming down the hall, “they turn around and go the other way.”
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