As Congress ramps up efforts to rein in the power of pharmacy benefits managers as a way to address the rising cost of prescription drugs, some House Republicans have pushed back on those efforts to say lawmakers should focus on more pressing issues, such as the looming government shutdown.
Three House committees introduced joint bipartisan bills last week seeking to increase transparency from hospitals, insurance companies, and PBMs in an effort to lower costs, building on similar legislation making its way through the Senate. The legislation would require hospitals and insurance companies to provide information about healthcare costs and disclose the negotiated provisions that led to that agreement.
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“Our bipartisan legislation meets this moment by giving patients what they are rightfully demanding: The ability to get the right care, at the right time, at a price they know and can afford,” Ways and Means Committee Chairman Jason Smith (R-MO) said in a statement. “It will lower costs by giving patients the healthcare price information they need to make the decisions that are best for them and their families — something 95% of Americans support.”
The bill is being led by the Ways and Means, Energy and Commerce, and the Education and the Workforce committees and would increase transparency by requiring the public disclosure of patient prices from hospitals, insurance companies, labs, imaging providers, and ambulatory surgical centers. The legislation would also require insurers and PBMs to disclose their negotiated drug rebates and discounts so patients can see the real costs of their prescription drugs. The bill builds on previous efforts from the Trump administration to increase price transparency rules.
In doing so, lawmakers say the new regulations would lower out-of-pocket medication costs for seniors as well as expand access to more affordable generic drugs. The bill would also provide employers with more comprehensive information to ensure they are getting the most affordable deals for their employees.
However, the proposals are not being met with approval from all in the House GOP, as some rank-and-file Republicans have expressed frustration with GOP leaders advancing legislation they say is largely influenced by Democrats.
“We’ve paid Big Pharma enough money for COVID vaccines. Republicans should be focused on cutting spending, especially with the DOJ’s weaponization against President Trump, and launching an impeachment inquiry into Joe Biden’s corruption,” Rep. Marjorie Taylor Greene (R-GA) told the Washington Examiner. “We don’t have time to push Big Pharma and Dr. Fauci’s priorities.”
Some GOP aides have also expressed concerns that the bills are being supported and even funded by big pharmaceutical companies, with several conservatives arguing bills that target PBMs would only raise drug prices.
“House Republicans should not be doing the bidding of Big Pharma this period,” a senior House GOP aide said. “They need to focus on investigating Biden and cutting spending.”
Other Republicans pushed back on that notion, arguing the legislation would only serve to lower healthcare costs and wouldn’t assist Big Pharma in any way — something that has become a major focus from both sides of the aisle.
“Almost every single Republican voter is asking the House to lower their healthcare costs,” another senior GOP aide told the Washington Examiner. “Tens of millions of adults have medical debt. More than 95% of Americans support price transparency to drive down costs. While lowering healthcare costs across the board by building on President Trump’s work to force hospitals to post their prices, this bill will also cut the deficit by nearly $1 billion.”
Advancing such legislation could hurt the chances of Republicans in the upcoming election cycle, others argued, with at least one GOP Senate campaign staffer pointing to internal polling that showed candidates dealing with drug prices was a top issue for voters heading into 2024.
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“Not a single Republican voter is asking the House to pass a PBM bill,” the staffer said. “This is driven by pharma lobbyists, it’s bad politics and policy, and it will hurt us next fall.”
It’s not yet clear when the House will move to advance the legislation to the floor as lawmakers are currently turning their focus to their annual appropriations bills that must be passed by Congress by the end of the month in order to avoid a government shutdown. However, the issue of PBMs and drug price transparency is expected to become a major issue on the campaign trail as recent polling shows voters trust Democrats more than the GOP to lower costs.
