Congressional bicameral team pushes for insurance, pharmaceutical reform

(The Center Square) – Legislators in Washington, D.C., have taken a number of steps over the past few days to push for insurance and pharmaceutical reforms to be passed before the end of the year.

On Wednesday, a bicameral group of Republican and Democrat lawmakers held a press conference discussing the need for pharmacy benefit manager reform to protect small pharmacies across the country and “save lives.”

“Whether you are a Republican, Democrat, or an independent, we all want the same thing. We want accessible, affordable, quality health care,” said Rep. Buddy Carter, R-Ga. “We’re not here today to just discuss one bill or to discuss just one patient’s story. We’re here because there’s broad, bipartisan pharmacy benefit manager, or PBM, reform that is needed to save lives.”

Pharmacy benefit managers are the middlemen responsible for managing the drug prices covered by health insurance plans.

According to the Harvard Political Review, the problem with pharmacy benefit managers is that they “have vertically integrated with pharmacy chains and health insurers through massive conglomerates.” That then allows them to abuse their power to cut out small pharmacies and increase prices.

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Carter also signed a letter that was released last week calling on the Department of Justice to dig into the role pharmacy benefit managers played in the opioid epidemic.

Reps. Raja Krishnamoorthi, D-Ill., Deborah Ross, D-N.C., and Cliff Benz, R-Ore., all joined him in signing that letter.

“The opioid crisis has devastated communities in North Carolina and across the country, and PBMs may have fueled it by prioritizing profits over people,” Ross said on social media. “That’s why I joined a letter calling on the DOJ to investigate their role and hold these bad actors accountable.”

The letter looked at recent reports on the largest pharmacy benefit managers, CVS Caremark, Express Scripts, and OptumRx which state that they “colluded and conspired to steer patients towards OxyContin in exchange for $400 million.”

OxyContin is a trade name for the narcotic oxycodone hydrochloride, a painkiller available by prescription only.

This and the general “lack of transparency” is just one of the many complaints that legislators aired on Wednesday.

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“My colleagues who are joining me today, Democrats and Republicans … all recognize that PBMs are decreasing the accessibility, the affordability, and therefore the quality of health care in America,” Carter said. “We have an opportunity, right now, to advance bipartisan legislation that increases reporting requirements, which would heighten transparency and shine a light on the opaque practices of these PBMs.”

Carter was also joined by Sen. James Lankford, R-Okla., who is leading the effort to get legislation passed in the U.S. Senate.

“This year, we’re losing about one pharmacy a day in America,” Lankford said. “We want leadership to be able to take this up and to bring it up in the end-of-year package … Stop holding up legislation that is bipartisan, bicameral, and solving a problem that Americans need solved.”

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