Lawmakers Crackdown on Pharmacy Benefit Managers: The Kiplinger Letter
A crackdown on pharmacy benefit managers on drug costs might help Congress forget their differences.

To help you understand what's happening in health legislation and what we expect to happen in the future, our highly experienced Kiplinger Letter team will keep you abreast of the latest developments and forecasts (Get a free issue of The Kiplinger Letter or subscribe). You'll get all the latest news first by subscribing, but we will publish many (but not all) of the forecasts a few days afterward online. Here’s the latest…
At least one issue may overcome Congress’s current political dysfunction, a crackdown on pharmacy benefit managers (PBMs). In the House, lawmakers have already consolidated several related measures into a single piece of legislation, which will be among the first to receive a floor vote once the chamber acts on a plan to keep the government funded.
In the Senate, Majority Leader Chuck Schumer (D-NY) is expected to include the three major PBM-related bills that have emerged from committee in a broader healthcare package that is still to be worked out.
All the legislation includes transparency measures requiring PBMs to reveal how much they pay for various drugs, how much money they keep for themselves, and what costs/savings are passed along to insurers and patients. Greater oversight will likely help plan sponsors make better-informed decisions about contracts, leading to more competition between pharmacy benefit managers and lowering prescription drug costs overall.

Sign up for Kiplinger’s Free E-Newsletters
Profit and prosper with the best of expert advice on investing, taxes, retirement, personal finance and more - straight to your e-mail.
Profit and prosper with the best of expert advice - straight to your e-mail.
The legislation would also require the Government Accountability Office (GAO) to submit a report on the practices of pharmacy networks of group health plans, including networks that have pharmacies under common ownership with group health plans.
New restrictions on spread pricing are also certain, at this point. Spread pricing is when PBMs charge insurers more for a drug than they paid for it and keep the “spread” as profit. If they can’t stop passage, look for PBMs to lobby for looser requirements.
This forecast first appeared in The Kiplinger Letter, which has been running since 1923 and is a collection of concise weekly forecasts on business and economic trends, as well as what to expect from Washington, to help you understand what’s coming up to make the most of your investments and your money. Subscribe to The Kiplinger Letter.
Related Content

-
Alaska Airlines to Buy Hawaiian: Get Bonus Miles Now
How to use the Alaska Airlines credit card and frequent flyer program to save on trips to Hawaii, Alaska and beyond.
By Ellen Kennedy Published
-
11 Reasons to Consider a 1031 Exchange
Deferring capital gains taxes might be at the top of the list, but growing your portfolio and your wealth and helping with estate planning are also compelling reasons.
By Daniel Goodwin Published
-
As Cable Companies Move into Mobile, Customers Benefit: The Kiplinger Letter
The Kiplinger Letter The new cable bundle — home internet and mobile — is gaining steam. And the competition means good news for consumers.
By John Miley Published
-
New Voice Cloning Scam Has Regulators Scrambling for Solutions: The Kiplinger Letter
The Kiplinger Letter As fraudsters add voice cloning technology to their arsenal of deception, regulators are playing catch-up.
By John Miley Published
-
Small Businesses Hit Extra Hard by Rising Interest Rates: The Kiplinger Letter
The Kiplinger Letter On average, small business owners are paying interest rates in the range of 9.1%, per the NFIB.
By David Payne Published
-
GOP Lawmakers Demand SALT Deduction Cap Increase: Tax Letter
Tax Letter Republicans from high-tax states are clamoring for the SALT deduction cap to rise from its $10,000 limit.
By Joy Taylor Published
-
The Battle for Net Neutrality Rules Rages On: The Kiplinger Letter
The Kiplinger Letter Advocates remain hopeful new net neutrality rules will survive, while the telecom industry and business groups seek to prevent FCC action.
By John Miley Published
-
Autonomous Trucks Are Coming to a Road Near You: The Kiplinger Letter
The Kiplinger Letter What does the rollout of autonomous trucks and cars mean for the commercial sector?
By David Payne Published
-
Work Email Phishing Scams on the Rise: The Kiplinger Letter
The Kiplinger Letter Phishing scam emails continue to plague companies despite utilizing powerful email security tools.
By John Miley Published
-
Tech Giants Look to Curb AI's Energy Demands: The Kiplinger Letter
The Kiplinger Letter The expansion in AI is pushing tech giants to explore new ways to reduce energy use, while also providing energy transparency.
By John Miley Published