The Senate Finance Committee passed a draft healthcare package that includes mental health, pharmacy benefit manager (PBM) reform and drug pricing provisions.
The bipartisan package passed 26-0 on Wednesday.
The move comes after lawmakers in Congress have deliberated for months over how to target PBMs — middlemen that manage prescription drug benefits for health insurers — over their role in high drug prices.
The draft package — dubbed the Better Mental Health Care, Lower-Cost Drugs, and Extenders Act — includes a provision that would expand mental health and substance use disorder services for those enrolled in Medicaid or Medicare. It would also boost transparency around PBMs, such as forcing pharmacies to report the prices of prescription drugs.
In the package, lawmakers made room for the Protecting Seniors from High Drug Costs Act, which aims to reduce higher copays for seniors, as well as seek to limit what Medicare Part D beneficiaries are paying in cost-sharing to PBMs.
“Once again this committee has come together in the fight to expand access to mental health care and rein in the shadowy tactics by pharmacy benefit managers that hurt community pharmacies and drive up prescription drug costs for seniors and taxpayers — all while also making sure essential Medicaid and Medicare programs can continue,” Senate Finance Committee Chair Ron Wyden, (D-Ore.), said in a statement.
In addition to the mental health and PBM provisions, the draft package would also get rid of the $8 billion in cuts to the Medicaid Disproportionate Share Hospital program.
Those planned cuts would have put the financial viability of hundreds of safety net hospitals at risk and threatened access to care for some of the most vulnerable Americans, according to Sen. Bob Casey, (D-Penn.), noted in a statement.
PBMs have received increasing scrutiny from both sides of the aisle in recent months, with lawmakers introducing a slew of bills just this year that would seek to limit how PBMs contribute to higher drug prices.
That push has been supported by the pharma industry, which has been seeking to shift the blame for high drug prices onto PBMs.
Earlier this year, lobbying group PhRMA rolled out several ads targeting PBMs, arguing in one video that the middlemen “can profit from where you get your prescription filled,” and “no one should stand between you and your medicine.”
Meanwhile, PBM lobbying group the Pharmaceutical Care Management Association (PCMA) struck back against the Senate Finance Committee in a statement following the vote.
The group argued that the Better Mental Health Care, Lower-Cost Drugs, and Extenders Act would add “significantly more uncertainty” for Medicare Part D plans that are implementing a major restructuring to the program.
“This year, Congress has held an unprecedented number of hearings targeting PBMs and considered a multitude of narrowly focused bills targeting only our industry, which leads us to ask: What is Congress trying to solve for?” PCMA continued. “The legislation would do nothing to lower drug prices and improve affordability for patients.”
The draft bill will now move to the Senate, where its passage is a little more unclear. Still, Casey emphasized that the bill’s supporters will push for it to clear those hurdles.
“We have an obligation to ensure that healthcare is affordable and accessible for everyone across our nation,” Casey said in a statement. “This legislative package will help meet that obligation by protecting seniors from high drug costs and saving rural hospitals from devastating cuts. I look forward to fighting for its passage on the Senate floor.”
