CONTRIBUTED BY STATE REP. DEBBIE WOODS
OPINION —
As members of Congress begin settling back into work after their summer recess, Alabama’s United States senators need to be careful not to support wolf in sheep’s clothing healthcare legislation that could cost their constituents ungodly sums at the pharmacy counter.
At first glance, the bill in question, the Affordable Insulin Now Act, may seem like a foolproof way to resolve the Alabama population’s longtime struggles with diabetes and the out-of-pocket costs that come with it.
By capping the price of insulin, among other things, one would think that the bill would benefit few states more than Alabama, which has the fifth-highest percentage of adults with diabetes in the country. Unfortunately, that’s not the case thanks to a special-interest provision embedded within the legislation that would help major pharmaceutical giants at Alabamans’ expense — wiping away all the gains the rest of the bill would have otherwise provided and then some.
As a political giveaway of sorts for Sen. Bernie Sanders (I-Vt.) and other far-left lawmakers who have sought to regulate them for years, the bill would use the heavy hand of government to make it more difficult for groups known as pharmacy benefit managers (PBMs) to do their jobs.
While you’ve probably never heard of PBMs, they are very important to you, your family and your friends and neighbors, with 90% of American with prescription drug benefits belonging to a health plan that uses PBMs.
Your employer, or health insurance company pays PBM to work as their negotiating agents in purchasing your prescription drugs. They go head-to-head with the pharmaceutical giants and secure huge cost savings for you and your family.
Seema Verma, one of former President Donald Trump’s top healthcare cabinet officials, told Congress she was “thankful that we have the PBMs in the [Medicare] Part D program that are performing that negotiation on behalf of seniors.”
With a 2019 Government Accountability Office study finding that PBMs saved Medicare Part D 20% (nearly $30 billion) in budgetary costs in 2016, she had every reason to feel this way.
Yet, some members of Congress are trying to regulate PBMs to please their big drug company donors. These companies want to be able to charge more for their already extremely expensive products. And while members have introduced separate, independent bills to regulate PBMS, they know those pieces of legislation are bathed in controversy and are unlikely to pass. That’s why, now, they’re trying to secretly pass PBM regulations in otherwise commendable bills like the Affordable Insulin Now Act.
These members think their constituents won’t know better — that they will merely read the flowery press releases about how the bill would lower the cost of insulin and not raise any questions about how it would effectively increase the cost of all other drugs. These political leaders think they’re smarter than them, and while their arrogance is a tough pill to swallow, it’s the sad reality of the situation.
Thankfully, Alabama’s elected representatives have thus far remained steadfast in prioritizing people over political donors. Sen. Tommy Tuberville already sounded concerns about regulating PBMs, voting against them in a congressional committee. Alabama is fortunate to have representatives that know that they can reduce the cost of insulin without passing political giveaways, similar to how Gov. Kay Ivey and Alabama State House did in 2021 with House Bill 249, which capped insulin co-sharing at $100 per month for those on state-regulated health plans without providing any counterproductive giveaway to the big drug companies, and I have every reason to believe they will keep fighting for us no matter how tough the political pressure gets in Washington, D.C.
Debbie Wood serves in the Alabama Legislature representing Lee and Chambers Counties.