WASHINGTON — House Republicans have abandoned an effort to include reforms to pharmacy benefit managers in an end-of-year bill to fund the federal government.
Congressional leaders had reached a deal to rein in prescription drug middlemen earlier this week, but the larger package it was tacked onto fell apart following backlash from conservatives and top advisers to President-elect Trump. Instead, lawmakers are planning to pass a three-month government funding bill with extensions for basic public health programs and telehealth flexibilities ahead of a Friday deadline.
The reversal, after congressional leaders had announced a deal on PBM legislation Tuesday, means a host of legislation that multiple committees passed this Congress won’t become law. In addition to the PBM reforms, GOP lawmakers cut drug patent reforms, hospital billing transparency, Medicare pay bonuses for doctors, and reauthorizations of laws passed to address the opioid crisis and prevent pandemics from the year-end bill.
The removal is a major win for the PBMs and the health insurers that own them. After being battered for two years in congressional hearings and having their top executives dragged into Congress, the middlemen stand to remain untouched. The biggest PBMs are UnitedHealth Group’s Optum Rx, CVS Health’s Caremark, and Cigna’s Express Scripts.
It’s unclear if Democrats would support the proposal. Trump endorsed it in a post on the social media platform Truth Social.
Congress will start afresh next year with Republican majorities in the House and Senate. The House majority will be even slimmer than this year’s, which could make maneuvering to pass large tax cuts and health policy difficult.
There’s a chance some provisions could be revived in the future. Trump and Johnson in recent days have expressed an interest in putting guardrails around pharmacy benefit managers.
“We’re going to knock out the middleman… I don’t know who these middlemen are, but they are rich as hell,” President-elect Trump said during a news conference this week.
If Johnson keeps his position as House Speaker next Congress, he could also pursue legislation to rein in PBMs.
“We’re taking the middleman out of health care, which will dramatically drive down the cost of medication for Americans, that’s been a number one agenda item for a lot of us for a long time,” Johnson said in an appearance on Newsmax trying to sell the agreement.
However, some House conservatives in recent days parroted rhetoric from a PBM-backed front group that the proposed PBM legislation was a giveaway to the pharmaceutical industry.
John Wilkerson contributed reporting.