House eyes PBM reform next steps

 

House Energy and Commerce Committee leaders are confident the unfinished business of changes to the pharmacy benefit manager (PBM) industry will pass this year, but it’s unclear if Democrats will still vote for it.

© Greg Nash, The Hill

“I would love to see it as it is, in some bill early [in the year],” Energy and Commerce Committee Chairman Brett Guthrie (R-Ky.) told The Hill late last week.   “The good thing about that was it was bipartisan … But if not, we’ll continue to work … So we’ll be able to, I think we’ll be able to make the PBM reform and other things in that bill a reality.”    Lawmakers ended 2024 on the cusp of advancing a significant health package, including changes to the PBM industry payments to community health centers, a rollback of physician payment cuts and more. But the policies put forward in December never passed amid an 11th-hour revolt by conservatives.     The language is already written and could be inserted ready-made into a new bill or passed as a standalone under a suspension of the rules.    But Democrats are concerned the provisions will be added to the Republicans’ reconciliation bill, which will be a vehicle to cut spending to pay for an extension of President Trump’s 2017 tax cuts.  Guthrie, and health subcommittee chairman Buddy Carter (R-Ga.), acknowledged that could be a possibility.     “Leadership might want to use it as a pay-for but, you know, there are extenders in there, and that’s the most important thing to keep in mind that need to be addressed,” Carter said, referring to short-term extensions for telehealth flexibilities and health center funding that expire in mid-March.     “This is a reconciliation bill. I wouldn’t expect any Democrats to vote for the reconciliation bill” even if there are bipartisan provision in it, Guthrie said.    Rep. Diana DeGette (D-Colo.), ranking member of the Energy and Commerce health subcommittee, said the policies in the health package were bipartisan and shouldn’t be added to a partisan reconciliation bill that will get no Democratic votes.    “I think that I would worry if it got caught up in the reconciliation negotiations, because [the provisions] expires in March, and I think there would be substantial bipartisan support if it came up as a standalone package,” DeGette said. “I have assured the Republicans that if they did bring it up, and it was the same package as December, probably every Democrat in House would vote for it.”   https://thehill.com/newsletters/health-care/5109645-house-eyes-pbm-reform-next-steps/