Staff Reports
A new chapter in the ongoing saga of healthcare reform is about to unfold, and it involves the long-awaited smackdown of the notorious Pharmacy Benefit Managers (PBMs). Speaker of the House Mike Johnson, a staunch ally of President-elect Donald Trump, is set to initiate a grand plan to tackle these insurance middlemen as part of the year-end government spending package. The ordinary American may not realize it, but PBMs are about to lose their stranglehold on prescription drug pricing, and it’s about time.
At a recent press conference, Trump, bringing his signature flair to Mar-A-Lago, didn’t hold back in labeling PBMs as the “horrible middleman” that benefits the few at the expense of many. Here we have a system where the middleman rakes in profits that even the drug companies envy—while doing little to no actual work! The Trump administration has vowed to eliminate these unnecessary intermediaries, aiming to make prescription drugs affordable and accessible for all. This isn’t just campaign rhetoric; the groundwork is being laid now, with Speaker Johnson ready to put PBMs on notice.
This is twice in one week that President-Elect Trump has targeted action at the Pharmacy Benefit Managers.
It seems like PCMA lobbying may be ineffective for the upcoming administration and the MAHA coalition. @Commpharmacy @TruthRX we can’t let up now! pic.twitter.com/QzR1vIXw1f
— J Cates (@_JeremyCates) December 16, 2024
The fact is, three colossal PBM players—CVS Caremark, Express Scripts, and OptumRx—have created a monopoly, controlling about 80 percent of the PBM market. They dictate which medications are available and how much patients pay out of pocket. Under this mismanaged system, PBMs thrive by promoting pricier medicines rather than genuinely ensuring patients receive the best healthcare options. This apparent collusion demands a hard rethink, and it seems Johnson and Trump are leading this charge headfirst.
The alarm bells have rung loud and clear about how PBMs impact the medication costs for American seniors. A pharmacist recently voiced his frustration in front of Congress, pointing out that patients and their physicians are often sidelined in treatment decisions, forced to bow to the power of the PBM dollar. The emphasis on profit over patient well-being isn’t just a blip on the radar; it’s an endemic problem that reeks of a broken healthcare system. Trump previously attempted to tackle this mess with a policy that would benefit seniors by allowing them to receive direct discounts from drug manufacturers. Sadly, it was discarded like so much loose change by the Biden administration.
However, there’s optimism on the horizon. With the upcoming spending bill, Trump’s administration has a chance to not only resurrect the commitment to deliver savings to seniors but to also initiate new reforms that could redefine how PBMs operate entirely. The proposed Modernizing and Ensuring PBM Accountability Act aims to obliterate the corrupt nexus between medicine pricing and PBM profits. It promises to shift the balance back to patients, where it belongs.
As Congress pushes towards passing this essential legislation before Christmas, it’s clear this could mark a significant win for the conservative agenda and further cement Trump’s legacy in the health care debate. A sound, patient-focused system is the goal, and with allies like Mike Johnson at the helm, it seems inevitable that the power of the PBM middlemen will soon face its reckoning. Who knew that a little Christmas spirit could go a long way in striking back against corporate greed? Keep an eye on this development—it’s shaping up to be an incredible journey toward real reform.
