Illustration: Sarah Grillo/Axios

Pharmacy benefit managers usually operate behind the scenes, quietly influencing the 5.8 billion drug prescriptions Americans fill every year. But they'll take a step into the spotlight today.

Driving the news: The Senate Finance Committee is set to grill the industry over its role in rising drug prices, and at the same time, the Trump administration is weighing a seismic shift in how these companies get paid.

Between the lines: PBMs don't have many enthusiastic allies.

The biggest threat for PBMs is the Trump administration's proposal to eliminate drug rebates in Medicare and Medicaid, instead routing those savings to patients at the pharmacy counter.

What they're saying: Independent experts are giving sober forecasts for the proposal. It wouldn't be a drug pricing panacea, they say, and it could make everything more expensive.

The bottom line: PBMs are getting hammered. The next few months will dictate how their businesses — and patients' costs — will change, and how much of that change will happen before the 2020 election.

Go deeper

Trump says he expects to announce a Supreme Court nominee "next week"

President Trump speaking prior to his departure from the White House on Sept. 19. Photo: Sarah Silbiger/Getty Images

President Trump said Saturday he expects to announce a nominee for Justice Ruth Bader Ginsburg's vacant Supreme Court seat “next week” and that the person will “most likely” be a woman.

What he's saying: “I think we’ll have a very popular choice whoever that may be," Trump said before departing on Marine One. "We want to respect the process. I think it’s going to go very quickly, actually.”

Go deeper: Trump says Republicans have an obligation to fill Ginsburg's seat

Susan Collins says Senate should postpone Supreme Court vote

Sen. Susan Collins. Photo: Tom Williams/Getty Images

Sen. Susan Collins (R-Maine) said in a statement Saturday she believes whoever is elected in the 2020 presidential race should pick the nominee to fill Justice Ruth Bader Ginsburg's Supreme Court seat.

Why it matters: Collins will be key in how the nomination process plays out. As one of the most centrist Senate Republicans, whether or not the Senate confirms Trump's SCOTUS nominee could hinge on her vote.

Updated 2 hours ago - Politics & Policy

Coronavirus dashboard

Illustration: Sarah Grillo/Axios

  1. Global: Total confirmed cases as of 4:15 p.m. ET: 30,602,281 — Total deaths: 953,591— Total recoveries: 20,833,568Map.
  2. U.S.: Total confirmed cases as of 4:15 p.m. ET: 6,751,119 — Total deaths: 198,969 — Total recoveries: 2,556,465 — Total tests: 93,150,052Map.
  3. Politics: In reversal, CDC again recommends coronavirus testing for asymptomatic people.
  4. Health: The dwindling chances of eliminating COVID-19.
  5. World: Guatemalan president tests positive for COVID-19 — The countries painting their pandemic recoveries green.