Good morning ... Hello, first day of the NCAA tournament; goodbye, productivity.
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Pharmacy benefit managers — the middlemen between drug companies and employers’ health care plans — are getting a lot of attention in the debate over drug pricing, in part because their contracts are so secretive. But Axios’ Bob Herman obtained a copy of the template that Express Scripts, the largest PBM in the country, uses to negotiate those contracts.
The big takeaway: The language is clearly written with the PBM's financial interests in mind, and critics say those kinds of provisions can result in lost savings for everyone, especially for small companies and their employees.
Three key ways this framework appears to work in Express Scripts’ favor:
The other side: "It is clear to us that there are several vocal PBM critics who are eager to provide their biased interpretations of this template contract to serve their own agenda,” Express Scripts spokeswoman Jennifer Luddy said.
Sen. Ted Cruz. Photo: Bastiaan Slabbers/NurPhoto via Getty Images
Four prominent conservatives — Sens. Ted Cruz and Mike Lee and Reps. Jim Jordan and Mark Meadows — have come out swinging against their fellow Republicans’ efforts to stabilize the Affordable Care Act’s insurance markets.
The latest: My colleague Caitlin Owens scooped yesterday that Sens. Lamar Alexander and Susan Collins are trying hard to build support for a revised stabilization bill — a proposal that many experts and insurers agree could substantially reduce the next round of premium increases.
Tell us how you really feel: I try to stay out of the prediction business, but folks, I don’t think Cruz, Lee, Jordan and Meadows are gonna change their minds on this one. After all, the conservative quartet wrote in the op-ed:
“This Frankenstein combination of a new Republican-created insurance bailout plus funding ObamaCare’s existing pro-abortion ... bailout is exactly what we counseled against.”
Yes, but: If these proposals have a shot at passing, it’d be as part of a government funding bill that will likely rely on a coalition of Democrats and moderate Republicans.
Marilyn Tavenner is leaving America’s Health Insurance Plans after a rough three years at the helm of the health insurance industry’s major lobbying group. Bob caught up with Matt Eyles, a top AHIP executive who will replace Tavenner as CEO in June, to talk about what’s next.
The U.S. uninsured rate fell by about 6.3% from the end of 2013 to the end of 2016 — the period in which President Obama was in office and the law’s coverage expansion was taking place. But about 20% of those coverage gains have since evaporated, according to a letter to the editors of the New England Journal of Medicine.
Key quote: "It is unclear how many of the 2017 changes are attributable to premium increases and difficulties in the ACA marketplaces that began in 2016 and how many are attributable to new efforts to destabilize the law under President Trump."
What we're watching today: HHS secretary Alex Azar testifies at a House Appropriations subcommittee hearing on HHS' budget request (details). VA secretary David Shulkin will also appear before House appropriators.
Senate HELP Committee hearing on the 340B drug discount program.
But also, basketball. Kentucky faces off against Davidson at 7:10pm.
Get in touch: I always welcome your tips: firstname.lastname@example.org.