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Wyden and Crapo turn to public pressure on PBMs

Illustration of a pill casting a shadow in the shape of a question mark

Illustration: Sarah Grillo/Axios

The top lawmakers on the Senate Finance Committee pushed on multiple fronts today to try to wrap a PBM overhaul into the second government funding package — including appealing for help from the White House.

Why it matters: The six-bill minibus is likely the last legislative vehicle for such policy changes before the election. If it fails to make it, the legislation would have to compete with a host of other unfinished business in a lame-duck session.

What they're saying: Finance Ranking Member Mike Crapo tried to enlist the Biden administration's help at a hearing this morning with HHS Secretary Xavier Becerra on the department's FY25 budget request.

  • "I'm asking now that the president step up and use the bully pulpit to get this legislation moved in this Congress," Crapo said, noting that the budget was silent on PBMs.
  • Becerra pledged to work with the committee and referenced a recent White House listening session on PBMs that was at times highly critical of the drug supply chain players.
  • The Finance Committee last year advanced a package that would have changed the way PBMs are paid in Medicare, by no longer tying compensation to the price of drugs.

Between the lines: Finance Chair Ron Wyden told Axios today that he recently spoke with House Energy and Commerce Chair Cathy McMorris Rodgers about PBM legislation.

  • He said he'd had "good conversations" but declined to get into specifics, including whether there was any progress bridging a divide over whether changes should be limited to Medicare or extended to commercial health insurance.
  • "I've been talking to the key members in the House," Wyden said.
  • Wyden and Crapo also jointly appeared at an event with pharmacists Thursday morning outside the Capitol calling for action on PBMs. Crapo said at the event that he hoped for action "within the next few days."

Reality check: This effort still faces tough odds of making into the funding package, which has to be finalized by March 22.

  • Often, lawmakers use public events like today's to ramp up pressure when behind-the-scenes talks haven't borne fruit.
  • Negotiators also are dealing with a range of contentious non-health issues to get the funding deal done and may be reluctant to add complicated health policy to the mix.

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