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Insurance department seeks increased budget, adds staff to enforce Act 77 on PBMs
Summary
At a legislative budget hearing, the Pennsylvania Insurance Department said its 2025 budget request would increase operating appropriations and include staff additions to implement and enforce Act 77 governing pharmacy benefit managers (PBMs). Department leaders said most funds come from fees, not the general fund.
The Pennsylvania Insurance Department outlined its 2025 budget request during a legislative budget hearing and said it seeks roughly $43 million — a $3.9 million increase — while the state health insurance exchange, Penny, asked for about $52 million, an $11.4 million increase. Commissioner Humphreys and staff told lawmakers most of the funds for both entities come from fees and other non‑general‑fund sources.
Lawmakers pressed the department about provisions added to the budget to support enforcement of Act 77, the 2024 law that expanded state oversight of pharmacy benefit managers. Representative Mullins asked specifically how new staff would be used; Commissioner Humphreys said the hires would be spread across consumer complaints, rate and product review, and legal appeals, including positions to adjudicate appeals involving specialty drugs.
"A few positions will be dedicated to their rate review and product review side," Humphreys said, adding the department expects an increase in appeals from pharmacies and insurers and wants to adjudicate them "as quickly as possible." The department said the proposed additions tied to Act 77 total eight staff in the Insurance Regulation and Oversight Fund line and would be paid from fee revenue rather than the general fund.
Lawmakers who represent rural and smaller community pharmacies emphasized local impact, telling the department that many independent pharmacies serve as front‑line health providers in their districts. The department repeated that the new staff would work on both intake of pharmacy complaints and on the legal side to speed adjudication.
Department staff at the table for the hearing included Chief of Staff Jody France and Budget Director Anu Upadi, who the commissioner identified when sworn testimony began.
Looking ahead, the department said it will use the new positions both for complaint intake and for adjudicatory work on disputes that arise under Act 77. No formal vote or appropriation was decided at the hearing; lawmakers asked the department for follow‑up budget detail.
Less urgent details: the department reiterated its long‑standing policy that most operating dollars come from assessments and fees, not direct general‑fund appropriations.
