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House expands Prescription Drug Affordability Board authority to set upper payment limits
Summary
The House approved House Bill 424 to extend the Prescription Drug Affordability Board's authority to set upper payment limits across commercial markets. Supporters said the measure aggregates purchasing power to lower costs; opponents warned of potential market failures and access problems. The bill passed with 94 affirmative votes.
The Maryland House of Delegates on Feb. 20, 2025, passed House Bill 424, extending authority for the Prescription Drug Affordability Board to set upper payment limits that would affect more of the state's commercial insurance market. The clerk recorded 94 affirmative votes and declared the bill passed.
Sponsors and backers argued the bill aggregates the state's purchasing power to lower prescription prices for Marylanders. "At its very basic level, this bill is doing by expanding the authority to the commercial market ... this bill expands that negotiating power to 6,000,000 people," said Delegate (unnamed, supporter), who described how other countries and proposals to negotiate at larger volumes obtain lower prices and cited an example of price differences for a specific drug.
Opponents urged caution, citing the board's own report warning of potential supply-chain issues and market failures. "The thing that scared me most ... is what they put in their own report from September. '3 key takeaways. Number 1 takeaway could cause supply chain issues and market failures,'" said Delegate (unnamed, opponent). Other members warned of impacts on orphan drugs, pharmacies, research and development, and hospital services.
Floor exchanges included personal testimony: several members recounted family experiences with costly medications and said the policy tool could prevent Marylanders from choosing between food and medicine. Supporters pointed to Maryland's state experiments, past reinsurance programs and the state's lower insulin prices as precedents for state-level policy interventions.
After an extended debate with members speaking for and against the bill, the clerk announced there were 94 votes in the affirmative and declared House Bill 424 passed on third reading. The bill will proceed as prescribed by House procedures.
