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Sponsors pitch HB 448 to force PBMs, insurers to 'share the savings' from rebates
Summary
Sponsors told the House Insurance Committee HB 448 would require pharmacy benefit managers and insurers to pass manufacturer rebates to patients in deductible or coinsurance phases; sponsors cited other states and a Milliman study as evidence that premiums need not rise.
Representatives Tim Barhorst and Rachel Baker told the House Insurance Committee that House Bill 448 would require pharmacy benefit managers (PBMs) and insurers to pass prescription-drug rebates or discounts negotiated with manufacturers through to patients who are in the deductible or coinsurance phases of their plans.
"In most cases, PBMs ... are pocketing the savings they receive from the rebates," Representative Barhorst said, arguing that patients in high-deductible plans pay full list prices while PBMs and insurers keep negotiated savings. Representative Baker said states that have passed similar laws, including West Virginia and Arkansas, have not seen premium increases she considers out of line with national trends and cited a Milliman study on Arkansas as supporting evidence. "HB 448 is a proven policy that will not result in any significant increases in insurance premiums," she said.
Sponsors said the bill targets the common situation in which negotiated manufacturer rebates never reduce patient out-of-pocket costs for people paying deductibles or coinsurance. Committee members asked whether state experience is generalizable and whether cost shifting could occur; sponsors pointed to multiple states that have adopted similar rules and pledged to provide supporting data. No committee vote was taken on HB 448 at the hearing; this was sponsor testimony during the bill's first hearing.
