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Board monitors Colorado UPL ruling as Washington advances rulemaking
Summary
HCA staff told the Prescription Drug Affordability Board that Colorado’s recently blocked upper payment limit (UPL) and NASHP model legislation are informing Washington’s rulemaking; staff expect UPL rules to be finished by end of this year but not effective until roughly July 2027.
Mike Dornschwander, HCA director for the Prescription Drug Affordability Board, updated members on legal developments in other states and how they affect Washington’s timeline for upper payment limits. He said Colorado’s initial UPL — including a proposed cap on Enbrel tied to Medicare maximum fair-price levels — has been temporarily blocked by a judge and that NASHP released model PDAB legislation drawing on Medicare pricing.
"Colorado's upper payment limit has temporarily been blocked," Dornschwander said, noting the state’s experience is both a caution and a source of legal lessons for Washington. Staff told the board they are coordinating with the Attorney General’s office while finalizing rule language and collecting public feedback during the formal rulemaking process.
Staff described procedural timing: rulemaking is expected to be completed by the end of the calendar year, but rules do not take effect until 90 days after the next legislative session ends (the board noted that session ends 04/26/2027), making an effective date likely around July 2027. Dornschwander also explained statutory posting and objection periods the board must follow before voting on any UPLs.
Why it matters: A judicial block in another state changes the legal calculus and timing for states pursuing price limits. Washington staff said the delay gives the board time to refine methodology and incorporate inter-state legal developments before finalizing any UPL actions.
