As voters weigh in on their priorities for the midterm elections, the headlines are clear: affordability is their top concern. That’s why President Trump, members of Congress in both parties, and candidates for office across the country are advancing a range of policies to help Americans who are suffering from high prices, including rising health care costs.

This bipartisan commitment to affordability makes a pending Department of Labor (DOL) rule especially puzzling. The PBM fee disclosure proposal, which offers no additional transparency for employers, was introduced just days before Congress passed sweeping PBM reform in the Consolidated Appropriations Act (CAA). As a result, it is now redundant, outdated, and directly at odds with the Administration’s broader effort to reduce costs and eliminate unnecessary regulation. We recently highlighted a range of voices raising these concerns. The message is clear: the Department of Labor should not finalize this harmful and redundant rule as proposed. 

As proposed, the rule risks harming competition in the PBM market and increasing costs for patients and employers. If the rule moves forward as written, it will:

• Drive up cost for small businesses and unions – extending disclosure mandates beyond the statute will require costly system changes and administrative effort, burdens that would fall especially hard on small employers and labor unions.
• Bury mid-market PBMs in compliance costs, unnecessarily harming a competitive and effective market – costs the largest players can absorb and smaller competitors can’t, choking off the growth and competition the market needs.
• Undermine President Trump’s affordability agenda – while other agencies are working to cut needless regulations, the DOL rule piles on new reporting requirements, mandates, and compliance costs that will ultimately be borne by patients, employers, and taxpayers.
• Lock in the status quo, making it harder for new and emerging PBMs to compete – the aggressive timeline makes it extremely challenging to build and deploy complex compliance systems.

The proposal also ignores the CAA entirely by layering new mandates on top of requirements Congress already put in place, undercutting the law that lawmakers actually passed. The CAA now governs PBM transparency, reporting, and plan oversight to provide employers with the information they need to make informed decisions. DOL has an important obligation not to bury smaller PBMs and small businesses with bureaucratic red tape.

The graphic below outlines the transparency policy provisions that overlap between the enacted CAA and the proposed DOL rule: