In case you missed it, WTOP’s Mitchell Miller spoke with former U.S. Senator Pat Toomey (R-PA) about the current health care debate in Congress in a conversation titled; “The Political And Economic Ramifications Of Undermining The Free Market In Health Care.”

With the recent must-pass spending bills at the forefront of the legislative debate, Toomey cautioned:

“We don’t see legislation passing through the normal channels, the committee structure, debate and passage on the floor of both chambers, a conference committee. You know, the textbook process by which legislation used to be considered has really broken down. And so that leaves us in a situation where the occasional usually large must pass legislation, whether it’s government funding or the authorization for our national defense.  

“These big bills become the vehicle for, typically, rifle shot or narrowly focused pieces of legislation that might be extraneous to the big bill itself. So, I don’t expect to see a whole series of significant health care related legislation passing the Congress this year. But any number of these smaller targeted rifle shot bills could get snuck into one of these big must-pass bills. That’s what I would keep an eye out for.”

Toomey goes on to highlight how much of the health care debate has been focused on pharmacy benefit companies (PBMs), sharing the critical role they play in the prescription drug supply chain and why employers voluntarily choose to hire PBMs:

“Pharmacy benefit managers are companies that negotiate drug prices on behalf of the sponsors for health insurance plans. 

“And very often, the health insurance plans will cover prescription drugs. And when they do, very frequently, the employer will turn to a pharmacy benefit manager –  a PBM – to help them negotiate better prices from the pharmaceutical companies than they could negotiate on their own. 

“I think the single most important thing that it’s important to take away from this discussion is there’s a reason that employers choose [to hire PBMs]… They don’t have to use PBMs. Not everyone does, but most of them choose to use PBMs because they know the result is lower costs… 

 “Lower cost for them, that means lower costs for their workers – means lower costs for health care.” 

Miller and Toomey go on to discuss the potential ramifications of passing proposals narrowly focused on PBMs. Toomey warned:

“If the government just wades in and slams its fist down on one of the participants, then it almost always has a disruptive effect elsewhere… 

“By the way, the big unintended consequences, if there is some significant curtailment on PBMs, is going to be higher healthcare costs, higher insurance premiums… I’m pretty sure most members of Congress don’t want to vote for something that’s going to raise the cost of prescription drugs for their constituents. But that’s exactly what will be happening if they pass some of these bills… 

“So there are things that we can do to allow this really important sector of our economy to thrive without the government coming in, picking one sector of this and dictating the terms of the business relationships. I think that latter approach is a bad idea.” 

As Congress continues to work to pass a spending package, it is important that policymakers understand the catastrophic, costly effects of singling out PBMs and undermining their ability to secure lower drug costs for patients, families, and taxpayers.

Watch the full WTOP event HERE.

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Read Pat Toomey’s recent op-ed cautioning Republicans against undermining the free market in the health care system HERE.

Learn more about the costly implications of proposals targeting pharmacy benefit companies HERE. 

Find out more about the critical role and value of PBMs HERE.

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