Vicki Lightcap: PBMs provide a remedy to expensive healthcare

In Pennsylvania, the ever-rising cost of healthcare looms large over working families. A recent survey revealed a staggering reality: nearly three in five residents expressed apprehension about healthcare expenses in the last year. Even more alarming, 83 percent of respondents reported having a profound worry about affording basic healthcare coverage in the future. These statistics are not just mere numbers; they represent the anxieties faced by millions of Pennsylvanians struggling to navigate a broken healthcare system.

Amid these challenges, Pharmacy Benefit Managers (PBMs) provide a glimmer of hope in the fight for affordable healthcare. Unfortunately, PBMs now find themselves under siege by lawmakers in Harrisburg with HB 1993. Instead of recognizing their valuable role in the healthcare ecosystem, some policymakers have chosen to unfairly target them with proposed legislation and regulatory measures. 

HB 1993 is a direct threat to the stability of our healthcare system and prioritizes the interests of a few profit-driven entities over the well-being of patients and employers. If passed, HB 1993 could lead to higher premiums, reduced access to necessary medications, and overall poorer health outcomes. 

This shortsighted approach ignores the root causes of Pennsylvania’s healthcare affordability crisis and risks undermining the progress made in controlling prescription drug costs. Rather than vilifying PBMs, policymakers should work with all stakeholders to implement comprehensive solutions that tackle the systemic issues driving up healthcare expenses.

Often overlooked and misunderstood, PBMs leverage their bargaining power to ensure that essential medications remain accessible and affordable for those who need them most. They negotiate for lower prices on prescription drugs and ease financial burdens, ultimately benefiting consumers, patients, employers, and unions, alike. The savings produced by PBMs are substantial and can help reduce drug costs by up to 50 percent. 

PBMs also play a critical role in improving health outcomes. They promote medication adherence through clinical programs designed to ensure patients take their medications as prescribed, reducing the risk of adverse health events. Additionally, PBMs combat waste, fraud, and abuse within the healthcare system, safeguarding patients and optimizing resource use.

It’s not just patients that depend on PBMs. Over 1 million small businesses in the state also rely on these entities to manage their employees’ health benefits. At a time when employers need as many financial breaks as possible, PBMs keep healthcare costs in check and allow businesses to retain more of their earnings. 

While it’s encouraging to see the legislature make healthcare a priority this session, we shouldn’t prematurely accept policies that could do more harm than good. HB 1993 is a blatant attempt to serve special interests at the expense of those who rely on PBMs to streamline their healthcare.

Rather than adding more government red tape in healthcare, lawmakers should build on the progress and benefits brought by PBMs and oppose HB 1993. Let’s create an environment where affordable and accessible healthcare is finally a reality in the Keystone State. 

Vicki Lightcap is the former mayor of Pennsburg, Pennsylvania 

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