Why it matters: The Cigna Group, with its Express Scripts PBM subsidiary, is dedicating significant lobbying resources to influence multiple bills targeting pharmacy benefit manager practices and drug pricing transparency in Q1 2025.

The big picture: Cigna’s lobbying activities reveal a company playing defense on PBM reform while seeking to protect its health insurance interests through ACA marketplace stability and appropriate Medicare funding.

By the numbers: Cigna deployed a five-person lobbying team with extensive experience:

  • Brendan Devine and Kathryn Gallagher bring 13+ years of Capitol Hill experience
  • Gary Justin Kline previously lobbied specifically for Express Scripts before its Cigna acquisition
  • Courtney Lawrence offers health insurance expertise from his time at AHIP
  • The most recent addition, Julien Mitchell Relfe, joined in 2022 after lobbying for small businesses

Zoom in: Cigna is heavily focused on a slate of PBM reform bills that could fundamentally alter its Express Scripts business model:

Between the lines: Cigna faces opposition from diverse stakeholders on PBM reform, including:

  • The American Medical Association
  • AARP Inc.
  • National Association of Chain Drug Stores
  • Association for Clinical Oncology

The company is also engaged on drug pricing legislation:

What we’re watching: Cigna’s strong interest in S. 864/H.R. 247, the Health Care Affordability Act of 2025, which would extend enhanced subsidies for ACA marketplace plans – a policy where Cigna’s interests align with other major insurers like Kaiser, Highmark, and various Blue Cross Blue Shield organizations.

Budget concerns: The company is monitoring broader fiscal policy through lobbying on:

The bottom line: As PBM reform gains momentum with bipartisan support, Cigna is strategically deploying experienced lobbyists to shape legislation that could dramatically impact its business model while simultaneously working to ensure stable funding for government health programs that drive significant revenue.