Why It Matters

The House Committee on Oversight and Government Reform voted 40-2 Thursday, July 23, to advance H.R. 6610, the Pharmacists Fight Back in FEHB Plans Act, sending the bill to the full House. The legislation would overhaul how pharmacy benefit managers (PBMs) reimburse pharmacies under the Federal Employees Health Benefits (FEHB) program, which provides health coverage to federal employees, retirees and their families. It would also bar PBMs from steering enrollees toward their own pharmacies and require that a share of manufacturer drug rebates flow directly back to patients.

The Big Picture

The bill aims at an industry that has drawn bipartisan scrutiny in D.C. Committee Chairman Rep. Comer (R-KY) has argued that a small handful of PBMs control roughly 80 percent of the prescription drug market, using reimbursement practices that independent pharmacists say force them to dispense some prescriptions at a loss. The bill was co-sponsored by Rep. Comer and Rep. Auchincloss (D-MA), and a companion measure, H.R. 6609, would extend similar reforms to Medicare and Medicaid.

That bipartisan framing showed in Thursday's vote. On a committee split 26-21 along party lines, only two members broke ranks, Rep. Burlison (R-MO) and Rep. Min (D-CA), each voting against their own party's general position. Both committee leaders, Rep. Comer and Ranking Member Rep. Garcia (D-CA), voted in favor, as did nearly every other member who cast a vote.

What They're Saying

Rep. Comer has framed the bill as a check on PBM power, writing that PBMs exploit their control over the prescription drug market for their own financial gain. The Pharmaceutical Care Management Association, which represents PBMs, pushed back on that, with its president and CEO calling the bill "a huge cash transfer from taxpayers to pharmacists and nothing more" and warning it would raise costs for the federal health program without improving care for enrollees.

The Bottom Line

H.R. 6610 still needs approval from the full House and Senate before it could become law, and the PBM industry is likely to keep fighting it at each stage. But Thursday's lopsided, cross-party vote signals the bill has more institutional momentum than many pharmacy-reimbursement fights typically generate in Congress.

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