New Hampshire Lawmakers Seek Stronger PBM Reform

February 12, 2026

EGWP marketplace medicaid Medicare

Legislators in New Hampshire are actively pursuing PBM reform through legislation and regulatory action. This year, two omnibus bills have been introduced and scheduled for hearings in January. The first bill, SB 547, would broaden the definition of a PBM to include self-funded employers and third-party administrators, including a fiduciary duty requirement between a PBM and a health plan, as well as place new restrictions on steering to affiliated pharmacies, a spread pricing prohibition, and require additional reporting to the state.

The second bill, SB 478, would require PBMs to delink any compensation from the list price of a drug for the state-administered plan, while also making a delinked and pass-through option broadly available to employers in the state. The bill also aims to protect 340B safety net providers from discriminatory practices and provide parity access on formularies for all biosimilar medications, among other provisions.

perspectives

Americans continue to be satisfied with employer-sponsored coverage

A new national survey commissioned by AHIP finds American workers hold consistently positive views of employer-sponsored health coverage, with nearly 9 in 10 expressing satisfaction with their plans and a decisive 96% valuing the financial security their coverage provides. Workers view employer-provided coverage as integral to their employment decisions, with 68% ranking health insurance as […]
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April 15, 2026

EGWP marketplace medicaid Medicare

Solutions

AHIP and BCBSA provide progress update on prior authorization commitments

On April 7, The Cigna Group joined other health plans in announcing an update on the industry’s progress implementing the voluntary prior authorization commitments made in partnership with the Department of Health and Human Services and CMS last year. Since June 2025, participating health plans have eliminated 11% of prior authorizations across a range of […]
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April 15, 2026

EGWP marketplace medicaid Medicare

legislation

Washington lawmakers pass tax increase impacting insurers

Since returning in January, Washington lawmakers have been busy advancing a variety of tax increases to help manage significant budget shortfalls and introduce new revenue streams. One new source of revenue approved by both the Senate and House and included in the state’s budget is HB 2487, which removes a tax exemption for health plan-affiliated […]
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April 15, 2026

EGWP marketplace medicaid Medicare

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