PCMA Highlights Recent Pro PBM Comments

September 9, 2025

EGWP marketplace medicaid Medicare

PCMA recently highlighted several op-eds from policy analysts and economists who have spoken out on the value of PBMs. Satya Marar, visiting postgraduate fellow at the Mercatus Center at George Mason University, explained in a CounterPunch op-ed why PBMs are necessary to push back against the high list prices that drug companies alone set: “We’d pay even more if private health plans didn’t pool patients together and collectively bargain on drug prices through intermediary PBMs.”

A recent op-ed in Inside Sources by policy analyst Jason Reed echoes Marar’s assessment: “PBMs are the little-known heroes of the American health care system. They act as intermediaries to negotiate drug prices with Big Pharma on behalf of consumers…keeping Big Pharma in check and maximizing healthcare accessibility in exchange for meager profit margins as low as 2 percent (well below the S&P 500 average of 12 percent).”

Dr. Jeremy Nighohossian, senior fellow and economist at the Competitive Enterprise Institute, argues in a blog post that PBMs “play an integral role in negotiation and sourcing behind the scenes” and warns lawmakers in Washington against interfering with the PBM market that is delivering lower drug costs for Americans.

In an Inside Sources op-ed, Marar similarly cautions against pursuing policies that would undermine the ability of PBMs to negotiate lower drug prices: “Blanket, industrywide restrictions on negotiation practices that benefit patients and health plans would serve vested interests while backfiring on those they’re meant to help.”

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 […]
read more >

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 […]
read more >

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 […]
read more >

April 15, 2026

EGWP marketplace medicaid Medicare

You may also like