Merritt: Congressional attempts to target PBMs could jeopardize our healthcare system

You might be familiar with Pharmacy Benefit Managers (PBMs) — they administer prescription drug plans for more than 275 million Americans. Despite ongoing efforts to improve healthcare access and affordability, politicians in Washington are attempting to socialize our healthcare system and advance U.S. Sen. Bernie Sanders-backed provisions targeting PBMs. This approach has the potential to seriously jeopardize Indiana's healthcare system and could disrupt our healthcare infrastructure and business environment.

Many PBM reform efforts have some serious shortcomings that could negatively impact healthcare in Indiana. At its core, these efforts seek to restrict PBMs who negotiate drug prices on behalf of health insurance plans, Medicaid and other entities. Advancing proposed restrictions will do more harm than good and put patients’ access to life-saving medications on the chopping block.

One of the most pressing concerns is the potential for increased healthcare costs. The result of government-enforced reform will inadvertently be higher prescription drug prices. PBMs frequently engage in negotiations with Big Pharma, resulting in discounts that play a pivotal role in curbing healthcare expenses for consumers. These cost-saving measures are instrumental in alleviating the financial burden on the average patient, contributing to annual savings of over $1,000. This achievement is made possible by harnessing the collective power of a vast patient base, employing strategies such as rebates, audits and various other tactics. If these negotiation tools and tactics are curtailed, the savings might not be passed on to patients, leading to higher out-of-pocket expenses.

Reform bills could also disrupt the delicate balance and safety within Indiana's healthcare ecosystem. PBMs play a vital role in negotiating with drug manufacturers and pharmacies to ensure that patients have access to affordable medications. Additionally, they diligently evaluate the safety, effectiveness and cost-efficiency of medications, employing a discerning approach to determine which drugs to include in their list of prescription drugs. This oversight fosters a competitive environment, maintaining a balance between pricing and healthcare quality.

In addition to these concerns, there is also a genuine fear among some Hoosiers that embracing policies proposed by figures like Sanders could bring the United States closer to a system of socialized medicine. This adds another layer of complexity to the ongoing healthcare debate in Indiana and across the nation. We must resist the allure of heavy-handed government solutions that would hinder the choices and opportunities for patients in our state.

PBM reform presents significant risks to Indiana patients and businesses and leads to increased costs for seniors like me. Hoosiers deserve a healthcare system that ensures access to affordable medications, supports the local economy and provides stability and peace of mind for its residents. PBM reform bills threaten to undermine these essential principles and should be opposed for the sake of the state's healthcare future.

I hope Sen. Todd Young and Sen. Mike Braun will oppose any PBM reform legislation — there’s a path forward to help Hoosiers become healthier but PBM reform isn’t it. It is vital we nurture a competitive marketplace and protect the financial security and health of Indiana patients, and all those across the country.

Jim Merritt is a former Indiana State senator.