Bills would cost Oklahoma consumers
Who thinks health insurance is too inexpensive? For most people, the answer is, “Not me!” But Oklahoma lawmakers apparently think otherwise because they have advanced two bills that could increase citizens’ insurance costs by millions.
Prescription drug benefit managers (PBMs) use bulk-purchasing power to negotiate for lower drug prices. This is akin to the model used to provide low-priced goods to consumers by companies like Amazon and Walmart.
Senate Bill 841 and House Bill 2632 would make it much more difficult for PBMs to achieve drug savings for consumers by mandating that insurers use all pharmacies, even those that don’t contract with the insurer. Supporters argue it’s unfair some pharmacies currently are treated differently than others, but since when do we force people to buy products at a higher price when another provider will sell the same thing for less?
Also, if any pharmacy is guaranteed access to an insurance network, what’s the incentive for any pharmacy to negotiate? That alone guarantees higher prices.
If you doubt it, look at the various fiscal impact statements for HB 2632. State officials warn that the bill will increase costs for government employees on the state insurance plan by $5 million annually, saying, “The significantly deeper discount rates HealthChoice currently has with an exclusive specialty provider network would be lost under an open specialty pharmacy network …” An earlier fiscal impact statement warned that consumers could be subject to balance-billing by pharmacies. Put simply, a pharmacy can accept payment from an insurer, then turn around and ding a patient with a second bill that is much larger than what is now allowed when pharmacies agree to PBM contracts.
The legislation impacts state workers, but also the far larger group of people receiving insurance through an employer or those buying individual policies. It’s estimated PBMs will save Oklahomans on employer plans roughly $7.5 billion over 10 years, but much of that savings could be erased by this legislation, and working families would pay the price.
The Federal Trade Commission has warned that proposals similar to SB 841 and HB 2632 could “undermine the ability of some consumers to obtain the pharmaceuticals and health insurance they need at a price they can afford.” There’s a reason the list of those opposed to these bills reads like a who’s who of Oklahoma, including everyone from Boeing to the Muskogee Nation to the Tulsa Fraternal Order of Police.
It’s easy to see why pharmacists like these bills, but for average Oklahomans, the legislation promises mostly to increase costs, encourage price-gouging and divert tax money away from things like schools. When that happens, it won’t be insurance companies that are to blame, but the Legislature.