Senate Democrats to introduce PBM changes, health provisions dropped from December spending bill

Senate Democrats on Thursday are introducing as standalone legislation a package of health policies, including changes to the pharmacy benefit manager (PBM) industry that was left out of December’s government spending bill.

The effort, led by Sen. Ron Wyden (D-Ore.) and others, is an attempt to revive bipartisan reforms and funding extensions without trying to attach it to a continuing resolution.

With much of the attention in Congress focused on reconciliation, it isn’t clear whether there will be enough political will among GOP leadership to do anything but a “clean” funding bill, without PBM changes or other health extenders.

“Senator Wyden is ready to pass these bipartisan health care priorities, which have been blocked for unrelated reasons for too long. Introducing this legislation is the first step towards allowing the Senate to swiftly act,” a Wyden spokesperson said.

Bipartisan health leaders in mid-December had agreed a sweeping health package that included PBM reforms, extensions of Medicare telehealth flexibilities, reauthorizations of legislation to prevent pandemics and address the opioid crisis, payments to community health centers, and a rollback of physician payment cuts.

But the overall funding bill it was attached to was torpedoed by GOP lawmakers, Elon Musk and then-President-elect Trump, who complained that it was too lengthy and comprehensive.

The scaled-back version that was ultimately passed removed several health care and other provisions in favor of stripped-down legislation to fund the government until later this month.

The package being introduced Thursday includes reauthorizations of the opioid-fighting SUPPORT Act and the Pandemic and All Hazards Preparedness Act. The pandemic legislation had historically been bipartisan, but its initial inclusion in the spending bill late last year sparked a wave of online misinformation amplified by Musk.

Republicans also jettisoned a Medicare physician payment boost and a hospital billing transparency measure that were included in the original health package.

House GOP doctors are pushing hard to include the "doc fix" in the continuing resolution, which is expected to be unveiled this weekend.

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