On Dec. 11, the U.S. House passed the Lower Costs, More Transparency Act, legislation to require Pharmacy Benefit Managers (PBMs) to disclose drug rebates and discounts, revealing what they pay drug makers for prescription drugs. The bill would also require hospitals, insurance companies, labs, imaging providers, and ambulatory surgical centers to publicly list the prices they charge patients. 

The bill passed by a bipartisan vote of 320–71. However, Rep. Richard Neal was the only member of the Massachusetts delegation to vote against it. Why? The answer lies in the fact that Neal is the recipient of huge doses of campaign contributions from PBMs which act as middlemen between drug makers and insurers. PBMs negotiate prices in exchange for including drugs in insurers’ formularies. They are supposed to pass the savings to patients. However, PBMs, often working hand-in-hand with insurance companies that own them, pocket the discounts, leaving patients to foot the bill. 

Also, you won’t find Neal’s name on the Protecting Patients Against PBM Abuses Act, H.R. 2880, which his colleague Rep. Jake Auchincloss of Newton has co-sponsored.

According to OpenSecrets, between 2014-2022, Rep. Neal has taken a total of $88,000 in campaign donations from the top three PBMs, including $28,500 from CVS Health (Caremark) which has 32% of the market, $31,000 from Cigna Corp (Express Scripts) with 24% market share and $28,500 from UnitedHealth (OptumRx) with 21% market share. 

A report issued by the U.S. Government Accountability Office on Sept. 5, 2023 recommended that the administrator of Centers for Medicare and Medicaid Services should monitor the effect of rebates on plan sponsor formulary design and on Medicare and beneficiary spending to assess whether rebate practices are likely to substantially discourage enrollment by certain beneficiaries. 

A national poll from March 2023 found that 84% of likely voters say it’s important or very important to have rules that require PBMs to provide value and lower drug costs for consumers. What’s more, respondents want elected officials to take on the issue of regulating PBMs with 73% saying it should be a high or top priority for Congress and their state legislatures, and 72% saying they are more or much more likely to vote for a candidate who supports regulating PBMs. 

Sadly, there has been no coverage locally of Rep. Neal’s actions on behalf of PBMs by the Springfield local television news stations which are too busy showing the congressman posing with holiday revelers. For more information about how Neal is beholden to corporate interests, please visit richienealsecrets.com/. 

Matt L. Barron lives in Chesterfield and Jon Weissman lives in Granby.