Staff Reports
Big news out of Capitol Hill: Hannah Anderson, director of Healthy America Policy at the America First Policy Institute (AFPI), told the House Education and the Workforce Subcommittee that hidden deals between pharmacy benefit managers (PBMs), brokers and consultants are padding profits and hiking costs for patients. She called these arrangements “perverse incentives,” and Congress listened. This hearing is the latest move in a real push to unclog the middlemen who have made prescription drug costs a national joke — and to put patients back in charge.
What Anderson Told Congress
Anderson testified at the subcommittee hearing styled “Profits Over Patients: The PBM Business Model Under Scrutiny.” Her point was simple: PBMs and their undisclosed payments to brokers and benefits consultants steer plans toward higher list prices and fatter hidden fees. She warned those conflicts of interest affect tens of millions of Americans on employer plans and said, bluntly, “perverse incentives are driving up costs for patients.”
The hearing was no feel-good photo op. Representative Rick Allen, the subcommittee chairman, signaled he wants action — not press releases. Members from both parties complained about secrecy and money flowing under the table. That bipartisan unease matters because it means targeted reforms can get traction even when big, sweeping changes tangle in ideology.
Legislation: H.R. 7895 and the PBM Kickback Fight
Congress is already moving. Chairman Allen advanced the PBM Kickback Prohibition Act (H.R. 7895) in committee. The bill would ban PBM payments to brokers and consultants that steer business and could stop pay-to-play plan designs. In plain English: if you can’t hide the incentives, you can’t rig the system. This kind of narrow, surgical law is exactly what voters want when they say they want patients and doctors — not lobbyists and middlemen — running healthcare decisions.
Enforcement Is Happening Too
The hearings line up with real-world enforcement. The Federal Trade Commission reached a major settlement with a leading PBM, Express Scripts, that forces more transparency and even requires the company to provide “covered access” to the White House’s TrumpRx program as part of its remedy. That marks a rare moment where regulators, Congress, and the White House are tugging in the same direction to lower prescription drug costs.
TrumpRx: Helpful — But Not a Magic Wand
President Trump’s TrumpRx portal and the administration’s push for most-favored-nation pricing have already cut prices for many cash-paying drugs and added hundreds of generics to the federal catalog. That’s real progress. Still, analysts note TrumpRx mainly helps people who pay cash at the pharmacy today. For insured patients, the benefits depend on whether plans count those purchases toward deductibles and whether employers and insurers adopt the program. So yes, celebrate the wins — but don’t pretend the hard work is over.
Bottom line: Anderson’s testimony was the latest and loudest reminder that hidden PBM deals are not an abstract policy problem — they are a tax on illness. Congress has a clear, sensible path: ban kickbacks, force price transparency, back programs that expand competition like TrumpRx, and shore up rural care where big insurers too often leave patients stranded. If Republicans keep pushing these reforms, and if lawmakers of both parties stop playing favorites with middlemen, Americans might finally stop choosing between groceries and medicine. That’s a good fight; let’s keep it going.
