Employers looking ahead to a continued push by state and local governments to more closely regulate pharmacy benefit managers in 2024 are set to back stricter federal law preemption of these measures.
PBMs, which manage prescription drug plans of behalf of health insurers, have been criticized over lack of transparency and inflated costs to health plans, but the federal government has not yet enacted legislation to rein in these middlemen.
Groups representing companies with self-insured health plans say the states’ attempts to fill the void on PBM legislation threaten preemption protections under the federal Employee Retirement Income Security Act. What’s more, maintaining a nationally uniform regulatory system under ERISA, which turns 50 in 2024, is necessary to avoid a problematic patchwork of state laws, the employer groups say.
“The timing couldn’t be better to take a good look at ERISA and health care and determine where there could be areas that could be strengthened and modernized to ensure that ERISA self-funded plans can continue to offer the benefits they offer,” said Melissa Bartlett, senior vice president for health policy with the ERISA Industry Committee (ERIC), which represents the employee benefits interests of large employers.
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