Halpin-Backed Legislation Curbing Prescription Price Hikes, Cracking Down on Pharmacy Benefit Managers Now Law

SPRINGFIELD, Ill. – An effort by state Rep. Mike Halpin, D-Rock Island, to control spikes in prescription drug costs and require pharmacy benefits managers (PBMs) to inform customers of less-expensive generic drug alternatives is now law.

“Powerful pharmaceutical companies are doing everything they can to jack-up costs and limit patients’ coverage, but every Illinoisan deserves affordable health care. We can’t let big pharma’s drive to pad their bottom line determine whether parents can afford their kid’s medication,” Halpin said. “I’m working to build a stronger Illinois by building a stronger middle class, and that includes making health care more affordable for working families.”

Halpin helped pass House Bill 465, which will curb skyrocketing prescription drug prices by creating comprehensive regulations for PBMs including requirements that they inform customers of cheaper prescription alternatives, comply with oversight from the Department of Insurance and pay fines of up to $50,000 for violating the Illinois Administrative Code in their bookkeeping procedures. The bill also protect the rights of patients in the emergency room by prohibiting any insurer from denying coverage until the patient is considered stable. Combined, these measures should help substantially lower the cost of health care in Illinois. The legislation received strong bipartisan support and is now law.

As the middlemen between drug manufacturers and pharmacies, PBMs set drug prices on behalf of insurance companies. Until now, they have operated with virtually no oversight even though they manage public money through Medicaid, as well as managing prescription programs for private insurance and self-insured plans.

“Nothing is more essential than good health care,” Halpin said. “When a person is dealing with chronic health problems at a huge cost, it takes more than a simple financial or physical toll-although those are bad enough. Untreated, or poorly-treated, medical issues affect entire families, sometimes for years. Backing this legislation is just one of many steps I am taking to ensure that the people in my communities have access to the doctors and medicine they need at a reasonable price.”