The spigot is wide open now. Getting acquainted, easing into committee hearings with the trickle of a few bills.... that’s done, we’re at full throttle now. Morning committee’s start at 8 and 9. Meetings must fit in before then, so they start at 6:30 or 7. Looking forward to starting the day in the light soon.
Big questions regarding the potential for changes coming from the federal government that could bring significant financial impacts to our state. All of us are getting phone calls and emails from you... and rightly so, we all are worried by the “unknown.”
Here are my thoughts starting with Health Care services and Medicaid. No quick changes. The president will continue his “talking points,” but changes will be a collaborative effort with Congress, and that will take plenty of time. I don’t see or hear anything that I think is quick.
The Health Care Act will be reformed ... the alarmists talk “repeal,” but reality is reform. It will change, but it will also take time. As for Medicaid expansion and Montana, those federal funds are committed for this year.... long range planning will bring changes, short term, changes will be slow.
It has become obvious this past year or two just how out of control the whole health care system really is.... rates increasing, doctors leaving, data entry and record keeping driving everyone nuts. Cronyism, corruption, price gouging, and price controls.
I got a bit of a look behind the scenes this week with all of the above in the prescription drug sector. I am sponsoring a bill on behalf of the State Pharmacy Association, HB-276, to bring transparency for the pharmacies and create in statute the protection that they can’t be forced to sell below cost if beyond a certain percent, and if they can advise where the customer can get the prescription filled.
Rural pharmacies are beginning to lose money from the controls on both their cost and the retail selling price. Their net profits are putting them at risk of not being able to continue. We are not the only state, several have similar bills in the works.
The controls are handled by Pharmacy Benefit Management groups. Three companies control 80 percent of all the drugs. These are “for profit” companies, some owned by huge insurers, like Blue Cross/Blue Shield, a non-profit company and they own a large share of Prime Health Services. The bottom line for these PBM’s are growing at staggering rates while the rural pharmacies of our state are at risk of surviving. After a one hour committee hearing, the hallways were filled with PBM lobbyist’s and attorneys making their pitch direct to the committee members. Really intense still the next day. These folks are fighting hard to stop bills like ours, to avoid transparency into their controls. They are defending their turf. Two days later I was still getting the “stink eye” as I walked by them in the hall.
Rural pharmacies are a victim of the controls. Hopefully this bill will pass and get them some of the protection they need.