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To fight the drug affordability crisis, Trump must crack down on middlemen

by | Jun 3, 2026

Most adult Americans take at least one prescription drug, and for too many, getting that prescription filled means battling the very system that’s supposed to help them. Insurance denials have become alarmingly routine. A recent study found that 70% of commercially insured patients face initial claim rejections for new branded medicines. And even when patients manage to access treatment, affordability remains a major challenge: nearly 60% of U.S. adults worry about being able to pay for their medications.

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Trump must seize the chance to make health care affordable

by | Apr 1, 2026

Whether through the Labor Department rulemaking process, the final Notice of Benefit and Payment Parameters rule or another regulatory vehicle, the Trump administration must close the essential health benefits loophole to prohibit insurers and pharmacy benefit managers from profiteering and ensure that co-pay assistance benefits the patients it is intended to help. The administration has shown it is willing to take on pharmacy benefit managers. Until we take concrete action to close the essential health benefits loophole, billions of dollars will continue to be diverted from patients who desperately need them.

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How the “non-EHB” loophole is hurting employees and raising long-term costs

by | Sep 23, 2025

It’s no secret that employee health benefits are expensive. And understandably, employers and their benefits advisors are looking for ways to curb that spending. But in the pursuit of short-term savings, some are turning to an “insurance” scheme that shifts financial risk onto employees, disrupts essential medical care, and can ultimately result in higher long-term costs for businesses. Benefits professionals would be wise to recognize these schemes for what they are—and avoid them.

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Pharmacy benefit managers have become too powerful

by | Jan 2, 2025

Policies to reform the ability of benefit managers to profit from medication list prices and rectify misaligned incentives that lead to increased patient costs are critical to address their predatory role in our health system. Without action to advance proposals that would help patients better access the medicines they need, patients in Illinois and across the country will continue to be subject to pharmacy benefit managers’ “profit over patients” model. In the new year, Congress must act on reform.

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Administration Must End Prescription Drug Insurance Scheme

by | Sep 24, 2024

If the administration does not act, patients nationwide will continue to be subject to schemes that lead to higher out-of-pocket costs for the medications they need, risking medical debt or facing treatment delays and lack of adherence. To protect patients, essential health benefits drugs must be rightfully treated with the gravity that their name implies—medications that are “essential” to a healthy life for patients.

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