One state poised to take up a larger PBM reform package is Florida. In 2022, Gov. Ron DeSantis issued an executive order regulating the actions of PBMs that do business with the state, and he has made PBM reform a legislative priority for 2023. His legislative proposal includes anti-steering provisions, bans on spread pricing and clawbacks, and other licensing regulations. It also includes reporting requirements for manufacturers to give advance notice of and justify annual price increases. This proposal also marks a shift in the drug pricing debate that we will have to monitor. PBMs have been a favorite punching bag for quite some time, but this could mark a pivot toward addressing other problematic areas of the supply chain.
Conclusion
2023 feels like an unusual year for state legislatures. With pandemic policies winding down and hyperpartisanship creeping deeper and deeper into state capitols, it seems like we are at a crossroads of sorts. Because of these dynamics, large health reforms could face more headwinds than usual. However, with the table being set for the next presidential campaign, states with governors seeking to launch presidential bids might be more motivated than others to push through policies that favor patients and providers.
I predict that 2023 is likely to be a year of many small wins. Although that may not be reassuring to hear, it is important to remember that change typically occurs incrementally. It may not be satisfying, but it is healthy and usually the result of something we don’t often hear about in politics these days: compromise.
Joseph Cantrell, JD, is the ACR director of state affairs and community relations.
