Clemons: The era of PBMs is over. In Florida, we’re putting patients first.

Photo by National Cancer Institute on Unsplash

OPINION

BY REP. CHUCK CLEMONS

When I grew up in High Springs, we had a local pharmacy that was a pillar of our small community. The owners there knew everyone’s names and were true healthcare partners for patients and families. Many Floridians can say the same about the pharmacies in their hometowns. 

Whether large or small, pharmacies play a vital role in the healthcare continuum, delivering reliable and affordable access to medications and the care we need. But in recent years, greedy middlemen called Pharmacy Benefit Managers (PBMs) have snuck into the healthcare system and manipulated the relationships among patients, physicians, and pharmacies. 

As a result, drug costs have skyrocketed and patient choice has been eroded. 

This is capitalism gone amok. Capitalism is what gives people the freedom to start a business and make a living by offering products and services that people in the community want and need. But capitalism does not give a company license to steal from patients.

The unfortunate reality is that PBMs have short-circuited Florida’s free market by creating a predatory process that lets them use patient and taxpayer money to increase profits for their shareholders at the expense of some of Florida’s most vulnerable residents. It’s despicable.

But I’ve got good news for patients across the state: In Florida, we aren’t going to let this stand. 

This year, a good bill making its way through the legislative process would shine a light on PBM practices and put Florida patients first. The bill – HB 1509 by Rep. Linda Chaney – won unanimous approval in its first committee stop, buoyed by public testimony from a chorus of supporters ranging from patients and physicians to pharmacists and healthcare advocates. 

I’m proud to chair the House Healthcare Regulation Subcommittee, and I was really struck by the testimony of one particular woman who spoke in support of HB 1509. She is battling stage 4 cancer and has been receiving care from the gifted team at Moffitt Cancer Center for years. Her insurance company recently required her to switch pharmacies and get her life-sustaining medication from a PBM-affiliated pharmacy, or else it would no longer be covered.

It’s clear that this woman had to endure a seemingly endless cycle of frustration and delays because the PBM had ripped away her ability to choose how she received care–and she had to manage all of this while fighting cancer.

I’ve heard many similar stories, and when you pull back the curtain on these issues, one thing becomes apparent: PBMs and their affiliates are often the ones responsible for these abuses.

Last year, Gov. Ron DeSantis took the first major step toward holding PBMs accountable by issuing an executive order that called attention to this broken system. Now, my colleagues in the Legislature and I are working to build off that momentum by enacting historic reforms that will ultimately help restore the free market, drive down drug costs, strengthen patient choice, and make sure that what has long been done in the shadows finally comes to light. 

The time has come. Let’s fix this broken system and make sure Florida’s healthcare system works for patients.

Rep. Chuck Clemons is chair of the House Healthcare Regulation Subcommittee and serves as Speaker Pro Tempore of the Florida House of Representatives.

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  • As a health care worker for last 38 years I totally agree with you. It’s past time to get rid of PBMs

  • Thank God for this legislation. Keep the momentum rolling and go after DAs, judges and all kinds of lawyers, too. The law should not be a monopoly controlled by an elite class.

  • Too bad you don’t care as strongly about doing something to stop skyrocketing home owners insurance.

    • Arrest people who commit insurance fraud and don’t let those personal injury lawyers advertise on tv. Everything is skyrocketing because the government is printing money and paying people not to work. They should never have shut down the economy for the fake WEF Covid scamdemic.

  • Wonder if the drug store was Rimes & Cain or Petteway’s? The old soda fountain at Petteway’s was great for an afternoon treat & Mr. Cain was in a class all his own.

    Those days are gone. The demise of civilization as we knew it is happening before our very eyes.

  • Clemons is right. PBM’s are skimming and price-fixing medications. CVS Caremark, Express Scripts and OptumRx control 80% of the Rx market. Each of them have affiliated pharmacies that own insurance companies, or are owned by insurance companies – a major conflict of interest

  • Finally someone is putting the brakes on PBM’s.
    Thank you Chuck Clemons!

  • Ohh, oooh! Now do pawnshops – the crack addict’s ATM!

    They have a strong lobby (unfortunately), but need stricter rules. If we can better regulate pawn shops and pass crime victim-friendlier legislation, it will eliminate a ton of break-ins and other theft by those seeking fast cash for drugs. Few realize there is a pawn shop lobby and the hell they’ve unleashed. https://www.sun-sentinel.com/news/fl-xpm-1996-11-25-9611240128-story.html

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