Letter to the Editor: Please Ask the House to Vote No on SF0036

Reader Diane Gore writes: "This bill provides a blank check for large pharmacy chains to charge an unlimited amount for their services and prevents insurers from applying cost saving measures necessary for families to afford health insurance."

March 03, 20225 min read

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(Cowboy State Daily Staff)

By Diane Gore, President, Blue Cross Blue Shield of Wyoming

One of the many battles being fought in the legislature during this Budget Session doesn’t have to do with the budget, federal programs, or redistricting. It has to do with the cost of health insurance.

SF0036 – Pharmacy Benefit Managers Act Enhancements allows Wyoming state government to interfere with how insurers and businesses design their health plans and will substantially raise prescription costs and health insurance premiums. This bill will make prescription drugs and health insurance more expensive, placing the health of Wyoming citizens at risk.

Blue Cross Blue Shield of Wyoming (BCBSWY) estimates this bill will cost its members at least $48 million dollars per year. That equates to at least $400 per member or $1,600 for a family of

four annually. The increased health care costs this bill creates will be passed to BCBSWY members and businesses through higher drug costs and increased premiums. Yes, higher drug costs and premiums than we are already paying in a state with some of the highest health care costs in the United States. Almost 73% of these increases will go to support the drug manufacturers, over 18% will go to national chains and less than 9% will go to Wyoming’s independent pharmacies.

BCBSWY is driven to get the right medication, for the right person, at the right time, and at a cost that is as affordable as possible to help ensure sustainability and optimal health outcomes. However, SF0036 unnecessarily gives away millions of dollars to large pharmaceutical manufacturers for no good reason. Additionally, SF0036 dramatically raises health care costs by allowing pharmacies to charge additional fees for “pharmacist services” which are not defined, meaning the “sky is the limit” for how much they can charge to dispense every prescription and insurers will have no way to protect their members from these increased fees.

The language in the bill prevents insurers from applying cost saving measures that include negotiations with drug manufacturers to reduce the cost of prescriptions. For example, a prescription at full price with a cost of $10,000 might be discounted to $6,000, saving the insurance plan $4,000. The savings ($4,000 in this example) are currently passed through 100% to self-insured plans and applied to reduce premiums for fully insured plans. This bill eliminates the savings, which will increase the premiums—not only for BCBSWY members, but also for everyone with health insurance in Wyoming.

Why is this happening?

Proponents of this bill are independent pharmacists asking to be paid more. BCBSWY believes local, independent pharmacies are vital in Wyoming, and that these pharmacies should be paid appropriately for the drugs and services they provide. However, this bill fails to accomplish this. Instead, through substantial government overreach, SF0036 gives away the hard-earned money of Wyomingites to wealthy pharmaceutical companies, while barely helping independent pharmacies.

This bill provides a blank check for large pharmacy chains to charge an unlimited amount for their services and prevents insurers from applying cost saving measures necessary for families to afford health insurance and prescriptions needed to protect their health. While hard-working Wyoming citizens are paying the price for SF0036, the beneficiaries of the increases are drug manufacturers, large corporate chains, and Wall Street investors, with only a small percentage going to independent Wyoming pharmacies. There is no other legislation across the entire country that contains the same sweeping provisions as this bill.

This bill is now under consideration in the House of Representatives. BCBSWY and our business partners listed below ask you to please contact your Representative and ask them not to interfere with your health and not to spend your money for the “blank check pharmacy” bill. Ask them to vote “NO” on SF0036 – Pharmacy Benefit Managers Bill Act Enhancements.

Diane Gore, President & CEO BCBSWY

Marsha Allen, Executive Vice President, Wyoming Auto Dealers Association Cindy Baker, Administrative Service Manager, City of Cody

Preston Bostrom, President, Rocky Mountain Administrators & Rocky Mountain Review Brad Brooks, Board of Public Utilities, City of Cheyenne

Devon Brubaker, Airport Director, Rock Springs Airport Earla Checchi, Finance Manager/HR Manager, WAM-JPIC

Tony Cross, Airport Manager/HR Manager, Jackson Hole Airport Julie Cross, Admin Asst. Big Horn Regional JPB

Bob Dill, General Manager, Automation & Electronics, Inc, Casper Dave Fraser, Executive Director, WAM-JPIC

Nakisha Garner, Treasurer, Town of Lingle Tracy Glanz, Clerk/Treasurer, City of Worland

Cheryl Hageman, Consultant, Wyoming Educators’ Benefit Trust Renee Hahn, Manager, Amoco Reuse Agreement Joint Powers Board Darrin Hass, HR Director, City of Cheyenne

Jeff Hockin, CEO Crum Electric Supply, Co, Casper Lori Hughes, Clerk/Treasurer, Town of Ten Sleep Angie Johnson, Clerk/Treasurer, Town of Meeteetse Timothy A. Kaumo, Mayor, City of Rock Springs Kathy Lenz, Clerk/Treasurer, Town of Sundance Kelly Lewis, Treasurer, Town of Glenrock

Robin Lockman, City Treasurer, City of Cheyenne Bob McLaurin, Legislative Manager, WAM-JPIC Kelley Millar, Clerk/Treasurer, Town of Upton

Noamie Niemitalo, President CCCBT Trust, Campbell County Richard Reyes, Clerk, Town of Lingle

Michele Richlin, Clerk/Treasurer, Town of Deaver

Penny Robbins, Clerk/Treasurer, Town of Mountain View Justin Schilling, Member Service Manager, WAM-JPIC Lisa Scott, Admin Office Manager, Yellowstone Airport George Siglin, Mayor, Town of Lingle

Tammy Taylor, Clerk, Town of Glenrock Matt Thomas

Mike Todd, Executive Director, Local Government Liability Pool Anita Vaugh, Clerk/Treasurer, Town of Superior

Katie West, Office Manager, Cheyenne Regional Airport Joe Wiesen

Agile Benefits Consulting, Cheyenne Amangani Resort, Jackson

Campbell County Coordinated Benefit Trust Casper Surgical Center

City of Gillette Cyclone Drilling, Inc

Fremont County Commissioners High Country Behavioral Health L&H Industrial

Neiman Enterprises Inc.

Northern Wyoming Mental Health Center Novo Benefits, Cheyenne

Oftedal Construction, Inc.

Pathfinder Inspections and Field Services LLC Sheridan County Government

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