Policies that Impact Maryland

Maryland is seeing more people than usual drop out of ACA health care plans after the first quarter after federal subsidies were allowed to sunset by Congress. The state saw an 8% disenrollment rate from people unable to pay for their ACA health care plans from January to the end of March, which translates to about 18,000 residents. Read more at WYPR.

State officials determined that Ozempic, a popular diabetes treatment and weight-loss drug, is unaffordable for Marylanders and voted Monday to limit how much state and local governments will pay for it on state health plans... Read more at Maryland Matters.

Gov. Abigail Spanberger on Tuesday vetoed legislation that would have created a state board to review prescription drug costs, saying that evidence from other states shows that such boards do not achieve the goal of lower prices... Read more from Cardinal News.

Legislation signed by Maryland Gov. Wes Moore (D) would de-couple the state from following the recommendations of a federal vaccine advisory panel that was remade by Health Secretary Robert F. Kennedy Jr. The Vax Act, signed by Gov. Wes Moore (D) Tuesday, directs the state’s health secretary to issue official recommendations for immunizations, screening and preventive services, rather than relying on the Centers for Disease Control and Prevention’s Advisory Committee on Immu

AbbVie Inc., Novartis AG, AstraZeneca Plc, and drug industry group PhRMA notched a victory Tuesday after a federal appeals court vacated an order rejecting their request to block a Maryland drug discount law, remanding the decision for review. The US Court of Appeals for the Fourth Circuit ruled a lower court “erred” when it denied the drugmakers and the Pharmaceutical Research and Manufacturers of America’s motion for a preliminary injunction against Maryland’s H.B. 1056.

Medical breakthroughs are often measured in lives saved and diseases prevented. That is only part of the story. They are also a powerful driver of economic growth, workforce strength, and long-term public revenue. For communities like Frederick County, that connection is not theoretical. It is visible in our local economy every day... Read more from Rick Weldon, CEO of the Frederick County Chamber of Commerce, at The Frederick News Post .

Maryland’s small businesses and independent pharmacies are the backbone of our communities, yet they are being squeezed by a prescription-drug system that rewards powerful middlemen over the very people it is meant to serve. Pharmacy Benefit Managers (PBMs) and the insurance giants that own them dictate prices, reimbursement and access with almost no transparency, driving up costs for employers and threatening the survival of local pharmacies... Read more from Liz League, CEO

Right now, the U.S. is drifting toward a dangerous dependency. America relies on China for a significant share of the raw ingredients used to manufacture medicines — sometimes as much as 80 to 90 percent of active pharmaceutical ingredients. Meanwhile, 477 FDA-registered drug manufacturing facilities operate in China, yet the FDA inspected only 204 foreign drug and device establishments in fiscal 2024... Read more from The Hill .

Last summer, Lorena Alvarado Hill received a series of unexpected medical bills. A teacher’s aide in Melbourne, Florida, Hill is a single mom who works shifts at J.Crew on the weekends to send her daughter to college. Hill and her mother, who lives with her, had been enrolled in an insurance plan through HealthFirst. Hill paid nothing toward the premiums for the government-subsidized plan, which previously had covered her scans and other appointments. Read more at KFF Health

The program was meant to help hospitals provide for poor patients by offering drug savings. But critics say a Texas company has turned it into a big business, driving up costs for patients and insurers. Read more at NYT .

If Americans want to pay less for prescription drugs, there is no way to do it without reforming the Pharmacy Benefit Manager industry. Congress should do so by the end of this year. The PBMs, once known for reducing drug costs, no longer exist. Literally, they are no longer independent companies. They sit inside the insurance giants that own them. Cash machines to help health conglomerates hit quarterly numbers. Read the full article at DC Journal .

A new Health Affairs study has confirmed that UnitedHealth Group — the nation’s largest health care conglomerate — is doing more than dominating the market; it’s playing by a different set of rules. Researchers Daniel Arnold of Brown University and Brent Fulton of UC Berkeley analyzed new federal “Transparency in Coverage” data and found that UnitedHealth’s insurance arm, UnitedHealthcare, pays its own Optum physicians 17% more on average than it pays other doctors for the

More than half of American adults manage multiple chronic conditions. The prevalence is enough to strain the U.S. healthcare system and challenge patient access to new treatments. To compound the issue, pharmacy benefit managers (PBMs) and others siphon nearly half of every dollar spent on brand-name drugs, driving up costs for patients. Read the full article on the Partnership to Fight Chronic Disease .

The conclusion of the longest government shutdown in history and rising political acrimony rightly receives a great deal of attention but this focus makes it easy to overlook areas where beneficial legislation is politically possible. The broad political agreement that it is necessary to reform how pharmacy benefit managers (PBM) operate exemplifies the potential bipartisan opportunities. Read the full article on Forbes .

Although for patients the outcome of both conflicts is the same — confusion about coverage and care access — the disputes at the center of each is different. The insurer’s dispute with CWC is a familiar story — the women’s healthcare provider wants payment increases for services under commercial, Medicaid, and Medicare Advantage plans. Allegations of inadequate reimbursements have been at the center of contract disputes between payers and providers for years, with providers

In its first report on the 340B drug discount program’s effect on the budget, the Congressional Budget Office revealed that a previously obscure federal program originally meant to help a few dozen safety-net hospitals has exploded into a multibillion-dollar subsidy for thousands of nonprofit hospitals, driving up healthcare costs for patients — burdening taxpayers and contributing to the federal deficit — while delivering little measurable benefit to patients in need. Read

Maryland’s low-income taxpayers are required to utilize for- profit pharmacies in Hawaii and California. Pharmacy Benefit Management (PBM) owned and chain drug store contract pharmacies benefit from a federal program intended to support low-income Maryland taxpayers. Read the full report on the Pioneer Institute .

The 340B Drug Pricing Program was created to provide safety-net providers (known as covered entities) access to discounted outpatient drugs. However, 340B has evolved from a modestly sized program to the second-largest drug-purchasing program in the U.S., with drug purchases totaling $66.3 billion in 2023. Read the full report at the USC Leonard D. Schaeffer Institute for Public Policy & Government Service .

The 340B Drug Pricing Program is a federal program in which manufacturers provide heavily discounted drugs to qualifying hospitals and clinics. Despite claims by its advocates that it is “free”, it increases healthcare costs for employers and their workers due to lost drug reabates. New research has estimated the financial impact of the 340B program on each state. Read the full report on IQVIA .

President Trump is working to reshape the country’s manufacturing economy in the “America First” image through a combination of hardening domestic supply chains against hostile countries and creating economic opportunity for American workers. Ahead of the 2026 midterm elections, Republicans hope a stiff cocktail of foreign policy maneuvers, tax relief and regulatory reform will make MAGA dreams a reality. Read the full article at The Washington Times .