By: Paul Dragu
On Thursday, Gov. Steve Bullock vetoed a bill that its sponsor praised as model legislation for nationwide prescription drug cost reform.
Sen. Al Olszewski, R- Kalispell, the bill’s sponsor, who was usually chipper during hearings on the bill, wasn’t so much following the governor’s action.
“This is a sad day for Montanans,” Olszewski said in a statement.
State Auditor Matt Rosendale, whose team put in long hours to craft Senate Bill 71, didn’t mince words in his response.
“Bullock’s veto is a gift to the pharmaceutical and insurance industries and it’s a slap in the face to consumers,” he said in a statement. “By vetoing Senate Bill 71, Bullock chose to side with the pharmaceutical and insurance industries, protecting their multibillion dollar profits at the expense of Montanans suffering from ever-increasing prescription drug prices.”…
Senate Bill 71 had bipartisan support and even that of a couple of Havreites who drove to the Capitol to testify on its behalf. It was a proposal based on research and work on the part of Rosendale’s office that had been going on for 18 months before it was proposed.
It was estimated to save about 70,000 Montanans upward of $8 million a year in prescription drug costs. The estimate was based on Marilyn Bartlett’s previous work for Montana’s health plan. Bartlett, who served as the special projects coordinator for Rosendale, recently made number 13 on Fortune’s 2019 list of the World’s 50 Greatest Leaders for what she accomplished while working four years as administrator of the Health Care and Benefits Division of the state Department of Administration…
Bullock also mentioned four other bills he did sign as part of an effort to positively affect health care costs for Montanans — Senate bills 83, 335 and 270 (which prohibits PBMs from requiring pharmacies to charge more in copayments than it costs to make a drug) — and the aforementioned SB 125.
In a retort, Rosendale media relations spokesperson Kyle Schmauch detailed where he believed Bullock was wrong, and what the governor got right.
First off, while the other bills Bullock did sign “do some good things,” but they do not lower the cost of prescription drugs, Schmauch said. SB 71 was going to cut drug costs, not increase them, by eliminating two specific practices that lined the pockets of PBMs — spread pricing and rebates.
“SB 71 would have required that the millions of dollars in rebates be directed specifically to lowering health insurance premiums, instead of being retained by the PBMs to pad their multibillion dollar revenues. The rebate portion of SB 71 alone would have saved Montanans millions,” Schmauch says.
The assertion that Montanans served by regional or nonprofit health plans would be at a higher risk of increased prescription drug prices is “complete speculation,” Schmauch continued. And SB 71 would have required PBMs to pass on rebate dollars to the insurer to lower premiums for Montanans. Those savings wouldn’t stay with the insurers regardless their size or nonprofit status.
Schmauch said that when it comes to the bill reducing rural Montanans’ prescription choices and prohibiting mail-order pharmacies, the opposite is true. “SB 71 contained no prohibition of mail-order pharmacies, period.”
The proposal ensured that rural Montanans would have had options to access prescription drugs, instead of being limited to only one PBM or insurer-owned mail-order pharmacy…
One of the most outspoken advocates of the bill was Havre’s Dr. Marc Whitacre, an ophthalmologist at Northern Montana Health Care.
Whitacre testified in multiple hearings that he’d seen drug prices increase up to tenfold and other drugs completely disappear off the market, something he attributed to PBMs. If the general public knew about the schemes PBMs use to fill their pockets and increase drug costs, “there would be torches and pitchforks outside this room,” Whitacre testified during a March hearing before the House Business and Labor Committee.
Whitacre also believes the veto was “purely a political act.” He had read the governor’s letter explaining the reasons for his decision and remains convinced.
“He’s full of it,” Whitacre said of Bullock.
The PBMs sent some of their heaviest hitters to Helena, Whitacre said, referring to some of the lobbyists who testified on behalf of powerful PBMs. Those lobbyists, Whitacre suggests, probably affected Bullock’s decision.
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