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Floor Speech

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Mr. WYDEN. Mr. President, earlier this week, Democrats and Republicans from both the House and the Senate made a deal that struck a blow against the healthcare middlemen that manipulate our healthcare system to enrich themselves.

Unfortunately, the very first act of the second Trump administration--or should I say, the first Musk administration--was to step in and strip out the bipartisan agreement that stops the drug middlemen known as pharmacy benefit managers from ripping off taxpayers and seniors.

We all understand that healthcare is an unavoidable expense for most American families. That is why I went into public service. Healthcare is not a Democratic or a Republican issue; it is a family issue. And we know if you or your loved ones don't have their health, everything else in the house goes by the board.

Unfortunately, the chaos sown by the President-elect and his billionaire ``mini-me''--though, again, it is hard to tell which is which--they serve to protect the middlemen, the pharmacy benefit managers, and insurance companies that take money out of the system while our families are stuck with big medical bills and substandard care.

Donald Trump has spent the last 2 weeks telling everybody who will listen that he wants to take on the drug middlemen. Let me quote Donald Trump here. He said:

They're rich as hell.

We're going to knock them out.

Well, at the very first opportunity to do that, he abandoned that pledge in order to follow Elon Musk's lead.

You don't choose to do business with pharmacy benefit managers, but I will tell you, they are dining out on your paycheck, nevertheless. These PBMs squat between Big Pharma and the insurance companies. While they are supposed to negotiate coverage and the price of prescription medicine for your insurance plan, they have ended up favoring higher priced drugs by taking a fee that is linked to the price of the drug.

The effort to reform these PBM practices has been bipartisan from the get-go. It ought to be a no-brainer. I think I told the President of the Senate, the Senator from Idaho, Senator Crapo, and I kicked this effort off 2 years ago when the Senate Finance Committee passed a bill 26 to 0 and the House of Representatives has worked in a similarly bipartisan way.

Our legislation would end the practice of profiting off higher prices in Medicare by ensuring that a PBM can only receive a flat fee from drugmakers. That is going to save taxpayers' and seniors' hard-earned dollars because, finally, these pharmacy benefit managers are going to have an incentive to pick lower priced drugs.

Let me just pause on that point for a second. These middlemen are not the good guys. Earlier this week--and I heard my colleagues talking about matters involving opioids--the New York Times reported that in negotiations with opioid manufacturers like Purdue Pharma, the pharmacy benefit managers traded away protections designed to reduce the rate of opioid overdoses and addiction in order to make yet another fast buck. These are the people Donald Trump is letting off the hook at Elon Musk's direction.

The bipartisan agreement, I might also add, is particularly important for us Westerners because we have seen our small, independent community pharmacies hit so hard. These small businesses have been closing their doors at an alarming rate over the past decade, again, in large part, due to the practices by these PBM giants. The pharmacy benefit managers are able to pay independent pharmacies whatever they feel like and then the little pharmacy in Arizona or Oregon or Idaho or anywhere else--the small pharmacy has to accept what the PBMs will pay.

What we do in our bipartisan legislation, what a number of committees in the Senate have worked on--what has been the effort in the House and what our program is all about is giving the small pharmacies a chance to fight back by reporting unreasonable contract terms to a Federal watchdog who is in a position to enforce a fair contract.

That is going to mean that independent community pharmacies are paid what they are owed and keep their doors open in rural America without having to pay off the PBMs by gouging customers.

Beyond the drug middlemen--I am just going to mention several other areas that the bipartisan legislation cracks down on in terms of helping the American people. The bipartisan legislation goes after ghost networks that are blocking Americans from getting the care they need. What these ghost networks are all about is, essentially, the insurance companies take your money, and then there aren't any providers, there aren't any navigators, there isn't anybody to help you get your coverage.

So under what we are calling for in a bipartisan way, the insurance companies would have to have a list of doctors that actually are going to make care available so Americans who need care can contact them, make an appointment, and not have to pay extra costs by going out of the healthcare network they paid for.

Too often, based on investigations conducted by the Government Accountability Office, as well as the investigative staff in the Finance Committee, we have found that, essentially, these ghost networks mean there is no: There, there. You paid your money, and you can't get access to real care. Either the doctors don't take new patients, nobody picks up the phone, you aren't able to get what you paid for.

Finally, the bipartisan agreement--that Donald Trump has directed be rejected. The bipartisan agreement strengthens requirements for insurance companies that sell Medicare Advantage plans to make sure that their directories are actually up to date.

Once again, we are seeing an area that cries out for reform because Americans across the political spectrum are sick and tired of paying premiums for health insurance, only to find they can't actually get care when they need it. So Medicare Advantage, ghost networks, these are the areas that we are strengthening in our bipartisan effort.

I will close by saying there is a lot more to like in the legislation when it comes to healthcare, like continuing access to telehealth and Medicare.

Again, Mr. President, bipartisan.

The late Senator Orrin Hatch negotiated with me the Chronic Care bill, which had telemedicine provisions which became the foundation for what we did to fight COVID--again, during the Trump administration.

But we are not getting the benefits of telehealth if we reject this bipartisan agreement, as Donald Trump is urging. Telemedicine is in our package and higher funding for community health centers.

I want to commend Senator Sanders and Senator Cassidy for working in a bipartisan way on that. And we also have improvements to help moms and kids and Americans with disabilities and seniors with Medicaid coverage. Those, of course, are the dual eligibles, the folks who are eligible for Medicaid and Medicare.

I come to the floor simply to say, we have the holidays coming up. Everybody understands that. But there is another gift we can give to the American people, and that is a more fair shake in American healthcare.

We are spending enough money, Mr. President. We are spending over $4 trillion. There are 330 million of us. Divide the 330 million into $4 trillion, you could send every family of four in America a check for more than $50,000 and say: ``Get your healthcare.'' We are not spending it in the right places. I will tell you, in many instances, the reason that is the case is because of these middle men. They made sense 30 years ago when you didn't have all the technology and all the data and people who knew how to use it. But today, these pharmacy benefit managers are, in too many instances, ripping off seniors and taxpayers. And I hope Donald Trump will see that our bipartisan bill is important to do now; important to do before we go home and get some relief to seniors and taxpayers.

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