Voters across all 50 states want state policymakers to focus on health insurance and PBM practices

Americans are also concerned by the unintended consequences of state price setting policies

The latest Morning Consult/PhRMA poll of more than 20,000 Americans, including insights from all 50 states and 435 congressional districts, shows voters are concerned about government price setting policies in the states once they learn how the policies can hinder access and affordability of medicines. Instead, Americans want to see state and federal policies address the actual health care obstacles they face as patients — largely imposed by harmful practices from health insurers and their middlemen.

Here are things you should know:

1. Insurance coverage and unfair pharmacy benefit manager (PBM) practices are top pain points in health care for Americans. 

• More than twice as many Americans believe health insurance coverage getting more expensive and covering less (68%) is a larger problem than the cost of prescription drugs (32%). 
• Eight in 10 Americans are concerned that PBMs profit off financial assistance intended to help patients access and afford the medicine they need or prevent people from fully benefiting from this assistance.
• Eight in 10 Americans also expressed concern that just three PBMs control eighty percent of the U.S. prescription drug market. 

2. Government price setting schemes, such as establishing so-called “prescription drug affordability boards” cause concern among two-thirds of Americans. 

• Most Americans (64%) report opposition to government price setting drug boards when they learn that they could limit people’s access to newer prescription medicines for diseases like cancer and Alzheimer’s.
• Most Americans (65%) oppose government price setting boards once they learn they consist of unelected bureaucrats who make decisions about the medicines people need — instead of doctors and other health care providers.
• Most Americans (74%) also think that these unelected bureaucrats shouldn’t have the power to set maximum prices on medication.

3. Government price setting doesn’t address what Americans want and need: removing insurer-imposed hurdles to access care or lowering out-of-pocket costs. 

• One in five Americans report facing a formulary exclusion; the same amount report facing prior authorization issues. Both circumstances could leave patients without the medicines they need.  
• Eight in 10 Americans favor requiring all health insurance plans to cover certain medications used to treat chronic conditions from day one of the plan year, instead of making patients wait until they meet their deductible. 
• Eight in 10 Americans want to mandate that insurers and their middlemen pass discounts and rebates they receive on medicines directly to patients at the pharmacy counter. 

States looking to address Americans’ real health care concerns should pursue a patient-centered approach to improve access, affordability and the patient experience throughout our health care system instead of applying one-size-fits-all government price setting schemes. Americans — to the tune of over eighty percent — support state policymakers holding health insurers and PBMs accountable for their self-serving actions that increase costs at the pharmacy counter for patients.

To learn more about solutions policymakers can pursue to lower costs and increase health care access, visit PhRMA.org/States.