Employer Health Plans Fear State PBM Crackdown Preemption Threat

Employers looking ahead to a continued push by state and local governments to more closely regulate pharmacy benefit managers in 2024 are set to back stricter federal law preemption of these measures.

PBMs, which manage prescription drug plans of behalf of health insurers, have been criticized over lack of transparency and inflated costs to health plans, but the federal government has not yet enacted legislation to rein in these middlemen.

Groups representing companies with self-insured health plans say the states’ attempts to fill the void on PBM legislation threaten preemption protections under the federal Employee Retirement Income Security Act. What’s ...