The rotunda of the U.S. Capitol in Washington. Photo: Diego M. Radzinschi/ALM
Supporters of the employer pharmacy benefit manager mandates in the House Consolidated Appropriations Act, 2026 spending package face drama in the Senate.
The so-called "minibus" package is providing transportation through Congress for $1.2 trillion in funding provisions that are needed to keep federal health, labor, education, financial services and national security operations running normally after Jan. 30.
Members of the House ended up approving the package by a 341-88 vote Thursday, with strong support from both Republicans and Democrats.
Senate Majority Leader John Thune appears to be eager to send the CAA, 2026 package and other three other big spending packages to President Donald Trump for his approval by the Jan. 30 deadline.
But Republicans hold just 53 seats in the Senate.
The National Taxpayers Union is objecting to "earmarks" in the CAA, 2026 package, or provisions that provide funding for specific projects and programs. Sen. Rick Scott, R-Fla., and other Republican colleagues are trying to push the earmarks out of the package.
Thune may have to struggle to find Democrats to make up for any Republican defections, because Democrats in the Senate want the package to include restrictions on federal immigration enforcement efforts.
Efforts to change the package affect how quickly the package gets through the Senate. If the Senate approves a new version, that could force congressional leaders to send the package back to the House for a new vote.
The PBM provisions: Rep. Buddy Carter, R-Ga., a pharmacist who has been promoting federal PBM oversight legislation for years, noted in comments about House passage of the omnibus package that the PBM provisions in the package have support from Shawn Gremminger, the chief executive officer of the National Alliance of Healthcare Purchaser Coalitions.
Carter said the employer PBM provisions in the package would require PBMs to send group health plans and insurers detailed data on prescription drug spending at least twice a year.
The provisions would also require PBMs to provide drug plan spending summary documents for health plans and plan participants, Carter said.
Gremminger praised the reporting provisions.
"The comprehensive PBM reform legislation mandates end-to-end transparency," Gremminger said.
The new reports would give "employers the information they need to ensure their employees and families are receiving the best price on drugs, " Gremminger added.
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