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Democrats' anger over how the U.S. Department of Homeland Security is handling immigration law enforcement is threatening passage of the employer pharmacy benefit manager transparency provisions in the $1.2 trillion 'minibus' spending package now heading toward the Senate floor.
Congressional leaders hope to pass most of the package by Friday, to keep big parts of the federal government from shutting down Saturday.
The biggest part of the package, which includes health, education and labor funding provisions, passed in the House Thursday by a 341-88 vote.
Democrats appeared to be open to helping Republicans provide the 60 votes needed to bring the package up on the Senate floor under the usual Senate rules.
The situation changed Saturday, when Alex Pretti, an ICU nurse who worked for the U.S. Department of Veterans Affairs, died in Minneapolis while protesting federal immigration enforcement efforts. Observers have accused federal immigration enforcement personnel of putting Pretti on the ground and then shooting him.
Senate Democratic Leader Chuck Schumer said in a statement Sunday that the spending package should no longer include funding for the U.S. Department of Homeland Security.
"Senate Democrats will not provide the votes to proceed the votes to proceed to the appropriations bill if the DHS funding bill is included," Schumer said.
Schumer and many other Democrats now want Senate Republicans to put the $64 billion Department of Homeland Security funding request in a separate bill.
What it means: The odds that the employer PBM provisions in the package that passed in the House last week will become law this week appear to be much lower than they were just four days ago.
The minibus funding package: The funding omnibus package is a collection of six appropriations bills. Each of the appropriations bills is a package of hundreds or thousands of funding provisions.
Policymakers have traditionally called big funding bills "omnibus packages," because the packages act as buses that give other bills rides through Congress.
In recent years, Congress watchers have started calling smaller, more focused funding packages "minibus packages."
The employer PBM transparency provisions are two small parts of a $1.2 trillion collection of funding provisions related to federal health, education and labor agencies and programs.
The PBM provisions: The employer PBM transparency provisions in the minibus package would require:
◆ Employer health plan fiduciaries to monitor pharmacy benefits carefully.
◆ Fiduciaries to monitor the compensation paid to PBMs and other service providers carefully.
◆ Health plan service providers to end plan fiduciaries detailed pharmacy benefits tracking reports; and require the service providers to cooperate with audits.
◆ PBMs and similar service providers to pass all discounts they negotiate on to the plans.
The history: Congress came close to passing a big appropriations package containing similar PBM provisions — which had broad, bipartisan suupport, in December 2024.
Congressional leaders then kicked the PBM provisions off the spending package bus at the last minute, after Elon Musk, who then was acting as an unofficial government efficiency advisor to President-elect Donald Trump, told congressional leaders to streamline the package.
Musk and Republican leaders in Congress never explained why the PBM provisions came out of the package.
House Republican committee leaders repeatedly said at hearings that they thought similar legislation would pass through Congress soon.
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