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...And Unions Worry for Pharmacy Benefit Changes.

Meanwhile, almost a dozen organized labor groups from around the state sent a letter Monday to House and Senate leadership urging them to protect union health plans as Beacon Hill considers cracking down on pharmacy benefit managers as a way to control prescription drug costs.

The unions said they agree that more transparency is needed in the drug supply chain, but contend that "drug manufacturers and independent pharmacists are seeking to deflect legislative attention and increase profits by attacking pharmacy benefit managers (PBMs)" and proposing reforms that would impact self-funded health plans under the Employee Retirement Income Security Act of 1974 (ERISA).

"ERISA includes a broad preemption provision intended to permit the uniform administration of these employee benefit plans nationwide. Simply, our unions and our plans deserve legal continuity nationwide. Nevertheless, interests have proposed laws that impede the national uniform plan administration by either mandating or forbidding particular elements of plan structure or benefit design," the union representatives wrote. "It is important to note that our plans are not required to enter into agreements containing these practices – we choose to do so for the benefit of our members based on cost and service. In a word, plan choice is imperative for us and our union members."

The Senate last year approved a prescription drug pricing bill for the third session in a row, but the House has not shown an interest in following suit. But both Senate President Karen Spilka and House Speaker Ronald Mariano have suggested there is more to come this session on health care issues, particularly as they look to respond to the financial floundering of Steward Health Care.

The letter was signed by representatives of Central Massachusetts AFL-CIO, Greater Southeastern Massachusetts AFL-CIO, Norfolk County Central Labor Council, Merrimack Valley Central Labor Council, Plymouth-Bristol Central Labor Council, Quincy and South Building Trades, Boston Carman’s Union Local 589, IBEW Local 2222, SMART NERC, Massachusetts and Northern NE Laborers District Council, and Quincy Laborers Local 133 as part of the Save Our Benefits MA coalition.

The coalition gave examples of some of policies being proposed around the country that its members disapprove of: eliminating the ability of self-funded plans to incentivize shopping at pharmacies with lower prices through PBMs, eliminating protections from price gouging for specialty drugs and at specialty pharmacies, and regulating employers and unions with self-funded plans as if they are PBMs.

"In states where these attacks on private health insurance and prescription drug coverage are successful, the cost of prescription drugs could increase by billions of dollars in the next decade. Those costs will be borne by employers/unions and their employee policyholders," the coalition said. 



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