Diane Gore

One of the many battles being fought in the Legislature during this Budget Session doesn’t have to do with the budget, federal programs, or redistricting. It has to do with the cost of health insurance. 

Senate File 36 — Pharmacy Benefit Managers Act Enhancements allows Wyoming state government to interfere with how insurers and businesses design their health plans and will substantially raise prescription costs and health insurance premiums. This bill will make prescription drugs and health insurance more expensive, placing the health of Wyoming citizens at risk. 

Blue Cross Blue Shield of Wyoming (BCBSWY) estimates this bill will cost its members at least $48 million per year. That equates to at least $400 per member or $1,600 for a family of four annually. The increased health care costs this bill creates will be passed to BCBSWY members and businesses through higher drug costs and increased premiums. Yes, higher drug costs and premiums than we are already paying in a state with some of the highest health care costs in the United States. Almost 73% of these increases will go to support the drug manufacturers, over 18% will go to national chains and less than 9% will go to Wyoming’s independent pharmacies. 

BCBSWY is driven to get the right medication, for the right person, at the right time, and at a cost that is as affordable as possible to help ensure sustainability and optimal health outcomes. However, SF 36 unnecessarily gives away millions of dollars to large pharmaceutical manufacturers for no good reason. 

Additionally, SF 36 dramatically raises health care costs by allowing pharmacies to charge additional fees for “pharmacist services” which are not defined, meaning the “sky is the limit” for how much they can charge to dispense every prescription and insurers will have no way to protect their members from these increased fees. 

The language in the bill prevents insurers from applying cost saving measures that include negotiations with drug manufacturers to reduce the cost of prescriptions. For example, a prescription at full price with a cost of $10,000 might be discounted to $6,000, saving the insurance plan $4,000. The savings ($4,000 in this example) are currently passed through 100% to self-insured plans and applied to reduce premiums for fully insured plans. This bill eliminates the savings, which will increase the premiums — not only for BCBSWY members, but also for everyone with health insurance in Wyoming. 

Why is this happening? 

Proponents of this bill are independent pharmacists asking to be paid more. BCBSWY believes local, independent pharmacies are vital in Wyoming, and that these pharmacies should be paid appropriately for the drugs and services they provide. However, this bill fails to accomplish this. Instead, through substantial government overreach, SF 36 gives away the hard-earned money of Wyomingites to wealthy pharmaceutical companies, while barely helping independent pharmacies. 

This bill provides a blank check for large pharmacy chains to charge an unlimited amount for their services and prevents insurers from applying cost saving measures necessary for families to afford health insurance and prescriptions needed to protect their health. While hard-working Wyoming citizens are paying the price for SF 36, the beneficiaries of the increases are drug manufacturers, large corporate chains, and Wall Street investors, with only a small percentage going to independent Wyoming pharmacies. There is no other legislation across the entire country that contains the same sweeping provisions as this bill. 

This bill is now under consideration in the House of Representatives. BCBSWY and our business partners ask you to please contact your representative and ask them not to interfere with your health and not to spend your money for the “blank check pharmacy” bill. Ask them to vote “NO” on SF 36.

(Diane Gore is the president and CEO of Blue Cross Blue Shield of Wyoming. This piece was co-signed by more than 50 representatives from BCBSWY business partners, including the City of Cody, Yellowstone Regional Airport, Town of Meeteetse and Town of Deaver.)