ELLY GRIMM
• Leader & Times
Improvements to healthcare have long been a hot topic and recently, some action taken at the state level could help Kansans with just that.
The first of these bills, which Gov. Laura Kelly signed Thursday, was Senate Bill 20, which regulates Pharmacy Benefit Managers (PBMs), the middlemen responsible for negotiating drug prices between manufacturers, pharmacies, and insurers, as well as setting reimbursement rates for prescription medications.
“I’m pleased to support smart, bipartisan legislation that places long overdue guardrails on PBMs by requiring those who conduct business in our state to do so in a fair and transparent manner,” Gov. Kelly noted in a release from the State of Kansas. “Increasing regulation of PBMs is a critical, necessary step towards lowering costs for Kansans and ensuring their health needs and best interests are put first.”
“We’ve seen more than 100 local Kansas pharmacies close in the past decade alone. This has left thousands of Kansans in pharmacy deserts, forcing them to travel long distances to pick up their needed prescriptions. Kansans deserve better, and that’s what SB 20 will do,” Senate Minority Leader Dinah Sykes, District 21, noted in the State of Kansas release. “This bill will increase transparency and accountability within our pharmaceutical industry, ensuring Kansans and locally-owned pharmacies are not being priced out of their life-saving medications or the pharmaceutical market. I am proud of the bipartisan work that went into crafting this legislation and getting it across the finish line. The path for this commonsense reform wasn’t without hurdles, but my colleagues and I worked across the aisle to provide much-needed relief to hardworking Kansans.”
The bill enacts several changes to current PBM practices, including granting the Kansas Insurance Commissioner increased authority to regulate PBMs, ensuring all pharmacies are reimbursed using the National Average Drug Acquisition Cost (NADAC), mandating that drug rebates pass through to health plans, and bans spread pricing so PBMs can no longer charge health plans more than they reimburse pharmacies, which previously resulted in a profit for PBMs.
"Kansans deserve a prescription drug system that works for them, not one that operates behind closed doors by those who seek to profit from it,” Senate Vice President Tim Shallenburger, District 13, noted in the State of Kansas release. “Senate Bill 20 brings transparency, fairness, and accountability to pharmacy benefit managers by banning spread pricing, ensuring fair reimbursement rates, and strengthening reporting requirements. Most importantly, this bill works to lower prescription costs, protect rural communities and independent pharmacies, and ensure Kansans across this state have access to care and medications they rely on every day. Through Senate Bill 20, a new regulatory framework guarantees that the needs of patients – not PBMs – are prioritized.”
The second bill signed was Senate Bill 271, bipartisan legislation that permanently updates the outdated income eligibility requirements for Kansas’ Children's Health Insurance Program (CHIP) and protects access to affordable health coverage for Kansas children.
“Every Kansas child deserves access to quality, affordable health care,” Gov. Kelly noted in a release from the State of Kansas. “For far too long, Kansas has relied on temporary fixes to address the outdated standards that made it harder for families to get the coverage they need. I’m pleased to sign this bipartisan, common sense legislation that cements these updates to the Kansas CHIP income eligibility requirements and prioritizes the health, well-being, and future of Kansas kids.”
Senate Bill 271 adjusts the household income eligibility threshold for the State CHIP from 250 percent of the 2008 federal poverty level to 250 percent of the current federal poverty income guidelines, aligning Kansas with the rest of the nation, and this change safeguards access to coverage for working families while ensuring income eligibility keeps pace with today’s economic realities, the State of Kansas release noted. The bill also directs the Secretary of Health and Environment to codify the existing practice of using a sliding-fee scale that charges premiums per family and ensures that eligible children can maintain coverage at renewal if families remain eligible and pay all delinquent premiums. The legislation also removes outdated provisions regarding waiting periods and penalties for non-payment of premiums within a continuous eligibility period to align state and federal law.
Other leaders praised the bill.
“This was a true bipartisan effort to pass a clean SB 271,” Representative Susan Ruiz, District 23, noted in the State of Kansas release. “We recognized that passing this bill has been a long time coming and was the right thing to do for the children of Kansas.”
"Making CHIP premiums based on a sliding-fee scale per family is a practical, family-first approach," Representative Will Carpenter, District 75, noted in the State of Kansas release. "Senate Bill 271 ensures costs are more affordable and predictable, so families don't have to choose between paying for health coverage and other basic needs. This bill is a commonsense step to keep more Kansas children covered."
