1. United States
2. Ohio
3. Letter

I am writing to thank you for the passage of the PBM reforms in the Consolidated Appropriations Act of 2026 (H.R. 7148), signed this past February. While this landmark legislation finally mandates delinking and 100% rebate pass-throughs, I urge you to stay vigilant and accelerate the implementation timeline. Currently, many of the most significant cost-saving measures are not set to take effect until 2028 or 2029. Americans struggling with high out-of-pocket costs cannot wait three more years for relief. The feasibility of a faster timeline was proven by the February 2026 FTC settlement with Express Scripts, which requires major pricing changes by January 1, 2027. There is no reason the rest of the industry should be allowed to lag behind. I urge you to support oversight and supplemental legislation that: 1. Accelerates the Effective Date: Move the 100% rebate pass-through and "delinking" requirements to the 2027 plan year to provide immediate relief, matching the standard already set for Express Scripts. 2. Funds Strict Enforcement: Ensure the HHS, the FTC, and the DOL (under its new transparency rules) have the resources to audit PBM contracts now. We must prevent PBMs from re-branding rebates as "service fees" or "bona fide fees" to bypass the fair market value requirements of H.R. 7148. 3. Protects Local Pharmacies: Fully enforce the "Any Willing Pharmacy" provisions to stop PBMs from steering patients away from trusted local pharmacists and toward PBM-owned mail-order or specialty pharmacies. Transparency is not enough if the savings are trapped in a multi-year transition period. Please ensure these reforms are implemented with the urgency this crisis—and the new 2027 industry precedent—demands.