Support the Break Up Big Medicine Act (S.3822)

I urge you to support the Break Up Big Medicine Act, S. 3822. This bipartisan legislation would address a basic conflict of interest in health care: allowing one corporate parent to control both the companies that pay for or manage care and the providers or suppliers involved in delivering it. The bill would prohibit common ownership between certain medical providers or management services organizations and insurers, pharmacy benefit managers, or drug and medical-device wholesalers. It would give companies one year to comply and authorize enforcement by federal agencies, state attorneys general, and private parties. These are targeted structural rules, not a ban on integrated care itself: companies could continue operating in these markets, but would have to divest businesses that create the prohibited ownership conflicts. The need for scrutiny is clear. Reporting on the proposal notes that three pharmacy benefit managers handle about 80 percent of prescription drug claims, while three wholesalers control about 98 percent of drug distribution. The Federal Trade Commission’s work on prescription drug middlemen has also drawn attention to the market power and business practices of the largest PBMs, several of which are connected to insurers and other parts of the health care supply chain. Concentration alone does not prove misconduct, but it makes transparency and meaningful competition especially important. When the same corporate family can influence coverage, drug distribution, and care delivery, patients and employers may have little ability to tell whether decisions serve their needs or the company’s financial interests. Independent doctors, pharmacies, and other providers should be able to compete on quality and service, rather than face disadvantages against companies that control multiple stages of the market. I recognize that structural separation could require significant changes for some businesses. That is precisely why the bill provides a transition period. Congress should pair that transition with careful implementation, while ensuring that patient access is protected. But concerns about adjustment should not become a reason to leave entrenched conflicts untouched. Please support S. 3822 and work to advance it through the Senate. Patients deserve a health care system where decisions are made for their care, not to steer business within a corporate empire.