Raja Krishnamoorthi, U.S. Representative for Illinois’s 8th District, said on X that pharmacy benefit managers (PBMs) inflate prices, squeeze local pharmacies, and that his bipartisan PBM Reform Act would curb abuses and lower costs.
"Pharmacy benefit managers are middlemen in the drug supply chain who inflate prescription prices and squeeze local pharmacies to pad their profits," said Raja Pac Krishnamoorthi, U.S. Representative of Illinois's 8th congressional district (D). "My bipartisan PBM Reform Act cracks down on these abuses, protects community pharmacies, and lowers costs for Illinois families."
In July 2024, the Federal Trade Commission (FTC) released an interim staff report titled "Pharmacy Benefit Managers: The Powerful Middlemen Inflating Drug Costs and Squeezing Main Street Pharmacies." The report detailed how PBM practices, such as steering to affiliated pharmacies and opaque fees, can raise patient costs and threaten independent pharmacies, underscoring the need for reform.
According to Krishnamoorthi, the bipartisan PBM Reform Act was introduced on July 10, 2025. It would open Medicare Part D networks to "any willing pharmacy," direct the Department of Health and Human Services (HHS) to set fair contract standards, and require PBMs to disclose retained revenues and lowest-cost options to plan sponsors. It also grants audit rights and requires disgorgement of certain remuneration to curb steering and opaque fees.
An Ohio Auditor of State review of Medicaid managed care pharmacy data found that PBMs using "spread pricing" retained approximately $224.8 million in one year by charging the state more than they reimbursed pharmacies. The audit highlighted a lack of transparency and recommended contract changes; Ohio subsequently moved to curb spread pricing to protect taxpayers and community pharmacies.
The FTC’s January 14, 2025 interim report found that the Big Three PBMs generated more than $7.3 billion from 2017 to 2022 by marking up specialty generics—often by hundreds or even thousands of percent—on drugs for cancer, HIV, and other serious conditions. The findings follow a July analysis showing nearly $1.6 billion from just two oncology generics via affiliated-pharmacy steering.
Krishnamoorthi has represented Illinois’s 8th District since 2017 and serves in House leadership roles. In July 2025, he joined a bipartisan group introducing the PBM Reform Act to bolster pharmacy access and curb harmful PBM practices. His office describes the bill as aimed at protecting patients and independent pharmacies from opaque fees and steering.
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