Clear coverage of hospitals, insurance, pharma, and Washington.
Greater insight into PBM revenue streams and rebate arrangements will give employer plan sponsors critical leverage to negotiate pharmacy contracts and satisfy their federal fiduciary obligations.
Restricting new brokers could constrain consumer access to enrollment assistance and disrupt health plans that rely heavily on third-party distribution to drive ACA marketplace enrollment. The escalating litigation also injects regulatory uncertainty into payers' long-term commercial growth strategies for the 2027 plan year.