{"database": "press", "table": "releases", "rows": [["https://www.crapo.senate.gov/media/newsreleases/crapo-statement-at-bipartisan-health-care-policy-markup", "Crapo Statement at Bipartisan Health Care Policy Markup", "2023-11-08", "2023", "2023-11", "Republican", "Senate", "ID", "Mike Crapo", "C000880", "www.crapo.senate.gov", "crapo", "https://www.crapo.senate.gov/media/newsreleases", "scraper", "Washington, D.C.--U.S. Senator Mike Crapo (R-Idaho), Ranking Member of the U.S. Senate Finance Committee, delivered the following remarks at an open executive session to consider the Better Mental Health Care, Lower-Cost Drugs and Extenders Act.\n\nAs prepared for delivery:\n\n\u201cThank you, Mr. Chairman.\n\n\u201cThree months ago, this Committee took crucial steps toward improving health care access and affordability for Americans from all walks of life. In advancing the Modernizing and Ensuring PBM Accountability Act, we demonstrated the bipartisan conviction and momentum needed to move good policy from concept to law.\n\n\u201cAt that time, the Chairman and I committed to continuing our work on prescription drug benefits. With this markup, we honor that commitment.\n\n\u201cToday, we are taking up commonsense, comprehensive proposals championed by Members across the dais to strengthen our federal health care programs.\n\n\u201cFor two decades, Medicare Part D has served as a lifeline for countless seniors and Americans with disabilities, ensuring coverage for a wide range of safe and effective medications.\n\n\u201cHowever, market dynamics have shifted. Consolidation has constrained competition, compromised plan quality and heightened the potential for conflicts of interest across the supply chain.\n\n\u201cVertically integrated insurers, merged with pharmacy benefit managers\u2014or \u2018PBMs\u2019\u2014now account for more than 80 percent of the Part D market, up from just 30 percent in 2010.\n\n\u201cFour PBMs manage benefits for 90 percent of enrollees. The three largest specialty pharmacies are all PBM affiliates, controlling more than two-thirds of specialty drug dispensing.\n\n\u201cIn short, the market-driven dynamism envisioned with Medicare Part D\u2019s enactment has given way to an opaque, highly concentrated and distorted pharmacy benefit landscape. This situation demands oversight and legislative improvements.\n\n\u201cTaxpayers and seniors finance the program. We are the client. We have a responsibility to promote accountability and improvement, particularly for the most vulnerable and high-need Americans.\n\n\u201cOver the past five years, out-of-pocket costs for Medicare seniors have risen at nearly three times the rate for commercially insured consumers. According to a recent report from the Government Accountability Office, Part D beneficiaries pay more than their insurers for 79 of the 100 most highly rebated drugs under the program.\n\n\u201cThe warped, distorted rebate system that dominates the program curbs access to lower-cost medications. It instead exposes patients to cost-sharing based on inflated sticker prices. In a perverse form of reverse insurance, discounts on the medications used by the highest-need enrollees cross-subsidize the healthiest seniors, with no direct savings at the pharmacy counter.\n\n\u201cThanks to the tireless efforts of Senators Cornyn and Tillis, among others, the legislation before us today would chip away at this outdated model, providing relief to patients with chronic conditions and capping cost-sharing for all Part D enrollees at the net price of any given drug, inclusive of rebates.\n\n\u201cUnder policies led by Senators Blackburn and Lankford, seniors would also see increased pharmacy choice. Our bipartisan bill shores up the enforcement of pharmacy access protections. It would provide for a much-needed focus on independent community sites in medically underserved areas.\n\n\u201cWith these updates, the Committee\u2019s PBM reform legislation would adapt Medicare Part D to address these and other challenges facing today\u2019s seniors.\n\n\u201cImportantly, this comprehensive proposal would also pay for itself, upholding our bipartisan commitment to fiscal responsibility. Senator Cassidy\u2019s continued investment in cost transparency has proven crucial here.\n\n\u201cIn fact, our legislation generates net savings, which we have reserved to account for any costs incurred under Senator Lankford\u2019s targeted biosimilar access policy, which we remain committed to advancing.\n\n\u201cBeyond prescription drug access and affordability, the bill before us reaffirms this Committee\u2019s consensus-driven approach to health care improvements on a wide range of fronts.\n\n\u201cMental health provisions crafted by Senators Cornyn, Thune and Daines would drive care integration, improve telehealth access and help to address workforce strain, based on bipartisan proposals developed last year. Today\u2019s legislation also extends key flexibilities for states to ensure appropriate sites of care for behavioral health needs, thanks to leadership from Senators Thune and Blackburn.\n\n\u201cUnder a policy led by Senator Barrasso, frontline health care providers would retain incentives to enter into value-based payment models. Clinicians would also receive targeted relief from reimbursement cuts triggered by the volatility of the Physician Fee Schedule.\n\n\u201cAnother vital policy extension, championed by Senator Grassley, would avert further cuts to doctors across our states, which could otherwise exacerbate ongoing shortages.\n\n\u201cOutlining every provision would take more time than we have here today. Virtually all Members of this Committee have contributed\u2014in meaningful, essential ways\u2014to the patient-focused, fiscally sound and evidence-driven final product.\n\n\u201cSenators across the dais have also produced a range of compelling amendments, creating a robust roadmap for further collaborative work moving forward.\n\n\u201cFrom enhancing access to groundbreaking early cancer screening technologies to strengthening the Physician Fee Schedule through sustainable, structural reforms, we have endless opportunities for meaningful, Member-driven policymaking in the future.\n\n\u201cSpecifically, one such amendment, the Medicare Multi-Cancer Early Detection Screening Coverage Act, which I lead alongside Senators Bennet, Cardin, and Scott, has support from a majority of the Senate \u2013 including 19 cosponsors on this Committee \u2013 as well as from a majority of House Members, and from more than 700 local and national stakeholder groups, representing all 50 states. Given this rare and broad bipartisan support, I look forward to working together to move this policy through the Committee.\n\n\u201cThis markup, along with our successful markup from July, provides an optimistic blueprint for this type of work.\n\n\u201cToday, I look forward to advancing this comprehensive, deficit-cutting, bipartisan legislation\u2014and working to pursue its full Senate passage and enactment.\n\n\u201cThank you, Mr. Chairman.\u201d\n\n###", 1, "2026-03-30T01:40:41Z", "2026-04-08T01:01:09Z"]], "columns": ["url", "title", "date", "year", "month", "party", "chamber", "state", "member_name", "bioguide_id", "domain", "scraper", "source", "date_source", "text", "has_text", "collected_at", "updated_at"], "primary_keys": ["url"], "primary_key_values": ["https://www.crapo.senate.gov/media/newsreleases/crapo-statement-at-bipartisan-health-care-policy-markup"], "units": {}, "query_ms": 1.6543869860470295, "source": "dwillis/congress-press", "source_url": "https://github.com/dwillis/congress-press", "license": "MIT", "license_url": "https://github.com/dwillis/congress-press/blob/main/LICENSE"}