The Honorable Brett Guthrie, Chairman
House Committee on Energy and Commerce
2161 Rayburn House Office Building, Washington, DC 20515
The Honorable Representative Frank Pallone, Ranking Member
House Committee on Energy and Commerce 2125 Rayburn House Office Building, Washington, DC 20515
The Honorable Representative Jason Smith, Chairman
House Committee on Ways and Means
1011 Longworth House Office Building, Washington, DC 20515
The Honorable Representative Richard E. Neal, Ranking Member
House Committee on Ways and Means
372 Cannon House Office Building, Washington, DC 20515
Dear Representatives Guthrie, Pallone, Smith, and Neal,
On behalf of the Pharmaceutical Industry Labor-Management Association (PILMA) – a partnership of skilled union workers and leading biopharmaceutical companies committed to sustaining a strong and innovative American life sciences sector – we welcome your committee’s upcoming hearings featuring the CEOs of the five biggest health insurance companies on how to make health care more affordable for all Americans with commercial insurance coverage.
We share your interest in improving healthcare affordability and believe these hearings present a pivotal opportunity to advance reforms that strengthen competition, reduce costs, and ensure every American can access high-quality, cost-effective care.
In particular, we encourage you to spotlight pharmacy benefit manager reform (PBM) in these hearings – which we believe represents one of the clearest and most effective opportunities to provide relief to American workers and their families. Currently, harmful practices by insurers and PBMs, such as spread pricing, withholding patient rebates, and steering prescriptions to affiliated pharmacies inflate costs, erode the value of hard-won union health plans, and leave working families paying more for the medicines they need.
The current prescription drug insurance system is unsustainable. Rising costs place a heavy burden on working families, including the skilled pipefitters, electricians, ironworkers, and other tradespeople who power America’s biopharmaceutical industry. Today, more than half of every prescription dollar goes to these middlemen rather than to manufacturers. Reforming PBMs is one of the clearest and most impactful paths to lowering costs and delivering real relief to American workers and their families. Greater transparency and accountability in the PBM marketplace are essential to achieving these outcomes
We applaud your respective committees’ recent work on PBM reform, and we encourage you to keep up momentum on the bipartisan PBM Reform Act of 2025 (H.R. 4317). This legislation represents a critical step toward curbing harmful middleman practices and lowering prescription drug costs for American families.
Thank you for your leadership and attention to these critical issues.
Sincerely,
Mark McManus
General President, United Association
Chairman, Pharmaceutical Industry Labor-Management Association