A coalition of consumer, health groups – including NCL – call for nutrition, ingredient, and allergen labeling on alcoholic beverages

February 27, 2024

Media contact: National Consumers League – Melody Merin, melodym@nclnet.org, 202-207-2831

Washington, DC – A coalition of consumer and health groups is urging Treasury Secretary Janet Yellen to ensure that the agency responsible for regulating most alcoholic beverages in the U.S. – the Alcohol and Tobacco Tax and Trade Bureau (TTB) – keeps its commitment to require standardized alcohol labeling on all beer, wine, and distilled spirits products by initiating three promised rulemakings on nutrition, ingredients, and allergen labeling on an accelerated basis.

The appeal comes in the form of a February 27 letter from five leading public interest groups as TTB begins a series of “listening sessions” on labeling and advertising of alcoholic beverages on February 28. Raising concerns that the listening sessions are no more than a delay tactic to maintain the status quo and “slow walk deliberations for months,” the organizations – the Asthma and Allergy Foundation of America (AAFA), Center for Science in the Public Interest (CSPI), Consumer Federation of America (CFA), Food Allergy Research and Education (FARE), and National Consumers League (NCL) – called for TTB to publish the rulemakings by June 2024.

The Treasury Department promised that TTB would issue mandatory alcohol labeling rules in a November 17, 2022 letter in response to a lawsuit filed by CSPI, NCL, and CFA. The Department stated its intention to publish the three rulemakings before the end of 2023.

“We write … to express our dismay and serious concern that TTB has backtracked from its written undertaking of the November 17, 2022 agreement,” the groups wrote to Secretary Yellen. “TTB has, in effect, enabled recalcitrant companies by delaying indefinitely rulemakings on mandatory alcohol labeling while opting for a voluntary rule under which labeling “Serving Facts” or “Alcohol Facts” and ingredients are optional.”

Focusing on the health consequences of delaying action on alcohol labeling, the letter from advocates to Secretary Yellen describes how better alcohol labeling will benefit the 84 percent of U.S. adults who drink alcoholic beverages – 216 million people – and who currently do not have the facts about the alcohol they are consuming to protect their health and safety. Overconsumption of alcohol is a costly public health problem that has become much worse in recent years, as alcohol-related deaths have risen substantially. Among the key concerns, alcohol is involved in about 30 percent of all traffic crash fatalities in the U.S, is a source of empty calories that contributes to obesity, can impact blood sugar control in people with diabetes, and labeling can be a life-or-death matter for people with food allergies. Additionally, excessive drinking increases the risk of liver disease, hypertension, cardiovascular disease, alcohol use disorders, certain cancers and severe injuries.

“The consensus among public health and nutrition experts and consumers themselves, in favor of mandatory and complete alcohol labeling is overwhelming,” said Thomas Gremillion, Director of Food Policy at the Consumer Federation of America. “By reneging on its promise to initiate rulemakings, TTB continues to deny Americans the same helpful and easily accessible labeling information now required for conventional foods, dietary supplements, and nonprescription drugs.”

The letter to Secretary Yellen also stresses that alcohol manufacturers have the capability to put standardized Serving Facts labels on their products, when required. This is the case for products such as some hard ciders, hard seltzers, and wine coolers that are regulated by the Food and Drug Administration, which requires such products to have the same Nutrition Facts panel and ingredients statements on nonalcoholic beverages, from soft drinks to juices.

“To date, TTB has taken the position that requiring standardized nutrient content labeling on alcoholic beverages is too costly and burdensome for beverage alcohol manufacturers,” said Sally Greenberg, CEO of the National Consumers League. “However, the inconvenient truth for the industry is that some of the very same companies whose products do not include a Serving Facts statement if they are regulated by TTB already put complete alcohol labeling on their hard ciders, hard seltzers, wine coolers, and other FDA regulated wines and beers.”

Highlighting that the time has come for mandatory alcohol labeling, the letter makes clear that the agency’s current voluntary labeling rules are not working. Although the rule gives companies the option of putting “Serving Facts” or “Alcohol Facts” and ingredients information on their products, new research from the Center for Science in the Public Interest finds that most manufacturers have opted out of TTB’s voluntary program. Using TTB’s COLA database to examine the labels for 132 of the nation’s top beer and wine brands, CSPI’s study found that only 11 labels of the 65 beer brands examined (17%) and none of the 67 wine brands included ingredients lists while 18 beers (28%) and no wines used the voluntary “Serving Facts” label, and one additional beer brand carried the voluntary “Alcohol Facts” label. CSPI’s review also showed that even when serving information is included on beer and wine labels, there is no standard format for where and how the disclosures appear, making it hard for consumers to find information easily and compare different brands.

“We have the data that demonstrate that Treasury’s voluntary rule has failed to adequately improve transparency in alcohol labeling,” said Dr. Peter G. Lurie, President of the Center for Science in the Public Interest. “Ensuring that the agency ends this ineffective voluntary regime by issuing mandatory labeling rules necessitates national leadership. This is why we are appealing directly to Secretary Yellen to intercede personally to require the agency to commit to publish all three proposed rules by June 2024.”

The 2022 letter whereby TTB undertook to publish standardized alcohol content, calorie, and allergen labeling by the end of 2023 resulted from a lawsuit filed by Center for Science in the Public Interest, Consumer Federation of America, and the National Consumers League on October 3, 2022. The suit charged TTB with failing to act on a citizen petitionsubmitted to the Treasury Department in 2003 to mandate alcohol labeling. CSPI, CFA, and NCL filed the petition along with a coalition of 66 other organizations and eight individuals, including four deans of schools of public health.

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About the National Consumers League (NCL)

The National Consumers League, founded in 1899, is America’s pioneer consumer organization.  Our mission is to protect and promote social and economic justice for consumers and workers in the United States and abroad.  For more information, visit nclnet.org.

The 340B drug discount program should be helping patients in need, not boosting pharmacy chain profits

By Sally Greenberg, Chief Executive Officer, National Consumers League

The federal 340B drug discount program is a worthy and critical program. Created by Congress in 1992, it mandates that pharmaceutical manufacturers participating in the Medicaid program must offer prescription medicines at discounted rates to community health centers and safety-net hospitals serving low-income and uninsured patients. Over the years, this program has given vulnerable patients access to the drugs they need and freed up resources for the qualified facilities to offer more health care services to indigent communities.

Over the past decade or so, however, this valuable program has been increasingly corporatized by for profit entities known to increase costs for consumers including middlemen like pharmacy benefit managers and pharmacy chains. Too many of the dollars circulating through the 340B program are benefiting the well-off and for-profit corporations, instead of consumers with significant health and financial needs. News stories have shined a spotlight on big health systems using the program to bolster profits, while hallowing out critical resources in underserved areas. However, more attention needs to be given to the billions of 340B dollars going to major pharmacy chains like CVS, Walgreens, Walmart and Rite-Aid that are not benefiting the patients this program is intended to serve. Increasingly, however, policymakers at the federal and state level are suggesting bailing out these for-profit entities under the guides of “contract pharmacy” legislation.

Here’s the problem: In 2010, the federal government issued guidelines allowing 340B-eligible health providers to contract with for-profit retail pharmacies to dispense medications, with virtually no rules or safeguards. Since that time, the number of pharmacies participating in the 340B program has grown from 789 in 2009 to over 25,000 today. If this meant more access to affordable drugs for consumer, that would be one thing, but this has not been the case. As contract pharmacies have increased, so too has consumer challenges affording their medicines, nearly in parallel. For example:

  • Even though 340B contract pharmacies are receiving drugs at discounted prices, there is no evidence they are passing those savings onto consumers. One analysis from the respected IQVIA firm found that 340B discounts were shared with consumers in only 1.5 percent of eligible pharmacy claims.
  • Although the 340B program is intended to benefit underserved, vulnerable communities with high proportions of poor and uninsured patients, hospitals in the program are contracting with pharmacies that are not, in fact, in areas afflicted with poverty and a scarcity of health care services.
  • The vast majority of 340B contract pharmacy arrangements are with the aforementioned big national chains like CVS and Walgreens, which are enjoying enormous profits as a result of their participation in the drug discount program. Contract pharmacies collected an estimated $13 billion in gross profits in 2018, with a 72% profit margin on 340B drugs (because they are getting those drugs at a steep discount, which they don’t share with consumers). Needless to say, fattening corporate pharmacy profits should not be this program’s mission.

Contract pharmacy abuse of the 340B program has not gone unnoticed by policymakers in Washington. In January 2024, leaders in the U.S. Senate questioned CVS Health and Walgreens as part of as part of an ongoing investigation into how health care entities use and generate revenue from the 340B Drug Pricing Program. The Government Accountability Office (GAO) and the Department of Health and Human Service Office of the Inspector General (OIG), also highlighted issues with the program’s integrity as it relates to contract pharmacy use. 340B is in desperate need of transparency and oversight, not unfettered expansion.

Yet that is exactly what is happening in some U.S. states. This matter is taking on a greater urgency now as several states are contemplating legislation that doubles down on the problem instead of fixing it. Consumers would be shocked to learn their state representatives are ushering through changes that would further solidify the profitable role these large corporate contract pharmacies are playing in the abused 340B program. Policymakers at the state and federal level need to address a fundamental question – where do 340B savings go? And when the answer is to corporate pharmacy giants – not patients – it’s time to reconsider ill-conceived policies giving contract pharmacies even more access to 340B drug discounts.

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About the National Consumers League (NCL)

The National Consumers League, founded in 1899, is America’s pioneer consumer organization.  Our mission is to protect and promote social and economic justice for consumers and workers in the United States and abroad.  For more information, visit nclnet.org.

Watchdog group to present annual awards to incoming CFPB Director Chopra, Michigan Governor and AG, and SEIU Local 2015 President Verrett on Tuesday, 10/12

October 11, 2021

Media contact: National Consumers League – Carol McKay, carolm@nclnet.org or (724) 799-5392

Washington, DC—The National Consumers League (NCL), the nation’s pioneering consumer and worker advocacy organization, will honor Rohit Chopra, incoming Director of the Consumer Financial Protection Bureau, Michigan Governor Gretchen Whitmer, and Michigan Attorney General Dana Nessel, with its highest honor, the Trumpeter Award, on Tuesday, October 12 in Washington, DC.

In addition to the Trumpeter Award, NCL will honor April Verrett, President of Service Employees International Union Local 2015 in Los Angeles, with the 2021 Florence Kelley Consumer Leadership Award, named for NCL’s first general secretary and one of the most influential figures in 20th Century American history.

MEDIA ADVISORY

What: National Consumers League’s 2021 Trumpeter Awards
When: Tuesday, October 12, 2021 | 7 pm Dinner and Presentation of Awards
Where: The Mayflower Hotel | Grand Ballroom | 1127 Connecticut Ave, NW, Washington, DC 20036

The National Consumers League, founded in 1899, has been honoring visionaries in consumer and worker protection with its annual Trumpeter Award since 1973. Past honorees include: Senator Ted Kennedy, the award’s inaugural recipient, as well as Labor Secretaries Hilda Solis, Robert Reich, and Alexis Herman, Senators Carl Levin and Paul Wellstone, Delores Huerta of the United Farm Workers, U.S. Representative John Lewis, and other honored consumer and labor leaders.

Last year’s Trumpeter recipients were Federal Communications Commission Commissioner Jessica Rosenworcel and journalist Vicky Nguyen. Attorney General for the District of Columbia Karl Racine was recipient of the Florence Kelley Consumer Leadership Award.

This year’s Trumpeter Awards will feature a reception, dinner, and speaking appearances by NCL leadership and the honorees, as well as:

  • Maria Cardona, CNN Commentator & Principal of Dewey Square Group
  • Former FTC Chairman Jon Leibowitz
  • Grace Whiting, President and CEO of the National Alliance for Caregiving
  • Karl Racine, Attorney General of the District of Columbia
  • NCL Board Chair Dominique Warren, Deputy Director of Government Relations at Service Employees International Union

To learn more, visit nclnet.org/trumpeter_awards.

Due to COVID restrictions, attendance at this event is limited. Members of the media may inquire about attendance options by contacting Carol McKay, (724) 799-5392.

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About the National Consumers League

The National Consumers League, founded in 1899, is America’s pioneer consumer organization. Our mission is to protect and promote social and economic justice for consumers and workers in the United States and abroad. For more information, visit www.nclnet.org.

The boom in e-commerce has been a boon for fraudsters

The COVID-19 pandemic has greatly accelerated the growth of e-commerce…

NCL joins advocates in applauding Senate for repealing the national banking regulator’s predatory lending rule, urging the House to act soon

Media contact: National Consumers League – Carol McKay, carolm@nclnet.org(412) 945-3242 or Taun Sterling, tauns@nclnet.org(202) 207-2832

Washington, DC—The National Consumers League (NCL) applauds the Senate for voting to overturn the OCC’s “fake lender” rule, which allows predatory lenders to evade state interest rate laws by putting a bank’s name on the paperwork. In a 52 – 47 bipartisan vote this week, the U.S. Senate voted to approve S.J. Res. 15, a resolution under the Congressional Review Act (CRA), which was introduced by Senators Chris Van Hollen (D-MD) and Sherrod Brown (D-OH). Rep. “Chuy” García introduced a parallel resolution, H.J. Res. 35, in the U.S. House of Representatives. Now that the Senate has approved the resolution, the House needs to take swift action to stop the ongoing harm.

“We applaud this bipartisan rejection of rent-a-bank schemes,” said Sarah Robinson, NCL’s Public Policy Manager. “As consumers and small businesses look to rebuild from the devastation of the coronavirus pandemic, they must be protected from predatory lending. We now urge the House to move with urgency to prevent this rule from continuing to do harm.”

NCL was part of a broad coalition of more than 375 organizations representing all 50 states and the District of Columbia calling on Congress to overturn the “fake lender” rule, which threatens to harm consumers nationwide.

The rushed “fake lender” rule took effect in December and was issued by the Office of the Comptroller of the Currency (OCC). The rule protects “rent-a-bank” schemes whereby predatory lenders (the true lender) launder their loans through a few rogue banks (the fake lender), which are exempt from state interest rate caps. The rule overrides 200 years’ worth of case law allowing courts to see through usury law evasions to the truth and replaces it with a pro-evasion rule that looks only at the fine print on the loan agreement. Predatory lenders charging 100 percent to 200 percent APR are already starting to push high-cost installment loans across the country that exceed the rates permitted under states’ laws.

A broad, bipartisan cross-section of experts and officials have called on Congress to repeal the fake lender rule. They include a bipartisan group of 25 state attorneys general, concerned the rule would effectively gut their state usury laws. The Conference of State Bank Supervisors, National Association of Consumer Credit Administrators, National Association of Federally-Insured Credit Unions, and many other groups also support Congress overturning the rule.

According to national polling, two-thirds of voters (66 percent) are concerned about the ability of high-cost lenders to arrange loans through banks at rates higher than the state laws allowed.

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About the National Consumers League

The National Consumers League, founded in 1899, is America’s pioneer consumer organization. Our mission is to protect and promote social and economic justice for consumers and workers in the United States and abroad. For more information, visit www.nclnet.org.

NCL supports Peloton treadmill recall

Media contact: National Consumers League – Carol McKay, carolm@nclnet.org(412) 945-3242 or Taun Sterling, tauns@nclnet.org(202) 207-2832

Washington, DC—The National Consumers League (NCL) supports Peloton Interactive Inc’s decision to recall its Tread+ treadmill.

“The company has finally come to its senses and agreed to recall its treadmill, which has been caused deadly injuries to children,” said NCL Executive Director Sally Greenberg. “Use of Peloton’s Tread+ exercise machines resulted in at least 72 reports of injuries, including the death of a 6-year-old boy.”

There were also 29 reports of children suffering broken bones, cuts, and abrasions. The agency that regulates these products, the Consumer Product Safety Commission (CPSC), took the unusual step of issuing an administrative subpoena in April when the company refused to provide information about the fatal injury to a child.

“It’s critically important that the company work with the CPSC to recall 125,000 treadmills, at no cost to customers, and safely replace or repair the treadmills so they no longer pose a threat to children or pets,” Greenberg said.

The recall agreement was accepted Wednesday morning in a vote by the Commission. The agreement requires Peloton to halt sales of the Tread+ machine and fully refund consumers who wish to return their equipment.

Greenberg also pointed out how problematic CPSC’s rules are for launching a recall like this one and called on Congress to amend its statute. “We agree with Acting Chair Robert Adler’s assessment that the CPSC faces nearly insurmountable hurdles in protecting the public because, under its statute, the Commission is required to negotiate at length with companies before it is allowed to issue any safety warnings. No other federal safety agency is under such restrictions. That needs to change for the safety of the public.”

To read our previous statement concerning the Peloton Tread+ recall controversy, click here.

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About the National Consumers League

The National Consumers League, founded in 1899, is America’s pioneer consumer organization. Our mission is to protect and promote social and economic justice for consumers and workers in the United States and abroad. For more information, visit www.nclnet.org.

National consumer organization throwing support behind three major labor rights bills in Congress

Media contact: National Consumers League – Carol McKay, carolm@nclnet.org(412) 945-3242 or Taun Sterling, tauns@nclnet.org(202) 207-2832

Washington, DC—The National Consumers League (NCL), America’s pioneering consumer and worker advocacy organization, founded in 1899 to advance the needs of consumers and workers, is backing three important federal bills aiming to even the playing field between workers and employers. The three pieces of legislation—the Protecting the Right to Organize Act (PRO Act), the Farm Workforce Modernization Act (FWMA), and the Public Service Freedom to Negotiate Act—would strengthen labor laws and give workers greater opportunities to organize and form unions, protecting the most vulnerable in our labor force.

“Decades of industry lobbying have made it increasingly difficult for workers to organize,” said NCL Executive Director Sally Greenberg. “Employers enjoy unprecedented and unfair advantages during union organizing drives, which has led to far fewer opportunities for workers to make their voices heard in the workplace. NCL is pleased to support several legislative initiatives that would help right the course for America’s workers.”

According to a recent Gallup Poll, roughly two-thirds of Americans approve of unions—a number trending upwards up from about half in 2009.

“Consumers are recognizing that they are harmed when workers do not have a strong voice,” said Greenberg. “Industry abuses are more likely to go unchecked, resulting in unsafe and dangerous products making it to the marketplace. And when workers are fairly compensated on the job, they can afford to buy the products they create, stimulating further demand that benefits the economy.”

About the bills

The Protecting the Right to Organize Act (PRO Act) would enhance collective bargaining rights, impose penalties on employers if they retaliate against workers who are trying to organize, and update labor laws to protect workers. The bill passed in the House of Representatives with bipartisan support this spring on a 225-206 vote. The bill currently awaits action in the Senate. Of 50 Democratic and independent Senators, 45 are currently committed to supporting the bill. If the Senate passes the bill, President Biden has pledged to sign it.

NCL strongly supports the PRO ACT and urges the Senate to swiftly pass this important measure.

The Farm Workforce Modernization Act (FWMA) passed the House October 30, 2019, and was the product of bipartisan negotiations between leading Democrats and Republicans to modernize laws and treat with dignity and fairness our 2.4 million farmworkers, half of whom are undocumented immigrants. On March 18, 2021, the Farm Workforce Modernization Act, H.R. 1603, passed the House again by a bipartisan vote of 247-174, with 30 Republicans joining Democrats in support. H.R. 1603, like the earlier version of the legislation.

“America’s farms and food systems depend on immigrants who pick our crops. But because so many don’t have legal status, they live in fear of deportation and cannot challenge illegal or unfair treatment in their jobs or in their communities,” said Greenberg. “FWMA provides a path to lawful permanent residency for these workers. Under the bill’s provisions, farmworkers would be able to improve their wages and working conditions and seek enforcement when their rights are violated. It also makes America more food-secure by ensuring that farmers have workers to harvest their perishable crops.”

The FMWA is a pro-consumer, pro-worker, and pro-agriculture bill that NCL strongly supports. NCL urges the Senate to pass this legislation and send it to President Biden’s desk for his signature.

The Public Service Freedom to Negotiate Act (PSFNA, HR 3463 and S 1970), would set a minimum nationwide standard of collective bargaining rights that all states would have to provide to state and local workers.

There are nearly 17.3 million public sector workers across the country. Unlike private-sector workers, there is no federal law protecting the freedom of public sector workers to join a union and collectively bargain for fair wages, benefits, and improved working conditions.

Currently, 20 states do not provide all state and local public sector workers the ability to collectively bargain for fair wages and benefits.

Among the bill’s provisions is a requirement that public sector employers recognize labor unions chosen by a majority of the employees voting, and that they bargain with the labor organization over wages, hours, and other terms and conditions of employment. If states fail to meet these standards, the bill gives the federal government the authority to intervene on behalf of public-service workers, ensuring their rights to form a union and negotiate with their employer.

NCL strongly supports the Public Service Freedom to Negotiate Act and urges swift Congressional action in both the House and the Senate so that President Biden can sign the bill into law.

“America would be unrecognizable without the gains made by working families and unions,” said Greenberg. “The movement needs an even playing field to do its job. These three bills are a good start, and NCL is proud to support each of them.”

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About the National Consumers League

The National Consumers League, founded in 1899, is America’s pioneer consumer organization. Our mission is to protect and promote social and economic justice for consumers and workers in the United States and abroad. For more information, visit www.nclnet.org.

NCL statement on congressional demand that the Biden Administration investigate competition and consumer protection abuses in the live event industry

Media contact: National Consumers League – Carol McKay, carolm@nclnet.org(412) 945-3242 or Taun Sterling, tauns@nclnet.org(202) 207-2832

Washington, DC—The National Consumers League (NCL) today applauded action by leaders of the House Commerce and Judiciary Committees calling on the Biden Administration to more actively enforce antitrust laws in the live events ticket marketplace. In a letter to Attorney General Merrick Garland and Acting Federal Trade Commission Chairwoman Rebecca Slaughter, Representatives Bill Pascrell, Jr. (D-NJ-09), Frank Pallone Jr. (D-NJ-06), Jerrold Nadler (D-NY-10), Jan Schakowsky (D-IL-09) and David Cicilline(D-RI-01) signed a letter urging the Administration to more aggressively police antitrust violations in the live event industry and, specifically, to revisit the Department of Justice’s 2010 consent order which allowed the Live Nation-Ticketmaster merger to move forward, and launch an investigation of Live Nation Entertainment’s potentially unfair, deceptive, and anticompetitive conduct. The following statement is attributable to John Breyault, NCL Vice President of Public Policy, Telecommunications and Fraud:

“As we emerge from the COVID-19 pandemic and live events begin again, we must use this moment to address longstanding competition and consumer protection issues in the live event industry. The Live Nation Entertainment conglomerate controls 80 percent of primary ticket sales while holding significant market share in other areas of the live event industry, including venue ownership, event promotion, artist management, and secondary ticket sales. We urge the Biden Administration to heed Congress’ demand for stronger antitrust scrutiny of the live event industry and Live Nation Entertainment, in particular. Reining in the abuses of a rigged ticketing marketplace is a critically necessary step to restore fairness for live event fans.”

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About the National Consumers League

The National Consumers League, founded in 1899, is America’s pioneer consumer organization. Our mission is to protect and promote social and economic justice for consumers and workers in the United States and abroad. For more information, visit www.nclnet.org.

Jeanette Contreras portrait

PBMs profit while consumers foot the bill. Policymakers must act

By NCL Director of Health Policy Jeanette Contreras

As consumers, when we go to the pharmacy for our medications, we expect a fair price. However, there’s growing evidence that pharmacy benefit managers — or PBMs — have been impeding the savings that should be going to consumers. Consumers deserve  to share in the cost savings, and we need policymakers to step in and help make that happen.

We previously wrote about our disappointment in how PBMs have evolved from once honest brokers to becoming profit driven and greedy, now taking savings away from consumers and patients.

One avenue PBMs use to pocket savings is through pharmaceutical rebates. PBMs negotiate with companies to lock in discounts for drugs in order to secure the drugs’ placement on a list (formulary). PBMs have notoriously leveraged formularies to give greatest access to the drugs that pay the PBMs the largest rebates, leaving less expensive drugs off-limits to consumers.

A recent Senate Finance Committee report found that rebates to PBMs have significantly increased since 2013 (some as high as 70 percent). But these discounts fail to lower the patients’ out-of-pocket costs for necessary treatments, such as insulin. For one product, the manufacturer offered the PBM a 56 percent rebate – which means more than half of the savings for insulin are going to a company that doesn’t even make the lifesaving medication.

Insulin is expensive. Forbes recently reported that newer versions cost patients between $175 and $300 a vial. The story points out diabetes patients need multiple vials, the cost of which add up quickly; the total annual value of rebates and discounts for PBMs is likely to be more than $5,000 per patient. As a result, consumers lose, paying more than many of them can afford for lifesaving drugs.

Another way PBMs profit is by avoiding competition, which would drive value and savings for consumers. Three main PBMs accounted for about 60 percent of all U.S. prescription claims in 2019. And when it comes to insulin, with so few industry players, it’s no surprise that consumers again find themselves on the losing end.

We’re pleased to see that some policymakers in the states are taking steps to address these issues. In New Jersey, the state is shaking things up by creating alternatives to how it contracts with PBMs — which is, in turn, increasing competition and benefitting consumers. New Jersey residents are saving  a bundle (to the tune of $2.5 billion over five years).

In New Hampshire, a recent study shows that the state can expect to save an estimated $17.8-$22.2 million annually thanks to legislation that will utilize a similar competitive PBM contract process.

While this is encouraging news, there is still more work to be done to bring to light the role of PBMs. Policymakers need to step in to ensure PBMs deliver savings to patients as they were originally intended to do. We’re encouraging state and federal action to review the role PBMs play in driving up costs and to address the many loopholes they use to increase profits.

Consumers — not PBMs — should come first at the pharmacy counter. Reach out to your elected officials. Share this story on social media to help raise awareness. And stay tuned as we continue the conversation.

Jeanette Contreras portrait

Expanded Medicaid coverage for postpartum care

By NCL Director of Health Policy Jeanette Contreras

The COVID-19 pandemic has enlightened us to how the social determinants of health adversely impact maternal outcomes in low-income, medically underserved communities. Year after year, the United States continues to have the highest maternal mortality ratio among wealthy countries. In efforts to address this disparity, the American Rescue Plan Act includes a provision that allows states to expand Medicaid coverage to women for up to one year after childbirth.

The dismal maternal and infant mortality rates are directly correlated with the health disparities that disproportionately afflict black, indigenous, and women of color. A 2019 report from the Centers for Disease Control and Prevention (CDC) found that Black women were 3.3 times more likely than white women to die from pregnancy-related complications and Native American and Alaska Native women were 2.5 times more likely than white women to die within a year after childbirth.

Medicaid has traditionally been seen as a safety net for low-income pregnant women and children, providing health coverage that funds more than four in ten births in the U.S. each year. Under federal law, Medicaid must cover pregnant women with incomes up to 138 percent of the Federal Poverty Level (FPL) through 60 days postpartum. Each year, over 1.6 million women across the U.S. are effectively placed at risk for becoming uninsured when that 60-day coverage period ends.

Women who live in states that expanded Medicaid under the Affordable Care Act (ACA) are eligible to continue their health coverage through Medicaid. Additionally, the Families First Coronavirus Response Act, which passed last year, provides states with a 6.2 percent increase to the Federal Medical Assistance Percentage (FMAP) rate to cover new enrollees eligible under the ACA Medicaid expansion as long as the Public Health Emergency is in place or at least throughout 2021. However, the women living in the 14 states that have yet to expand Medicaid would find themselves uninsured.

Under the American Rescue Plan, for the next five years, states have the option to extend Medicaid and the Children’s Health Insurance Program (CHIP) eligibility to pregnant individuals for 12 months postpartum. Though each state’s Medicaid program is different, the inclusion of this provision incentivizes states to extend health care to mothers during the most vulnerable time in their lives. This increased access to health care will pave the way towards improving health disparities for our most at-risk women and infants beyond the pandemic.