Two Senators from Opposing Parties Unite to Create New Law to Bring Down Healthcare Costs
The person negotiating the price your health insurance company will pay for your medications usually receives their paycheck from the same corporation that owns your health insurance company. See the conflict of interest? And it gets even better. This same company often owns your doctor’s office and pharmacy too. Everyone receives their paycheck from the same corporation who also gives incentives for actions that create even more profits for the company and drives up costs for you, their customer.
Two senators, from opposing political parties, have united to propose legislation to break up these healthcare monopolies. Missouri Republican Senator Josh Hawley and Massachusetts Democratic Senator Elizabeth Warren joined together to create and submit legislation to help bring down healthcare costs, called Senate Bill 3822 on February 10, 2026, during the 119th Congress and nicknamed the legislation “Break Up Big Medicine Act”
What is the Summary of Senate Bill 3822, Break Up Big Medicine Act?
To prohibit pharmacy benefit managers, insurers, and prescription drug or medical device wholesalers from being under common ownership with certain medical service providers, and for other purposes.
The legislative process will now begin, requiring Senate Bill 3822 to be reviewed by the Senate Judiciary Committee next, then once finalized by that committee, it will need to be presented to the Senate to be called up for debate and a vote to pass. Then Senate Bill 3822 would go to the House of Representatives to be reviewed, debated and then passed and then go to the President to sign into law. The bill establishes specific penalties for antitrust violations that will be enacted with passage of the bill.
Fast Facts:
- 3 Pharmacy Benefit Managers (PBM’s) manage 80% of prescription drug claims (PBM’s establish the drug price between the insurer, the pharmacy and the drug wholesaler).
- 98% of Drug Distribution Controlled by 3 Prescription Drug Wholesalers
- 80% of Physicians work for a Corporate-owned doctor’s group that may also own a PBM and Pharmacy
- Health Conglomerates owning all the different players can evade statutory limits on profits established by law and known as the Medical Loss Ratio
- Conglomerates owning all the players in healthcare can hide profits via the unregulated pharmacy and physician business segments, avoiding regulations established to prevent price-fixing, price-inflation
The corporate ownership of all parts of the healthcare system have resulted in increased costs for doctor’s visits and prescription drugs. The medical doctor and the pharmacist no longer have the power to establish their prices because they work for the same corporation. To make matters worse, medications aren’t like ice cream where you can pass on a serving.
Healthcare costs continue to rise in the U.S.A. and impact all areas of healthcare, including caregiving, where long-term care requirements are private pay, unless a senior qualifies for the low-income entitlement program called Medicaid.
Medicaid will pay for ongoing care in a nursing home and part-time in-home caregiving services. All other seniors must private-pay for long-term care services.
Remember the scene in the movie “It’s a Wonderful Life” where as a boy, George prevents the pharmacist at the drug store, distracted because he had just received a telegram saying his son had died in the 1919 influenza pandemic, from making a mistake filling a client’s prescription? We now use technology to control many of our pill-filling systems but one of the advantages George Bailey had back then was he knew the pharmacist and the client he would be delivering the pills to that day. Definitely young George Bailey was not also the errand boy for the drug company and the doctor’s office who prescribed the medication. Now he would work for all of them. Bedford Falls most definitely had another drug store in town that a customer could go to if they weren’t satisfied, keeping competitive forces for pricing and service in play.
You may read all of Senate Bill 3822 here. Spread the word to your friends, neighbors and caregivers to learn more about how this bipartisan legislation will be a way to lower healthcare costs. This Break Up Big Medicine Act will address the ways corporations are overcharging Medicare, Medicaid and other insurers by controlling the pricing and avoiding accountability by gaming the system (Medical Loss Ration) that was established to prevent price gouging.
And remember, you can bring this political discussion up anywhere, with your care clients, with other caregivers, with your care managers, because both a Republican and Democratic Senator agreed price-fixing in healthcare needs to be regulated. The Break Up Big Medicine Senate Bill unites both political parties to create a pathway to make America’s doctor’s office visits and prescription drugs more affordable. We’ll follow this bill as the legislative process for SB 3822 continues through the Senate.
