PBS, Senator Chuck Grassley, Alison Kodjak discussed on Marketplace



Confidence. Hello, holly. What's happening on the roads right now in van Nuys? On the northbound four zero five Sherman way, we have a collision there that's blocking the carpool in two left lanes. And that has you backed up from Ventura boulevard. Is he day on a Monday as we move on with the news KCRW? It's four thirty five from NPR news. This is all things considered. I'm Ari Shapiro Chang. The Senate finance committee has been digging into the high cost of prescription drugs in the committee's third hearing on the topic tomorrow senators will cross examine executives from companies known as pharmacy benefit managers. Some of them are familiar CBS care, Mark, for example, and Express Scripts. These are companies that manage the prescription drug insurance plans for most insurance companies and employers and some senators and many others say pharmacy benefit managers. Carry a lot of blame for hydrog prices NPR's Alison kodjak joins us now. Hey, alison. Hi, also, what are the senators on the finance committee hoping to learn tomorrow? Well, there are couple of big things. The first is they wanna show how secretive this system is pharmacy benefit managers system. And how that secrecy can. Trouble. So the way the system works is drug company said what they called this list price for their medication really high. Then they negotiate price breaks this with the PB and they control the drug benefit for millions of millions of customers. So those discounts come in the form of secret rebates that drug companies pay back after the fact the whole system is try to secrecy in that breeds mistrust. So I talked with Senator Chuck Grassley today, he's the Republican chairman of the committee, and he called the PB a secret organization. Let's hear what to say. When you have a list price up here. And I'm raising my hand, and then you have rebates in between. And then you have a price down here for the consumer. How come we don't have everybody pay that that prices down here? What do you expect the pharmacy benefit managers, these PM's what to say to defend themselves? Well, they've been defending themselves a lot recently. So I'm expecting me here the similar thing, which is in the end they actually reduce overall drug spending because they can control what drugs are millions of customers by and so they can demand. These discounts a lot of communist and analyst I talked to say there's no question they've reduced spending mostly by directing consumers to generic drugs, which are cheaper than brand name drugs. But in areas where there are no generics. Benefits less clear. They say they save loads of money off the list prices, but many expert, including the secretary of health and human services. Are you the rebate system drives that initial list price artificially, high the PBS say that's the pharmaceutical manufacturers fault because they're the ones setting that price. Will are they correct about that well to some extent? Yes. Drug companies choose their initial price, and they raise those list prices every year even on drugs that are the same. They say they have to do this. So they can offer PBMR's better rebates. So there's this big blame game going on. And Senator Grassley even noted it when I talked with him, the pharmaceutical companies pointed their figure at the PBS, the PB M's pointer finger at the pharmaceuticals, and then both of those are pointing their fingers at the health insurance companies. So aggressively is really frustrated here he actually sort of threatened that he would call another hearing bring all these three groups together because he wants to get them all at the same table and figure out what's going on. So what happens next at this point? Do you expect anything to actually change? Well, there's a lot of action out there on drug prices, and particularly in this report issue legislation in the house and the Senate both Democrats and Republicans Senator Grassley says he's going to craft a Bill, but even more immediately. The Trump administration has proposed making these after the factory Bates illegal that they would. Require PM's instead to negotiate for discounts up front, which being customers would pay the lower price. Even if they haven't met a deductible, but those discounts and no longer be confidential. All right. That's NPR's. Alison kodjak. Thanks. Thanks turn out was way up in the two thousand eighteen midterms. And in the southwest that translated into gains for Democrats now. Republicans in south western states are pushing bills the change the rules around voting. Critics say these changes are designed to reduce turnout in future elections from Phoenix cage. As e Brett Jaspers reports on how it's playing out in Arizona. Republicans had full control of Arizona's politics until last fall. Then after democratic turnout surged they lost four out of nine statewide races, including a US Senate seat. Now. Republicans in the legislature are proposing new voting rules that could make it more complicated to cast a ballot one change would remove some people from the permanent early voting list. It says permanent early voting lists. I don't know why everyone morning the operative word which is early. That's the Bill sponsor Republican state. Senator Michele Eugene t Rita people on the permanent early voting list. Get ballots mailed to them so that they can mail them back or drop them off on election day. You Rita wants counties to purge people from that list, if they don't vote using an early ballot into consecutive election cycles, we wanna make sure that the lists are up to date. That's just good practice. That makes sense. On frankly, any kind of database that you have that you're really communicating with those who want to be communicated with that are using the service is a service. It's a convenience local election officials say they already have ways to maintain clean voting rolls. The secretary of state's office estimates two hundred thousand voters currently on the permanent early voting list. Didn't vote in both twenty sixteen and twenty eighteen but the office also says the bill's language is unclear making it hard to estimate the impact democratic Representative the Solomon calls it voter suppression to purge the permanent early voting list known as pebble or people. There is a creek debates around whether or not it is pebble or people. But I find it fitting that if this Bill passes the list will no longer be permanent. And so one might call it evil. Republicans dispute this is an attempt to make voting more difficult. The Bill doesn't remove people from the registration rolls. Just the mailing list for early ballots. Some local officials say it will create more confusion. Republican lawmakers have proposed other bills this legislative session that have drawn criticism from voting rights groups, including one that bans paying workers for each voter registration form, they turn in both the good and bad side of the fall out of the twenty eight teen election. Danielle Lang is an attorney with the campaign legal center, which works with voting rights groups across the country, including in Arizona. She says lawmakers often reexamined voting laws after an election. For example. There's a push from Iowa Republican governor to make it easier for convicted felons to. Restore their right to vote after release that effort is by partisan unlike zone as Bill which has advanced along party lines all Americans care about election integrity, and yet these issues get framed in very unhelpful partisan ways, Republicans control the Zona legislature, the Bill to purge the permanent early voting list still has to pass the full house GOP governor Doug ducey's office says it doesn't come on pending legislation for NPR news. I'm Brent Jaspers in Phoenix..

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