Prohibit PBMs administering federal health care prescription drug benefits from steering patients, restricting in-network pharmacy choice, spread pricing, overcharging beneficiaries, forcing brand-name drugs when lower-cost AB-rated generics are available, and reducing pharmacy reimbursement through claim adjustments or fees.

A PBM administering prescription drug benefits under a Federal health care program shall not— (1) engage in steering; (2) engage in any practice that restricts a beneficiary from using any in-network pharmacy ... (3) charge a beneficiary more ... (4) require a beneficiary to obtain a brand name prescription drug when a lower cost, AB-rated generic version ... is available; (5) engage in spread pricing; (6) lower, impose a fee, or otherwise make an adjustment ... that in any way reduces the amount a pharmacy is reimbursed

The bill would bar several PBM practices affecting pharmacy choice, prescription costs, spread pricing, and reimbursement reductions in federal health care programs.

Text - H.R.9096 - 118th Congress (2023-2024): Pharmacists Fight Back Act | Congress.gov | Library of Congress
secondary · other · model gpt-5.5

The bill states that a PBM administering prescription drug benefits under a Federal health care program shall not engage in steering; restrict a beneficiary from using any in-network pharmacy; charge a beneficiary more than pharmacy reimbursement; require a brand-name drug when a lower-cost AB-rated generic is available; engage in spread pricing; or reduce pharmacy reimbursement through claim adjustments or fees.

The bill would ban several PBM practices in federal health care programs, including steering, spread pricing, beneficiary overcharges, forced brand-name drugs, and reimbursement clawbacks or fees.

H.R.9096 - 118th Congress (2023-2024): Pharmacists Fight Back Act | Congress.gov | Library of Congress
secondary · other · model gpt-5.5

The Globe reported that Rep. Jake Auchincloss had introduced a comprehensive PBM bill for federal government-run insurance plans. It said the bill would stop PBMs from requiring affiliated pharmacies, require a pricing metric for pharmacy reimbursement, prohibit brand-over-generic requirements, and eliminate some payment practices that incentivize higher prices.

This closely matches the promise and establishes concrete legislative effort by Auchincloss, but it is described as introduced legislation rather than enacted law.

never later_term A for effort

The Boston Globe Editorial Board, 'Knock out the middlemen': A campaign promise Donald Trump should keep
secondary · model gpt-5.5 · confidence 86%

Congress.gov lists H.R.7148 as law and records: Latest Action: 02/03/2026 Became Public Law No: 119-75. It also records House passage, Senate passage, House agreement to Senate amendments, presentation to the President, and enactment.

A later federal law containing PBM reforms was enacted during Auchincloss's later House service, supporting partial delivery of the broader PBM promise.

partial later_term

H.R.7148 - Consolidated Appropriations Act, 2026
secondary · model gpt-5.5 · confidence 90%

The enacted text requires Medicare Part D PBMs, beginning in 2028, to have written agreements and bars PBMs and affiliates from deriving remuneration for covered Part D drug services other than bona fide service fees, with rebates and discounts allowed only if fully passed through to the PDP sponsor. It also requires disgorgement of violating remuneration.

The law addresses PBM compensation and pass-through issues, but it does not fully enact the claim's full list of prohibitions on steering, pharmacy choice, brand-over-generic practices, overcharging, and reimbursement reductions.

partial later_term

Text - H.R.7148 - Consolidated Appropriations Act, 2026
secondary · model gpt-5.5 · confidence 91%

The enacted text requires reporting when a listed brand drug is covered and generic drugs referencing it are not covered, are placed on the same or higher-cost formulary tier, or face utilization management not applied to the listed drug. It also requires estimated beneficiary cost-sharing and written justification for more favorable coverage of the listed drug.

This creates transparency around brand-over-generic formulary treatment, but it is a reporting and justification requirement, not a direct prohibition on forcing brand-name drugs over lower-cost generics.

partial later_term

Text - H.R.7148 - Consolidated Appropriations Act, 2026
secondary · model gpt-5.5 · confidence 89%

The enacted text requires PBMs with affiliated retail, mail-order, or specialty pharmacies to report the percentage of prescriptions dispensed by affiliated pharmacies, cost ranges for affiliated and non-affiliated pharmacies, the lowest total combined cost available in-network, and an explanation of benefit designs that encourage enrollees to use affiliated pharmacies.

The law requires disclosure of affiliate-pharmacy steering and cost patterns, but it does not directly prohibit patient steering or guarantee unrestricted in-network pharmacy choice.

partial later_term

Text - H.R.7148 - Consolidated Appropriations Act, 2026
secondary · model gpt-5.5 · confidence 90%

The Washington Post reported that President Trump signed a government funding bill with PBM reforms, including transparency requirements, a ban on spread pricing in commercial health plans, and a prohibition on tying PBM compensation to the price of Medicare-covered medications. It also reported that additional PBM issues remained outside the law.

This supports partial fulfillment: spread pricing and compensation incentives were addressed, but the broader set of promised prohibitions was not fully enacted.

partial later_term

Washington Post Health Brief, PBM reform is done. Now they're fighting back.
secondary · model gpt-5.5 · confidence 84%

The Wall Street Journal reported that the House version of the Patients Before Monopolies Act was sponsored by Rep. Jake Auchincloss and Rep. Diana Harshbarger, and that the bill would require companies owning insurers or PBMs to divest pharmacy businesses. It also reported the two had previously teamed on legislation aimed at PBM steering to affiliated pharmacies.

This shows additional concrete Auchincloss legislative effort against PBM vertical integration and steering, but the article described proposed legislation, not enacted prohibitions.

never later_term A for effort

Wall Street Journal, Lawmakers Plot to Force Health Insurers to Sell Off Pharmacies
secondary · model gpt-5.5 · confidence 80%