Congress targets pharmacy middlemen — but details matter for drug costs
H.R. 10369 — To amend title XVIII of the Social Security Act, and the Employee Retirement Income Security Act of 1974, to create certain requirements with respect to pharmacy benefit managers. · Filed by Ryan Mackenzie (R-PA) · 4 cosponsors · Introduced Sep 14, 2026 · Referred to committee
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What it does
This bill would impose new regulatory requirements on pharmacy benefit managers (PBMs) — the middlemen who negotiate drug prices and manage prescription benefits for Medicare and employer health plans. Without access to the full text, the specific requirements cannot be detailed, but the bill targets PBM practices that have drawn bipartisan criticism for raising drug costs and reducing pharmacy access.
Why we flagged it
The bill's stated purpose is to impose requirements on PBMs under Medicare and ERISA. This is regulatory intervention in a sector known for opacity and high drug costs, not a commemorative, appropriations, or self-dealing measure.
What the text implies
- Depending on requirement type, bill could shift negotiating leverage between PBMs, insurers, pharmacies, and drug manufacturers — potentially raising or lowering drug prices for consumers.
- Requirements may impose compliance costs on PBMs that could be passed to employers and insurers, indirectly affecting employee health plan premiums.
The full analysis lists 3 implications of this text.
Who it affects
PBM regulation could lower drug costs and improve pharmacy access for patients, but the specific requirements are unknown. If requirements impose compliance costs without meaningful consumer benefit, or if they inadvertently reduce competition among PBMs, the impact could be negative.