Top News
New Report: Specialty Drug Costs Continue to Drive Health Care Spending for Public Sector Employers
The National Institute for Public Employee Health Care Policy and the Public Sector HealthCare Roundtable will release the 2025 Annual Specialty Drug Survey Report on Tuesday, March 24, providing analysis of 2024 plan year data from public sector health plans across the country.
The survey includes responses from 23 public sector plan sponsors representing 17 states. Collectively, respondents cover more than 5.5 million beneficiaries and report nearly $30 billion in commercial health care spending, including almost $8 billion in pharmacy benefit spending.
The findings underscore a clear and accelerating trend: specialty drug spending continues to outpace overall health care spending and now accounts for more than half of pharmacy benefit spending for many public sector plans. While employers are deploying a range of strategies to manage costs, the report highlights the need for broader policy solutions to address the structural drivers of specialty drug price growth across the health care system.
The report also outlines 12 policy recommendations aimed at improving transparency, accelerating biosimilar competition, and supporting innovative payment models to ensure sustainable access to life-saving therapies.
Full report available here.
Roundtable Joins CAPPA in FTC Meeting on Patent Litigation Reform
On March 25, 2026, the Public Sector Healthcare Roundtable joined the Coalition Against Pharma Patent Abuse (CAPPA) in a meeting with the Federal Trade Commission (FTC) to discuss patent litigation reform and rising specialty drug costs. The Roundtable introduced its membership and highlighted findings from the National Institute for Public Employee Health Care Policy’s 2025 Specialty Drug Survey, emphasizing continued growth in specialty spending and the need to strengthen generic and biosimilar competition.
The discussion also included preliminary analysis on serial patent litigation and its role in delaying competition and maintaining high drug prices. Participants discussed exploring potential enforcement actions targeting practices that rely on procedural strategies rather than scientific innovation, and the Roundtable looks forward to continuing to work with CAPPA and the FTC to advance solutions that promote competition and lower prescription drug costs.
CSRxP Meets with Senate HELP Minority Staff on Drug Pricing and Upcoming Hearing
On March 25, 2026, Members of the Campaign for Sustainable Rx Pricing (CSRxP), including the Public Sector Healthcare Roundtable, met with Thomas Eagen, Senior Health Policy Adviser for Ranking Member of the Senate Health, Education, Labor, and Pensions (HELP) Committee, Bernie Sanders (I-VT), to provide an overview of the coalition, its membership, and mission, and to discuss Senate HELP Committee minority priorities related to prescription drug affordability, competition, and oversight. The conversation highlighted key legislative proposals, including the Biosimilar Red Tape Elimination Act and the Medication Affordability and Patent Integrity Act, as well as broader transparency efforts such as the Patients Deserve Price Tags Act.
The meeting reinforced the importance of advancing a coordinated federal approach to prescription drug affordability, with a particular focus on leveraging biosimilars and generics as key tools to reduce costs and improve access for patients and purchasers.
House Republicans Weigh Health Care Offsets in Reconciliation Package
Congressional Republicans are considering a range of health care policy changes as potential offsets in a forthcoming reconciliation package aimed at funding defense and homeland security priorities. According to recent discussions led by House Budget Committee Chair Jodey Arrington (R-TX), lawmakers are exploring measures to address fraud and abuse across federal health programs, alongside proposals such as directly funding Affordable Care Act cost-sharing reductions (CSRs). Policymakers and stakeholders suggest health care remains one of the few areas in the federal budget capable of generating the scale of savings needed to offset an estimated $300 billion in new spending.
Potential policy options under consideration include targeting fraudulent marketplace enrollment, improper payments tied to durable medical equipment and home- and community-based services, and expanding the use of fraud prevention technologies and state accountability mechanisms. Some proposals could also include structural changes, such as funding CSRs, which the Congressional Budget Office has previously estimated could reduce premiums by roughly 11% while generating federal savings. At the same time, lawmakers have expressed interest in broader affordability-focused policies, though certain proposals, such as expanding health savings accounts, may increase costs rather than serve as offsets.
The scope and direction of the reconciliation package remain fluid, with key decisions likely to hinge on broader political dynamics and priorities from the White House. Proposals such as codifying a “most favored nation” drug pricing policy could further complicate negotiations, given their potential impact across Medicare, Medicaid, and employer markets. While proponents frame the effort as an opportunity to address health care affordability and program integrity, critics argue that proposed changes could reduce access to coverage and care, setting up a broader debate as Congress advances reconciliation discussions in the coming months.
Administrative Action
FTC Announces Creation of Healthcare Task Force
The Federal Trade Commission (FTC) has announced the creation of a new Healthcare Task Force aimed at strengthening its enforcement and advocacy efforts around competition and consumer protection in the healthcare sector. The task force will integrate expertise across multiple FTC divisions, including competition, consumer protection, economics, policy planning, and technology, to develop coordinated, agency-wide strategies, proactively identify
DOJ Urges Supreme Court to Leave Medicare Drug Negotiation Program Intact
The Department of Justice has filed a brief urging the Supreme Court not to take up legal challenges to the Inflation Reduction Act’s Medicare drug price negotiation program, reinforcing the federal government’s defense of one of the law’s most consequential drug pricing reforms. The filing responds to petitions from Bristol Myers Squibb and Janssen Pharmaceuticals, which argue that the program is unconstitutional on First and Fifth Amendment grounds. The brief marks the second time the Trump administration’s DOJ has asked the justices to reject a challenge to the program, underscoring continued federal support for implementation as litigation moves forward.
The government’s argument rests heavily on the position that participation in the negotiation program is voluntary and therefore does not amount to compelled speech or an unlawful taking. In its brief, DOJ also argues that the requirement for manufacturers to sign agreements describing negotiated prices as “fair” is consistent with other federal contracting frameworks and does not create a unique constitutional problem. The filing further emphasizes that the process constitutes a genuine negotiation, noting that manufacturers retained leverage in the first round and that the government accepted several counteroffers.
The latest filing adds to a growing body of favorable rulings for the government, as multiple appellate courts have now rejected similar industry arguments and no circuit split has emerged. That lack of disagreement among lower courts could make it less likely that the Supreme Court will intervene. A decision on whether the justices will hear one or more of the pending cases could come at any point before the Court’s current term ends in June or July, with any accepted case likely to be argued in the next term beginning in October.
HHS & CMS Announce New Healthcare Advisory Committee
The U.S. Department of Health and Human Services (HHS) and Centers for Medicare & Medicaid Services (CMS) have established a new Healthcare Advisory Committee composed of nationally recognized leaders across care delivery, financing, and innovation to provide expert, non-binding recommendations on strengthening and modernizing the U.S. healthcare system. Advising HHS Secretary Robert F. Kennedy Jr. and CMS Administrator Dr. Mehmet Oz, the Committee will focus on improving care across Medicare, Medicaid, CHIP, and the Marketplace, with an emphasis on shifting towards prevention, enhancing care quality and outcomes, reducing administrative burden, and ensuring program sustainability. Selected from more than 400 nominees, members will serve two-year terms and prioritize actionable policy solutions related to chronic disease management, real-time data utilization, support for vulnerable populations, and Medicare Advantage reforms. The Committee will meet regularly, with proceedings open to the public, and will begin its work later this year.
Congressional Action
Coalition Launches Medicare by Choice Proposal
A coalition of policy experts, including the Center for Health and Democracy (CDH) and a former administrator of the Centers for Medicare and Medicaid Services (CMS), have introduced a Democratic health care proposal called “Medicare by Choice”. The proposal calls for a single-payer national system that would replace private insurance by allowing all Americans, regardless of age, to enroll in traditional Medicare. Employers would also have the option to offer Medicare by Choice as a workplace benefit. CDH Executive Director and former staffer for Rep. Pramila Jayapal, Rachel Madley, said the proposal is intended to give Democrats a unifying health care option following the expiration of enhanced Affordable Care Act premium subsidies. In addition to expanding eligibility, Medicare by Choice would strengthen the existing Medicare program by adding coverage for dental, vision, and hearing services. The proposal would also streamline enrollment by consolidating Medicare Parts A, B, and D into a single program.
The “Medicare by Choice” proposal enters an ongoing debate within the Democratic Party. Democratic strategists have emphasized that electoral success must come first, arguing that policy ambitions depend on winning the 2026 midterms and maintaining control needed to enact changes. Strategists also stress the importance of protecting and strengthening existing programs like Medicare and Medicaid before pursuing broader structural reforms. While the similar proposed universal health care coverage system, “Medicare for All” is often considered too radical and vulnerable to GOP attack, Madley believes that Medicare by Choice is a realistic way forward for Democrats in 2028.
Congressional Democrats Release New Report Highlighting Consequences of H.R. 1
Senate Finance Committee Ranking Member Ron Wyden (D-OR) and House Energy & Commerce Committee Ranking Member Frank Pallone (D-NJ) released a new report that highlights the negative impacts of H.R.1 since it became law in July of 2025. The report shows significant access and affordability losses, noting that over 50% of Affordable Care Act (ACA) Marketplace enrollees report cutting spending on basic needs like food to afford care. The report places particular emphasis on system-wide provider and workforce losses, documenting 115 hospital and clinic closures or service reductions across 32 states within six months of enactment, including 49 maternity care, 79 primary care, 21 hospital, and 7 behavioral health service reductions. These impacts are coupled with substantial employment losses, with 6,440 healthcare workers laid off across 22 states. Components of H.R.1 have yet to be fully implemented since the bill became law, which many expect will lead to continued closures and layoffs of healthcare workers in the coming months and years.
