Opening Remarks: Senator Carper Fights to Increase Resources for Youth Mental Health Care and Hold PBMs Accountable

Today, U.S. Senator Tom Carper (D-Del.), a senior member of the Senate Finance Committee, participated in the committee’s markup of the Better Mental Health Care, Lower-Cost Drugs, and Extenders Act. This bill contains key priorities from Senator Carper and the Senate Finance Committee including aspects that address mental health, Pharmacy Benefit Managers (PBMs), and Medicare and Medicaid extenders for expiring provisions. Senator Carper led three provisions in this bipartisan legislation, which passed out of committee by a vote of 26–0.

Two of the provisions in the final markup originated from the Senate Finance Committee’s Working Group on Youth Mental Health, co-led by Senator Carper and Senator Bill Cassidy (R-La.). The Working Group released a discussion draft of critical youth mental health care policies in June 2022, and the legislation that passed out of committee today will better implement lasting solutions for mental health care for children on Medicare and CHIP. Included in the bill are:

1. A requirement for the Secretary of Health and Human Services (HHS) to provide comprehensive guidance to states on how to support mental health services and substance use disorder care for children and youth; and
2. A second requirement for HHS to regularly conduct an analysis of Medicaid health care data related to mental health services, and publish that data biennially.

The third provision led by Senator Carper in the Committee’s bill protects seniors from excessive cost sharing for certain medications. This provision was developed from the Share the Savings with Seniors Act that Senator Carper introduced in July 2023 with Senators John Cornyn (R-Texas), Thom Tillis (R-N.C.), and Sherrod Brown (D-Ohio). It requires that the total rebate that PBMs receive from manufacturers to be passed on to patients to lower their cost of chronic condition medications at the counter. By holding PBMs accountable for their prescription pricing practices, seniors across the country will see lower costs for their life-saving medications.

Senator Carper has been laser-focused on youth mental health resources, lowering health care costs, and increasing industry transparency:

• As the co-chair of the Senate Finance Committee’s Working Group on Youth Mental Health, Senator Carper led the passage of two provisions from the June 2022 working group discussion draft through the Bipartisan Safer Communities Act, which was signed into law in June 2022.
• As Governor, Senator Carper led the initiative to put a nurse in every public school and add a wellness center to every public high school.
  • He also established the Family Services Cabinet Council to provide better mental and physical health care coordination for children and families in the First State.
• This Congress, Senator Carper introduced the bipartisan PBM Oversight Act of 2023 with Senator Chuck Grassley (R-Iowa). This legislation would provide much-needed oversight from the Centers for Medicare and Medicaid Services into the ways PBMs determine which medications are included on the list of covered drugs under a person’s health plan, also known as drug formularies.
  • The legislation would also require that the practicing physician and practicing pharmacist that serve on P&T Committees are independent and free of conflicts of interest with respect to any PBM.
• Senator Carper led the Insulin Price Reduction Act with Senators Jeanne Shaheen (D-N.H.), Susan Collins (R-Maine) and Kevin Kramer (R-N.D.) which would hold PBMs, big pharmaceutical companies, and insurers accountable for surging prices by incentivizing reductions in list prices.
• Senator Carper co-sponsored legislation to require PBMs to disclose and provide information on the rebates negotiated with the drug manufacturers.

Read Senator Carper’s opening remarks as prepared below, and watch his remarks here:

I would like to thank Chairman Wyden and Ranking Member Crapo for continuing to focus on lowering prescription drug costs through PBM reform, as well as continuing our work to improve mental health care across the country.

I am grateful that several proposals that I authored have been included in the Chairman’s mark, including a provision, that Senators Cornyn, Brown, and Tillis joined me in, that will protect seniors from excessive cost-sharing for chronic condition medications.

For far too long, pharmacy benefit managers, also known as PBMs, have been left unchecked – pocketing rebates from manufacturers rather than passing them on to patients. One of my guiding principles – when it comes to drug pricing policy – is making sure that we lower costs for patients at the counter. This important provision will do just that by ensuring seniors with chronic conditions directly see the savings that PBMs negotiate on their behalf.

I would also like to thank the Chairman for the inclusion of several proposals I authored with Senator Cassidy, relating to the improving of youth mental health. Senator Cassidy and I co-lead the Youth Mental Health Working Group where many of those ideas originated, so I’m glad to see them moving forward. We are currently facing a national youth mental health crisis, and our work is not yet done. These provisions take an important step in improving the health of our children.

I look forward to taking bipartisan action on these important issues today.

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