Updates About Health Policy

Governor Whitmer and the Department of Insurance and Financial Services (DIFS) are introducing new licensing rules for pharmacy benefit managers (PBMs) to alleviate prescription drug costs for Michiganders. These changes, outlined on a newly launched DIFS website, stem from a set of prescription drug bills enacted last year. Governor Whitmer has stressed the importance of ensuring affordable access to necessary medications without forcing tough choices between health and other expenses.

Director Anita Fox highlighted the role of PBMs in managing drug benefits and the significance of DIFS’ licensing authority in safeguarding Michiganders from soaring drug expenses. The legislation, born from recommendations by the Prescription Drug Task Force, imposed crucial consumer safeguards, including oversight on PBM licenses, bans on “gag clauses” and “spread pricing,” and requirements for PBMs to furnish transparency reports to DIFS. These measures aim to provide clarity, reduce costs, and enhance access to crucial drug cost information for Michigan residents.

The Reproductive Health Care Act (RHA) passed in the Michigan House on Wednesday, November 1. Included in the RHA was the removal of the additional insurance policy to pay for an abortion, certain regulations for clinics, and language around partial-birth abortion procedures. However, this final approval of the bill package comes with amendments that ultimately passed in the closing margins of the House.

After an unforeseen no-vote in committee by Democrat Representative Karen Whitsett, Medicaid-funded abortions and the 24-hour waiting period were removed from the package to finally gain the Detroit Representative’s vote.

This legislation follows the passing of Proposal 3, where Michigan residents voted in favor of abortion rights in November 2022.

Representative Samantha Steckloff (D-Farmington Hills) was successful in passing her Oral Cancer Medication bill in both the House and Senate - legislation that advocates have been working on for years.

The Senate passed House Bill 4071 with 36 yes and 2 no votes, and the bill is now headed to Governor Whitmer’s desk for further consideration. Organizations like the Michigan Society of Hematology and Oncology, American Cancer Society Action Network, Leukemia & Lymphoma Society and many others were instrumental in final passage of the legislation.

Creating parity between oral chemotherapy and intravenous cancer treatments has been contested for over 15 years. Some argued against this bill as they feared premiums would increase for Michigan residents while only helping a small percentage of the population. However, Steckloff hopes that the bill will help cancer patients have a more accessible and affordable cancer treatment. The medication taken orally can help cancer patients by allowing them flexibility in where they are taking their medication instead of being at a hospital and receiving treatment for hours on end.

The bill would amend the Insurance Code so that oral chemotherapy would be covered at similar rates as intravenous cancer treatments. Oral cancer medication has often been underneath pharmacy insurance policies, causing the two different forms of treatment to be covered differently. The passage of the bill comes after the S1 substitute changed the Michigan Association of Health Plans’ opposition. The S1 substitute changed the minimum coverage for insurance companies to not have to change their insurance policy to $250 for a 30-day supply instead of the $150.