Health care costs continue to rise, and prescription drug prices are no exception. As out-of-pocket costs grow, many individuals are turning to marketplaces that help them find lower-priced medications. When a consumer pays cash for a covered drug at a lower price, the health insurer or pharmacy benefit manager often refuses to credit that payment toward the consumer's deductible or out-of-pocket maximum. Patients who do the right thing and shop for the best price are penalized for it.
 
As proposed in Governor Shapiro’s 2026-2027 budget, my legislation would require the health insurer or the pharmacy benefit manager to count what the consumer pays out-of-pocket for a covered prescription drug toward their deductible and out-of-pocket maximum. This will ensure that consumers receive fair credit toward their plan’s cost sharing requirements when they find a lower price for their prescription drugs.
 
Pennsylvanians should not be punished for being smart consumers. This bill will improve drug pricing transparency in the Commonwealth and ultimately lower prescription drug costs for everyone.
 
I invite you to join me in co-sponsoring this important measure to support consumer choice, promote fairness, and improve affordability in prescription drug purchasing.