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8 in 10 registered voters support requiring insurance & PBMs to share rebates directly with patients

A new PhRMA/Ipsos poll finds that there is wide support for policies that require health insurers and their pharmacy benefit managers (PBMs) to share savings with patients.


A new PhRMA and Ipsos poll of over 2,500 Americans finds that when it comes to health care, most registered voters are concerned about issues related to health insurance coverage and costs. Many voters voice concerns over their ability to afford their out-of-pocket heath care costs and the majority agree that navigating their insurance coverage is too complicated. Additionally, when voters are presented with information about pharmacy benefit managers (PBMs) concern grows, especially among seniors. To lower the cost of health care in this country, voters support solutions that ensure greater accountability from health insurance companies and PBMs. Eighty-three percent of voters support requiring health insurers and pharmacy benefit managers to share more of the rebates and discounts they receive directly with patients, so they pay less for their medicines.

Detailed findings: Health insurance costs and coverage rank as the most important health care issue among registered voters.

  • Three in five voters (58%) are concerned about their ability to afford their out-of-pocket health care costs, including deductibles, etc.

  • Nearly half (46%) agree they are afraid that in the event of a major event or emergency, their insurance would not cover their medical needs.

  • About one in five registered voters (17%) rank health insurance costs and coverage as their top two most important concerns.

Many voters are concerned with how health insurers and PBMs affect patient access and affordability.

  • Most voters agree (73%) that health insurance companies and middlemen, like PBMs, increase the costs for patients.

  • Similarly, 67% of voters agree that health insurers intentionally make coverage benefits complicated so that they can increase their bottom line. More registered Democrats than Republican voters feel this way (72% vs. 61%).

  • Most registered voters (84%) agree that Congress should focus on cracking down on abusive health insurance practices that make it harder to get the care people need.

And when registered voters are presented with information about PBMs, they are more likely to voice concerns about their role and impact on patients’ access to medicines.

  • Just 12% of registered voters are familiar with PBMs, when asked initially.

  • Eighty-one percent of registered voters are concerned that just three PBMs control 80% of the market, with no difference between Democratic and Republican registered voters.

  • A similar share of registered voters (81%) is concerned when told that PBMs are administrators, not doctors, but they determine what medicines are covered by your insurance and what people pay for them.

  • Out of every age group, seniors expressed the most concern about PBMs, with over four in five concerned about each of the five statements tested.

Registered voters expressed support for policy solutions that ensure greater accountability from health insurance companies and PBMs—such as improving transparency and predictability in health care costs and requiring discounts on medicines to be shared directly with patients at the pharmacy counter.

  • To lower health care costs, most registered voters (83%) support requiring health insurers and PBMs to share more of the rebates and discounts they receive directly with patients, so they pay less for their medicines at the pharmacy counter. This solution was particularly popular among seniors (85% among those 65+ expressing support).

  • Nearly all registered voters (89%) support the federal government requiring health insurance companies to be more transparent about which medicines are covered and what patients will pay out of pocket for prescription medicines, with supermajority support among registered voters of both parties.

  • A similar share (85%) also supports the federal government ensuring more predictability in health care costs. For example, patients want to know how much they will pay for things like prescription medicines every month.

The poll was conducted among 2,514 American adults using Ipsos’ probability based KnowledgePanel®, and it is representative of the American adult population. The margin of sampling error is plus or minus 2.2 percentage points at the 95% confidence level, for results based on the entire sample of adults.

For complete results, please download the fully annotated questionnaire.



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