Prescription Drug Affordability Board


In 2017, I lost an extraordinarily talented colleague and friend to suicide when he learned that his insurance would no longer cover his medical care. He was young, driven and desperate.

Before the Affordable Care Act, I struggled as a self-employed artist to find coverage I could sustain. However, even with the passage of the ACA and the protections it guaranteed, the cost has not become affordable for many Americans, the largest hurdle to health care being the cost of prescription drugs.

We could debate the many reasons why, but in the 2019 Maryland General Assembly legislative session, we took an essential step toward controlling the skyrocketing costs of health care with the creation of the Prescription Drug Affordability Board (PDAB), the first of its kind in the nation.

The PDAB is an independent body that will analyze every step of the supply chain and make recommendations about cost-saving measures, including exploring upper payment limits for government-purchased drugs. The board is comprised of five members appointed by the Senate president, speaker of the House, attorney general and governor. The architect of the bill and vice chair of the Health and Government Operations Committee, Joseline Peña-Melnik, worked for more than two years to ensure that the bill would not only provide relief to working families but also hold up to legal scrutiny. Even as our committee worked to strengthen the bill, we saw people across the nation begin to ration life-saving prescriptions, such as insulin, to catastrophic effect.

One of the concerns repeatedly raised during the hearings was that of time, because the General Assembly had passed a bipartisan price-gouging bill in 2017 that ran afoul in the courts and was declared unconstitutional, so as one of my colleagues pointed out, we couldn’t afford to get this wrong.

In the end, we had to compromise with a pilot program and a multi-year effort, but we were able to pass the bill with bipartisan support in the House and unanimous support in the Senate.

Though the governor did not sign the bill, he allowed it to go into law without his signature, and in July, the board was meant to begin its work.

Despite the urgency of this effort, and as states across the country turn their attention to Maryland to see if our pilot can be replicated, the board has been stymied in its efforts to begin its essential work. Although the first four members have been chosen — including former state health secretary to Governor Larry Hogan, Van Mitchell — the governor has hesitated to announce his appointment to the board and release the funds the General Assembly set aside in the budget to fund the essential work of the PDAB. As reported by Maryland Matters, Hogan spokesman Michael Ricci indicated in an August email that there is no timetable yet for appointing someone.

Health care is a right, but health care is meaningless when affordable isn’t affordable for a large percentage of the population. The legislative process can feel quite clinical, even plodding, but this is personal and this is urgent.

As legislators, we are often focused on local issues, traffic problems, zoning laws, taxes and revenues, and school construction, but this effort has national implications. This also affects me personally, as I have had a front-row seat to people raising families in the gig economy, forced to choose between insulin and rent, antidepressants and food, and meds for themselves or meds for their children.

This isn’t a partisan issue; it is a human rights issue. It’s life or death, and we don’t have time to play politics.


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