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Pharmacy Benefit Manager Reform Act
Carrier Updates
Thursday, February 19 2026
Federal momentum to address healthcare costs accelerated as Congress passed the Pharmacy Benefit Manager (PBM) Reform Act and the Department of Labor proposed new rules to increase transparency in PBM fees. This signaled an important shift toward the kind of openness, fairness and affordability Blue Shield of California has championed for years.
As Paul Markovich, president and CEO of Blue Shield’s parent company Ascendiun, said at two congressional hearings around healthcare affordability this January: “We need to make prescription drugs accessible and affordable by eliminating kickbacks in the form of rebates, fees and spread pricing.”
Blue Shield’s bold, bipartisan commitment
Blue Shield has long pushed for a more transparent and affordable prescription drug system. This is the kind of innovation our nonprofit health plan envisioned — changes that eliminate hidden fees and inflated costs created by traditional pharmacy benefit managers (PBMs).
In 2020, Blue Shield led the effort to bring together 18 other Blue plans to launch CivicaScript with a bold mission: to make generic medications available at one clear, consistent and affordable price. In this effort, Blue Shield engaged Gov. Gavin Newsom’s office early on, recognizing the need for strong public–private collaboration to drive meaningful change.
The vision advanced further in 2023 with Blue Shield’s launch of Pharmacy Care Reimagined, a first-of-its-kind initiative that moves away from the traditional PBM model. By working directly with vendors across the supply chain, Blue Shield has cut out unnecessary middlemen, reduced costs and rebuilt trust between patients and pharmacists through greater transparency and fairness.
These efforts paved the way for major statewide reform in 2025 — when California passed Senate Bill 41 (SB 41) with overwhelming bipartisan support. SB 41 became the most comprehensive PBM reform bill in the nation, curbing opaque PBM practices and setting the stage for a more patient-centered prescription drug system. The same week, Gov. Newsom also announced California’s new $11 insulin with CivicaScript — the result of a five-year partnership between the state, Blue Shield of California and CivicaScript to make prescription drugs more affordable for consumers. Together, these milestones laid the groundwork for change at the national level.
To Read More Click Here
As Paul Markovich, president and CEO of Blue Shield’s parent company Ascendiun, said at two congressional hearings around healthcare affordability this January: “We need to make prescription drugs accessible and affordable by eliminating kickbacks in the form of rebates, fees and spread pricing.”
Blue Shield’s bold, bipartisan commitment
Blue Shield has long pushed for a more transparent and affordable prescription drug system. This is the kind of innovation our nonprofit health plan envisioned — changes that eliminate hidden fees and inflated costs created by traditional pharmacy benefit managers (PBMs).
In 2020, Blue Shield led the effort to bring together 18 other Blue plans to launch CivicaScript with a bold mission: to make generic medications available at one clear, consistent and affordable price. In this effort, Blue Shield engaged Gov. Gavin Newsom’s office early on, recognizing the need for strong public–private collaboration to drive meaningful change.
The vision advanced further in 2023 with Blue Shield’s launch of Pharmacy Care Reimagined, a first-of-its-kind initiative that moves away from the traditional PBM model. By working directly with vendors across the supply chain, Blue Shield has cut out unnecessary middlemen, reduced costs and rebuilt trust between patients and pharmacists through greater transparency and fairness.
These efforts paved the way for major statewide reform in 2025 — when California passed Senate Bill 41 (SB 41) with overwhelming bipartisan support. SB 41 became the most comprehensive PBM reform bill in the nation, curbing opaque PBM practices and setting the stage for a more patient-centered prescription drug system. The same week, Gov. Newsom also announced California’s new $11 insulin with CivicaScript — the result of a five-year partnership between the state, Blue Shield of California and CivicaScript to make prescription drugs more affordable for consumers. Together, these milestones laid the groundwork for change at the national level.
To Read More Click Here