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Israeli Prime Minister Netanyahu speaks to a Joint Session: I was pleased to have Temple Emanuel of Newton’s Rabbi Michelle Robinson as my guest for the Joint Meeting of Congress with Prime Minister Benjamin Netanyahu. Rabbi Robinson serves as a Senior Rabbi at Temple Emanuel, the largest Conservative Synagogue in New England, with a membership of 1,500 families. Temple Emanuel is a place of support and solidarity, especially during this difficult time for Israel and the Jewish people.
Prime Minister Netanyahu delivered an eloquent exposition of the moral and strategic imperative for the US-Israel alliance. I agree, also, with his support for a demilitarized and deradicalized Gaza. I was disappointed, however, that the prime minister missed this opportunity to detail his plans for a day-of governance strategy in Gaza. Reconstruction should be in parallel with combat operations against Hamas, not subsequent to it, and it should be led by non-Hamas Palestinians; supported by American and Arab states; and committed to the security of both peoples. I strongly support diplomatic efforts in Rome to advance these objectives and return the hostages.
Addressing the fentanyl crisis at its source: As co-chair of the Select Committee on China’s bipartisan Fentanyl Working Group, I presided over the third meeting of the group, which focused on China’s role in trade-based money laundering to facilitate exports of fentanyl precursors to Mexican drug cartels.
About half of the $4 trillion laundered annually, for all purposes, flows through China, and the mechanics are complicated. But the drivers are straightforward: many wealthy Chinese want to exchange assets denominated in Chinese Yuan for dollar-backed assets, in order to hedge against domestic instability, but they cannot legally exchange those funds because of CCP capital controls. Therefore, there is demand for dollars that can only be fulfilled illicitly; into that breach steps criminal elements in China, Mexico and the United States who use encrypted apps to facilitate the laundering of cash, generated by fentanyl sales, into legal dollar-denominated products like real estate or tuition.
Efforts to disrupt this money laundering, centered in Treasury, must be synthesized with counter-fentanyl initiatives in law enforcement, customs, sanctions, and diplomacy. For this reason, the Working Group is considering authorizing a Joint Task Force to fuse together all organs of state power in one entity with one chief.
Countering Russia & China’s autocratic alliance: I joined NewsNation’s Blake Burman to discuss the North American Aerospace Defense Command (NORAD) intercepting one Russian and one Chinese bomber off the coast of Alaska. From Ukraine to the Alaskan coast, Vladimir Putin and Xi Jinping are doubling down on their autocratic alliance – a friendship that “knows no limits.”
Our strength in Ukraine defending the West is critical to our strength in the Indo-Pacific countering the CCP’s belligerence. It's not possible to be tough on China while soft on Russia.
Tackling health insurers’ predatory Rx drug pricing: During the Oversight Committee hearing on prescription drug prices, I questioned executives from the Big 3 pharmacy benefit managers, the middlemen of drug pricing: CVS Caremark, UnitedHealthGroup’s OptumRx, and Cigna Express Scripts. Each are Fortune 20 companies.
CVS & the other big PBMs claim that the Federal Trade Commission, the Medicare Payment Advisory Commission, independent experts, the New York Times, and the Wall Street Journal are all wrong: they don't mark up drugs.
During my questioning, however, I laid out CVS's own data on percent mark-ups over NADAC (the actual acquisition cost) for specialty drugs. I drew the data from a big, sophisticated employer in Massachusetts.
Multiple sclerosis Rx – 38,352%
Prostate cancer Rx – 6,375%
Leukemia Rx – 13,591%
Chronic kidney disease Rx – 5,037%
HIV Rx – 4,124%
Heart failure Rx – 161%
Specialty drugs are used by less than 2% of the population but account for 50% of the drug spend, and this is why: the PBMs are massively marking up the drugs necessary to treat the sickest patients. The result is higher out-of-pocket costs for patients and higher premiums for everyone.
If the PBMs can get away with these markups after negotiations with benefits experts at a Fortune 100 employer, imagine how they treat the small-business pharmacists that have to do business with them.
Pharmacists Fight Back: I introduced the bipartisan Pharmacists Fight Back Act to tackle the manipulative practices of Pharmacy Benefit Managers (PBMs) – the middlemen of drug pricing, which are owned by the Fortune 20 health insurance companies. PBMs are directly responsible for driving up drug costs through self-dealing, price-gouging community pharmacists, and limiting patient choice in federal healthcare plans. This bipartisan legislation is the most comprehensive PBM reform yet introduced at the federal level.
Recent analysis suggests the PBMs have captured about $300 billion of revenue from the US healthcare system, promising to ‘negotiate on behalf of patients and employers’, yet in return for all that money they engage in practices that raise out-of-pocket costs for the sickest patients and increase premiums for all of us. Away from public view in the middle of the supply chain, they have gotten greedy.
For federal plans, the Pharmacists Fight Back Act:
-> bans steering, spread pricing, clawbacks, and other PBM abuses in order to lower out-of-pocket costs & premiums and protect community pharmacists.
-> requires rebate pass-through in order to lower out-of-pocket costs.
–> mandates reporting of NADAC (the actual acquisition cost of generic drugs) and sets that cost as the baseline for mark-ups in order to prevent price-gouging on generic drugs.
Next up in my legislative work: de-linking PBM fees from the price & volume of drugs in order to fix incentives in the supply chain, and enacting policies to level the competitive field for transparent PBM start-ups.
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