Legislation is major advancement in employer-driven healthcare reform and hard-earned victory for the millions of Americans who rely on coverage
WASHINGTON – February 3, 2026 – The National Alliance of Healthcare Purchaser Coalitions (National Alliance) applauds passage of bipartisan healthcare reform, including long awaited pharmacy benefit manager (PBM) reforms, as part of the Consolidated Appropriations Act of 2026. The legislation represents a historic milestone for employers and other healthcare purchasers and working families seeking greater transparency and accountability for PBMs in the commercial healthcare marketplace.
“Today’s bipartisan passage is not only a policy win — it is a long overdue correction to a system that has lacked transparency for far too long,” said Shawn Gremminger, president and CEO of the National Alliance. “For years, employers have navigated a healthcare marketplace where critical information about pricing, rebates, and formulary decisions was kept out of view. These reforms finally level the playing field and put employers and working families first. We are deeply grateful to the coalition leaders, employer groups, and other partners who fought tirelessly to drive these reforms forward.”
Key reforms for employers and plan sponsors
The newly passed provisions advance long sought employer protections designed to ensure healthcare dollars are managed responsibly and savings flow directly to working families. Highlights include:
- Semi‑annual reporting by PBMs to employers on drug spending, rebates, spread pricing, formulary rationale, and benefit design
- Pass through of all rebates and discounts from PBMs to employers and plan sponsors
- Increased transparency into the generic drug and biosimilar marketplace
Outside of the landmark PBM policies, the legislation also requires off-campus hospital departments to have their own unique National Provider Identifier, a key mechanism in implementing site-neutral payments and a vital step toward hospital accountability for high prices.
Next steps
With congressional approval secured and the bipartisan package signed by President Trump, the focus shifts to federal implementation. Employers and plan sponsors can expect forthcoming regulations from the US Department of Health and Human Services to clarify reporting requirements, timelines, and compliance expectations.
About National Alliance of Healthcare Purchaser Coalitions
For more than 30 years, the National Alliance has brought together business coalitions and their employer and purchaser members to drive high-quality healthcare that enhances patient experience, promotes health equity, and improves outcomes while lowering costs. Its members represent public and private sectors, nonprofits, and labor unions that provide health benefits to over 90 million Americans—more than half of the employer-sponsored insurance market—spending over $850 billion annually. To learn more, visit nationalalliancehealth.org and connect on LinkedIn.
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